Authors: Erik Rakhimov / Editor: Steve Corry-Bass / Reviewer: Raghaventhar Manikandan / Codes: GP9, NeuP2, SLO1, SuP7 / Published: 31/05/2022
A 27-year-old woman presents with a 3 month history of headache that is worse early in the morning and when straining. Coughing and blowing her nose makes her headache worse. Today she presented with three episodes of vomiting. She has had no visual symptoms and no trauma.
Past Medical History of obstructive sleep apnoea and acne vulgaris for which her GP prescribed doxycycline. She is also on the oral contraceptive pill. She smokes 1 pack of cigarettes over a week.
On examination her BMI is 30. Her systemic and neurological examination was normal apart from mild bilateral papilloedema on fundoscopy. She has normal visual fields.
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Question 1 of 3
1. Question
Which of the following is NOT a risk factor for Idiopathic Intracranial Hypertension in this presentation?
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Question 2 of 3
2. Question
After giving analgesia what is the first initial management step in the ED?
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Question 3 of 3
3. Question
Her CT Head is reported as normal. A Lumbar puncture is performed with an opening pressure of 40 mmHg (normal 10-20 mmHg) and normal constituents. She reported significant relief in her symptoms after lumbar puncture.
What would be the single most effective way of reducing morbidity and preventing recurrence of headaches?
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