RESUMO
Headaches are a common complaint for most women during their lifetime, including gestation and puerperium. Tension-type headaches and migraine flare-ups are the most common headache complications after delivery, but the differential diagnosis of postpartum headache is broad. The clinician must distinguish common headache syndromes from dangerous causes of postpartum headache. We will focus on early postpartum headaches in the form of case discussions that will include clinical presentation, diagnostic criteria, and treatment.
Assuntos
Cefaleia/diagnóstico , Cuidado Pós-Natal , Complicações na Gravidez/diagnóstico , Adulto , Feminino , Cefaleia/etiologia , Cefaleia/terapia , Humanos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/terapia , Cuidado Pós-Natal/métodos , Gravidez , Complicações na Gravidez/terapia , Fatores de Tempo , Adulto JovemRESUMO
Most patients presenting for evaluation of headache meet diagnostic criteria for a benign, primary headache disorder based on history and physical examination findings alone. No further testing is needed in such cases. Additional diagnostic evaluation is needed in cases that do not meet criteria for a primary headache disorder or which are associated with unusual or worrisome features. This article will review secondary causes of headache listed in the International Classification of Headache Disorders-II in which blood and urine testing might aid in diagnosis. We offer recommendations for diagnostic evaluation when these disorders are suspected causes of headache.
Assuntos
Cefaleia/etiologia , Testes Hematológicos , Urinálise , CADASIL/complicações , CADASIL/diagnóstico , CADASIL/metabolismo , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/metabolismo , Cefaleia/classificação , Cefaleia/diagnóstico , Humanos , Síndrome MELAS/complicações , Síndrome MELAS/diagnóstico , Síndrome MELAS/metabolismo , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico , Doenças Vasculares/metabolismoRESUMO
BACKGROUND: Tularemia is a zoonotic disease caused by Francisella tularensis. Tularemia presents with various clinical illnesses, but meningitis is rare. OBJECTIVES: To describe a patient who developed typhoidal tularemia with atypical acute meningitis and to review the pathogenesis, clinical and laboratory features, and antibiotic drug treatment of reported cases of tularemic meningitis. DESIGN: Case study and literature review. SETTING: University hospital, tertiary care center. PATIENT: A 21-year-old healthy man who had recently worked as a professional landscaper in the Albuquerque, New Mexico, metropolitan area developed fever, malaise, headache, and a stiff neck. MAIN OUTCOME MEASURES: Francisella tularensis cerebrospinal fluid culture, antibiotic sensitivity, transmission source, and outcome. RESULTS: The cerebrospinal fluid contained a lymphocytic pleocytosis, negative Gram stain, and F tularensis isolation with chloramphenicol and streptomycin antibiotic sensitivities. CONCLUSIONS: Although tularemia is uncommon and tularemic meningitis is rare in the United States, attention is drawn to the increasing number of cases in professional landscapers, the atypical cerebrospinal fluid picture, and unusual antibiotic sensitivities.
