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Posted

If we get to order stuff lets do a Ct of head with out contrast and a LP if that is neg just to rule out a bleed or meningitis. I know in the er where I done my clinicals if there was a HA and CT was normal there might be a LP just to rule things out. What does that side of her head look like and feel like. I am still thinking this is going to be something way out there.

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Posted

OK, I think I have managed to make this one drag (Hello, becksdad!) on long enough. Your radiologist calls you and tells you that you need to have a heart to heart with the pt because she has a mass in her brain. I know this is not something you will be able to dx in the field, but she has the classic presentation so you may be able to make an educated guess should you come across it. Different headaches present differently. What is important in this story is the headache that is present when she wakes up and goes away after she has been upright for a while. The headache is caused by the pressure of the mass cutting off the outflow of CSF causing a temporary hydrocephalus. This is relieved when she is upright because the mass is no longer compressing the outflow tracts.

Hope everyone enjoyed this one.

Posted
she has a mass in her brain

headache is caused by the pressure of the mass

Do all lapsed Catholics get headaches?

goes away after she has been upright for a while

And are you saying there's no morality in the Church? I call bigotry on this one.

Posted

I'm new here so take it for what it's worth.

I love the scenarios, and was thinking that this 6 pager that everyone had a ton of questions about sounds like in real life would have been one of those pain in the A** calls that everyone complains about.

Could be a lesson to be learned from my perspective, every pt is a scenario that deserves this much thought and care.

Posted
Could be a lesson to be learned from my perspective, every pt is a scenario that deserves this much thought and care.

Good point!

Dwayne


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