EMC - November 2021 - By Helman, A. Shah, A. Baskind. R.
In this Part 1 or our two part podcast series on Red Flag Headaches we discuss a general approach, tips and tricks to assessing patients who present with headache followed by a deep dive into cervical artery dissections. With the help of Dr. Roy Baskindand Dr. Amit Shah we answers questions such as: what are the big 4 headache diagnoses that are not routinely picked up on plain CT or LP? Why are the symptoms of cervical artery dissection often fluctuating? Why do the symptoms of cervical artery dissection sometimes seem to not fit an anatomical distribution? What are the key clinical features that would trigger you to suspect cervical artery dissection? How do you decide which patients require a CT angiogram? What is the evidence for a causal relationship between chiropractic manipulation and cervical artery dissections? What is evidence for antiplatelet agents, anticoagulants and thrombolysis in the management of cervical artery dissection? Which patients with cervical artery dissection can be safely discharged from the ED and many more…
EMC - April 2023 - By Helman, A. Shah, A. Baskind. R.
This is part 2 of our 2-part podcast on red flag headaches that do not readily appear on plain CT head. In Part 1 we covered cervical artery dissections. In this episode, Dr. Roy Baskind and Dr. Ahmit Shah answer such questions as: when is an LP opening pressure required? When should we pull the trigger on ordering a CT venogram in the patient with unexplained headache? What is the value of D-dimer to screen for Cerebral Venous Thrombosis (CVT)? Which older patients who present with headache require an ESR/CRP to screen for Giant Cell Arteritis (GCA)? How do the presentations of CVT and idiopathic intracranial hypertension (IIH) compare and contrast? When is it safe to start steroids in the ED for patients suspected of GCA; will starting steroids in the ED 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…