Headache Case Studies One & Two

Case Study One

A 35 yr old woman presents at the front desk of your surgery, brought in by her partner with a story of a sudden onset of a very severe headache during intercourse. She felt like she was punched in the head suddenly and the intensity of pain was as bad as she could imagine right at the start. The pain was centred at the back of her head and she felt faint , collapsing for a few seconds. She vomited a few times.

 

The pain is a little better now but she still feels very unwell.. ​ On examination she looks unwell with some pallor. Her blood pressure is 175/95 and her pulse is 110 and regular. There are no focal neurological signs.

Case Study Two

A 24 yr old presents with a severe headache that developed over the past 4 hours.
He woke from sleep feeling very unwell this morning, and has developed a fever.
He has been very drowsy and went back to bed to sleep again but has been woken by the headache.

 

Over the previous days he has been brewing what he felt was the flu. He feels aches and pains all over and has a sore throat.

 

On examination his temperature is 39.5, BP 120/75 with a pulse of 110. He has no evidence of a rash, but finds the light irritates his eyes with retinoscopy, and has some neck stiffness.

 

He feels that his left arm is not a powerful as before, but is right handed and not sure of this.