Understanding Neurology

Disorders of sensation203REVISION QUESTIONS1 In the assessment and investigation ofsubarachnoid haemorrhage, which of thesestatements is true?a The headache reaches its maximum intensityinstantaneously or at most over a couple ofminutes.b Meningism is an important sign.c A normal CT scan done within the first12 hours of ictus excludes the diagnosis.d A normal lumbar puncture done within thefirst 12 hours of ictus excludes the diagnosis.e A normal lumbar puncture done a week afterthe ictus excludes the diagnosis.f A patient who presents with coital headachefor the first time can be reassured.3 Which of these statements is true?a Subarachnoid haemorrhage may present withnew-onset, chronic, daily headache.b Sudden-onset, unilateral headache associatedwith ipsilateral Horner’s syndrome andcontralateral hemiparesis suggests carotiddissection ipsilateral to the headache.c A normal temporal artery biopsy excludes thediagnosis of temporal arteritis.d Patients with cluster headache prefer to liestill.e Alcohol may precipitate a cluster headacheduring periods of remission.f Chronic arterial hypertension of moderatedegree does not cause headache.2 In patients with chronic daily headache, whichof these statements is true?a Patients presenting to Casualty with chronicdaily headache are unlikely to have migraine.b Patients over the age of 50 years who presentwith a new-onset, focal, daily headacheshould be considered to have temporalarteritis until proven otherwise.c Migraine prophylactic medication is effectivein patients with migraine and analgesiainducedheadache.d Analgesia-induced headache may take up to 6months to settle down after stopping theoffending agent.e All analgesic and triptan medications can beassociated with analgesia-induced headache.f Migraine may present with chronic dailyheadache.Answers1 a, e2 b, d, e, f3 a, b, f