| Disease
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Findings
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| Ischemic stroke
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- Occurs when a clot or a mass clogs a blood vessel and cutting off the blood flow to the brain
- Present as a
- Thrombotic stroke (thrombus develops at the clogged part of the vessel)
- Embolic strokes (blood clot that forms at another locations usually the heart and large arteries of the upper chest and neck, and travels to the brain)
- Urgent evaluation with brain / neurovascular imaging (such as MRI, CT, CTA, MRA), cardiac, and metabolic evaluation is often necessary
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| transient ischemic attack (TIA)
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- Caused by a temporary clot which often called a “mini stroke”
- Occurs rapidly and presents as a sudden onset of a focal neurologic symptom / sign lasting less than 24 hours
- Urgent evaluation with brain / neurovascular imaging (such as MRI, CT, CTA, MRA), cardiac, and metabolic evaluation is often necessary
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| Acute hypertensive crisis/Malignant hypertension
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- Presents as significantly elevated blood pressure (systolic pressure ≥180 and/or diastolic pressure ≥120 mmHg) with or wihout acute end-organ injury
- Urgent evaluation with MRI and CT of the brain, serum creatinine, urinalysis, cardiac (EKG, chest x ray, and cardiac enzymes) and metabolic evaluation is often necessary
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| Sentinel headache
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- Caused by small aneurysmal leaks into the subarachnoid space
- Presents as a episode of headache similar to that accompanying subarachnoid hemorrhage (days to weeks prior to aneurysm rupture) and focal neurologic symptoms and signs are usually absent
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| Sinusitis
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- Presents with acute and subacute headaches and facial pain
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| Primary thunderclap headache
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| Pituitary apoplexy
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- Caused by pituitary gland infarct or hemorrhage secondary to pitutiery adenoma
- Presents with acute headache, change in mental status, ophthalmoplegia, and decreased visual acuity
- Brain CT and MRI are the preferred imaging techniques
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| Cerebral venous thrombosis
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- Presents with isolated gradual onset headache or in combination with papilledema, seizures, bilateral focal deficits, and change in mental status
- Brain MRI with venography should be considered
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| Colloid cyst of the third ventricle
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- Caused by an acute obstructive hydrocephalus secondary to sudden obstruction in cerebrospinal fluid flow by the cyst
- Presents with an acute onset fronto-parietal or fronto-occipital headache which relieved by taking the supine position and may be associated with nausea, vomiting, mental status changes, seizures, coma
- Head CT or MRI of the brain are usually diagnostic
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| Cervical artery dissection
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- It usulay occurs spontaneously or after head and neck injury
- Presents with gradual onset head and neck pain with a local manifestations (such as Horner syndrome, pulsatile tinnitus, bruit, or cranial neuropathies)
- Neuroimagings are usually preferred (brain MRI with MRA and cranial CT with CTA)
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| Spontaneous intracranial hypotension
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- Presents with orthostatic headaches, nausea, vomiting, dizziness, diplopia, interscapular pain
- Caused by cerebrospinal fluid (CSF) leakage from spinal meningeal defects or dural tears
- Brain MRI is the preferred imaging techniques
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