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etiology of headache not apparent on noncontrast CT
Etiology:
1) vascular
- saccular aneurysms
- subarachnoid hemorrhage *a,b*
- acute cerebral infarction
- arteriovenous malformations *b,d*
- dural arteriovenous fistula *b,d*
- carotid artery dissection, vertebral artery dissection *d*
- central nervous system vasculitis *a,b,d*
- reversible cerebral vasoconstriction *d*
- cerebral vein thrombosis, cortical vein thrombosis *e*
2) structural
- neoplasms, especially in the posterior fossa *c*
- cerebral metastases *c*
- meningeal carcinomatosis *a,c*
- pituitary tumor, pituitary hemorrhage
- foramen magnum lesions
- Arnold-Chiari malformations
3) infections
- paranasal sinusitis
- meningoencephalitis *a*
- meningitis *a,c*
4) disorders of intracranial pressure
- cerebrospinal fluid leak *a,c*
- idiopathic intracranial hypertension *a*
* see Special laboratory & Radiology below for meaning of *a* & *b* & *c*, *d* & *e*, respectively
Special laboratory:
- lumbar puncture may be required *a*
- conventional angiography may be required *b*
Radiology:
- gadolinium-enhanced magnetic resonance imaging may be indicated *c*
- magnetic resonance angiography or CT angiography may be indicated *d*
- magnetic resonance veinography or CT veinography may be indicated *e*
Related
headache
References
- Medical Knowledge Self Assessment Program (MKSAP) 15, 18.
American College of Physicians, Philadelphia 2009, 2018.