Called yesterday to a male age 48 who had a "severe migraine". Vomiting and
complained of severe pain at the back of his head that he had not experienced
before. ABC's & LOC o.k but pulse @100 and BP 139/112 Very distressed state.
Given O2 etc
Some heated discussion took place with another provider who insisted that it
was only a "migraine", while I thought it was possibly more serious. Changes
in elevation on helo transfer exacerbated pain. Refered from DGH to neuro
unit for scan.
My question to the list: I have seen intracranial bleeds before but they have
all involved changes in pupils and LOC as well as peripheral weakness. How
common is it to have only a severe headache, especially at the back of the
head, with little or no other symptoms (if it is an itracranial bleed). One
view is S/S based on teextbook signs of which he had none, while my intuition
is that it could be more serious. Any opinions?
Davy Gunn
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