Ep181 Cerebral Venous Thrombosis, Idiopathic Intracranial Hypertension, Giant Cell Arteritis and Peripartum Headaches

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 11 April 2023

⏱️ 73 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, Dr. Roy Baskind and Dr. Ahmit Shah answer such questions as: when is an opening pressure on LP required? When should we pull the trigger on ordering a CT venogram in the patient with unexplained headache? Which older patients who present with headache require an ESR/CRP? How do the presentations of cerebral venous thrombosis (CVT) and idiopathic intracranial hypertension (IIH) compare and contrast? When is it safe to start steroids in the ED for patients suspected of giant cell arteritis (GCA); will starting steroids affect the accuracy of a temporal artery biopsy? How soon should patients suspected of GCA get a temporal artery biopsy? When should we consider posterior reversible encephalopathy syndrome (PRES) and pituitary apoplexy in the peripartum patient? How should we think about the differential diagnosis of vascular headaches? and many more...

Transcript

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0:00.0	This is part two of our two-part podcast on Red Flag Headaches with Dr. Amit Shaw and Dr. Roy Baskin.
0:07.3	Welcome back, gentlemen. It's time to talk about some more red flag headaches.
0:11.6	Great to be here, Anton. Thanks, guys.
0:15.5	Welcome to the Emergency Medicine Cases Podcast. I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in
0:21.6	emergency medicine from EMC Studios in Toronto.
0:26.3	EM cases is part of Shremi, the Schwartz-Riseman Emergency Medicine Institute. That's the nonprofit
0:31.5	organization dedicated to improving EM care through high-quality research and education.
0:36.2	The opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from a qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor Medicine Cases. Thanks to the more than 500 folks who came out to the virtual EM cases summit and to all the amazing speakers and
0:54.6	organizers.
0:55.4	I learned a ton and I hope you did too.
0:58.1	It was so inspiring and enlightening.
1:00.6	Now, if you missed it, no worries.
1:02.9	You can purchase streaming access to all the talks for the next three months at
1:06.9	EMCases Summit.com.
1:11.1	Let's just jump straight into a case.
1:13.0	A 25-year-old woman comes in three weeks postpartum with a gradual onset diffuse headache
1:19.0	over three to four days.
1:21.5	This is dissimilar to any headache she's had before.
1:24.7	She reports that when she was chatting with her husband earlier that day,
1:29.3	her husband's words became jumbled, and she had to ask him to repeat himself, which she never
1:36.1	really had to do before. She had no visual changes, no speech difficulty, no limb symptoms,
1:41.8	no numbness or weakness. On exam, she looked well, vitals were
	...

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