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Headache - low risk

This patient presents with a headache most consistent with  . Differential diagnosis includes migraine versus tension type headache. No headache red flags. Neurologic exam without evidence of meningismus, focal neurologic findings. Presentation not consistent with acute intracranial bleed to include SAH (lack of risk factors, headache history). Presentation not consistent with acute CNS infection to include meningitis or brain abscess, Temporal arteritis unlikely, as is acute angle closure glaucoma given history and physical findings. Presentation not consistent with other acute, emergent causes of headache at this time. Plan to treat symptomatically with pain medication. No indication for imaging/LP at this time.

Plan: pain medication, CT brain , serial reassessment


This pregnant patient presents with headache of rapid onset. Etiology is unclear but includes possible preeclampsia, HELLP, SAH or other ICH. Considered, but think unlikely, CVT, Waterman’s syndrome, carotid dissection. Plan to work up with basic labs, UA to screen for proteinuria, consider head CT, pain control, reassess.

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