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Is there a history of drug, caffeine, or alcohol ingestion? The hangover headache is well known and should not present a problem in diagnosis. Caffeine withdrawal headaches are also common because of the large amount of ... DIAGNOSTIC WORKUP
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Is there a history of exposure to drugs or toxins? Quinine, cocaine, atropine, and ApresolineŽ are just a few of the drugs that may cause photophobia.
Are there abnormalities on the eye examination? Almost any condition of the eye may ... DIAGNOSTIC WORKUP
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Headache is one of the most common primary care complaints. It may be an isolated or recurrent event; it may be idiopathic or secondary to an underlying structural lesion; or it may simply require an analgesic for pain relief or a complete and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Photophobia is ocular pain or discomfort upon exposure to light. It may be a symptom of a primary ocular disorder or underlying central nervous system disorder and should always be evaluated, unless a known etiology (e.g., migraine headache) is present.
Differential Diagnosis ... Workup and Diagnosis ... Treatment
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By age 7, 40% of children will have experienced headaches. By age 15, this figure rises to 75%. Headache can be the presenting symptom of a neurologic emergency such as subarachnoid hemorrhage, or of a chronic and common disease such as migraine. The pattern of onset, duration, and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Nuchal rigidity is characterized by involuntary muscle spasms that limit passive neck flexion. Although it has myriad causes, meningeal irritation may occur secondary to infection, so patients must be evaluated emergently for meningitis/focal infection. Cervical muscle spasms and dystonia... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... This symptom is best analyzed by using anatomy, as seen in Tables 32 and 33 , but differentiation by pathophysiology is interesting, particularly in muscle traction headaches and migraines.
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... Finding nuchal rigidity on examination has almost invariably prompted the diagnosis of meningitis and lumbar puncture, but the astute clinician will want to consider other possibilities to avoid a potentially hazardous procedure. Anatomy is the key. Visualize the structures of the neck
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... Sensitivity to light may be due to local eye disease or systemic disease, but in both cases it is usually due to inflammation, with three exceptions: albinism because there is poor pigmentation of the iris and choroid, allowing more light to get in; migraine,
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... A positive Brudzinski's sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips.
... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain About 90% of all headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Clinical features of... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... A reliable early indicator and tool used to diagnose meningeal irritation, Kernig’s sign elicits resistance and hamstring muscle pain when the examiner attempts to extend the knee while the hip and knee are flexed 90 degrees. However, when... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Commonly an early sign of meningeal irritation, nuchal rigidity refers to neck stiffness that prevents flexion. To elicit this sign, attempt to passively flex the patient’s neck and touch his chin to his chest. If nuchal rigidity is present, this... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without underlying pathology. For example, it can stem from wearing contact lenses excessively or using... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Muscle contraction (tension)
Migraine
Cluster (histamine) headache
Nonmigrainous vascular causes
Effort (physical activity)
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... Signs and Symptoms Sudden onset of fever, headache, vomiting, meningeal irritation (stiff neck and back), drowsiness, coma, paralysis, seizures, ataxia, psychoses
Treatment (Tx) Anticonvulsants, acyclovir (if viral)... Pictures
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... The most common patient complaint, headache usually occurs as a symptom of an underlying disorder. Ninety percent of all headaches are vascular, muscle contraction, or a combination; 10% are due to underlying intracranial, systemic, or psychological disorders. Migraine... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Signs and Symptoms Nuchal rigidity, Brudzinski’s and Kernig’s signs, exaggerated deep tendon reflexes, opisthotonos, sinus arrhythmias, irritability, photophobia, deep stupor, coma
Treatment (Tx) ... Pictures
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... Two major meningococcal infections (meningitis and meningococcemia) are caused by the gram-negative bacteria Neisseria meningitidis, which also causes primary pneumonia, purulent conjunctivitis, endocarditis, sinusitis, and genital infection.... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... West Nile encephalitis is categorized as an infectious disease that primarily causes an inflammation or “encephalitis” of the brain. West Nile virus (WNV), a flavivirus commonly found in humans, birds, and other vertebrates in Africa, west Asia, and the Middle East, causes the... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... A positive Brudzinski’s sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips.
... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain. About 90% of all headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Comparing benign headaches,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Commonly an early sign of meningeal irritation, nuchal rigidity refers to stiffness of the neck that prevents flexion. To elicit this sign, attempt to passively flex the patient’s neck and touch his chin to his chest. If nuchal rigidity is... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without any underlying pathology. For example, it can stem from excessive wearing of contact lenses or use of... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Robert B. Taylor
Headache is one of the 20 most frequent reasons patients visit primary care providers in the United States. Migraine headache, one of the common causes of recurrent headache, occurred one or more times... Approach. ... History ... Physical examination ... Testing ... Pictures
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... Differential Overview
❑ Migraine
❑ Tension
❑ Acute sinusitis
❑ Acute glaucoma
❑ Postconcussive ... Diagnostic Approach ... Clinical Findings ... Pictures
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... A severe inflammation of the brain, encephalitis is usually caused by a mosquito-borne or, in some areas, a tick-borne virus. Viruses transmitted by arthropods are arboviruses (arthropod-borne). Transmission by means other than arthropod bites may occur through... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... The most common patient complaint, headache usually occurs as a symptom of an underlying disorder. Ninety percent of all headaches are vascular, muscle contraction, or a combination; 10% are due to underlying intracranial, systemic, or psychological disorders. ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... West Nile encephalitis, part of a family of vectorborne diseases that also includes malaria, yellow fever, and Lyme disease, is an infectious disease that primarily causes encephalitis (inflammation) of the brain. It’s caused by the West Nile virus (WNV), a flavivirus commonly... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... A reliable early indicator and tool used to diagnose meningeal irritation, Kernig’s sign elicits both resistance and hamstring muscle pain when the examiner attempts to extend the knee while the hip and knee are both flexed 90 degrees. However, when the patient’s... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... A positive Brudzinski’s sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips.
... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain. About 90% of all headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Comparing
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... A reliable early indicator and tool used to diagnose meningeal irritation, Kernig’s sign elicits resistance and hamstring muscle pain when the examiner attempts to extend the knee while the hip and knee are both flexed 90 degrees. However, when the patient&rsquo... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Commonly an early sign of meningeal irritation, nuchal rigidity refers to stiffness of the neck that prevents flexion. To elicit this sign, attempt to passively flex the patient’s neck and touch his chin to his chest. If nuchal rigidity is present, this maneuver triggers pain and... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without any underlying pathology. For example, it can stem from excessive wearing of contact lenses or use of poorly fitted... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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...In most children, headache is not due toa serious cause. Diagnostic dilemma is to determine which childrenhave serious underlying pathology. Principal Causes of Headache Tension-typeheadache Vascular headache Migraineheadache Migrainewith ... Clinical Features and Diagnosis ... Table 25.1. Anatomic Location of Common Intracranial Neoplasms ... Diagnostic Approach ... References
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... A positive Brudzinski's sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips.
... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain. About 90% of headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Clinical features of... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... A reliable early indicator and tool used to diagnose meningeal irritation, Kernig's sign is hamstring stiffness and muscle pain when the examiner attempts to extend the knee while the hip and knee are flexed 90 degrees. This pain causes resistance to... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Commonly an early sign of meningeal irritation, nuchal rigidity refers to neck stiffness that prevents flexion. To elicit this sign, attempt to passively flex the patient's neck and touch his chin to his chest. If nuchal rigidity is present, this... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without an underlying disorder. For example, it can stem from wearing contact lenses excessively or using poorly fitted lenses. However... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Finding nuchal rigidity on examination has almost invariably prompted
the diagnosis of meningitis and lumbar puncture, but the astute clinician
will want to consider other possibilities to avoid a potentially hazardous
procedure. Anatomy is the... Pictures
... READ EXCERPTS »
...
Sensitivity to light may be due to local eye disease or systemic
disease, but in both cases it is usually due to inflammation, with three
exceptions: albinism because there is poor pigmentation of the iris and
choroid, allowing
... READ EXCERPTS »
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