Thursday, June 14, 2018

Acute headache

Q: Which of the following is of the highest priority in an approach to the urgent evaluation of an acute headache?

A) Carbon Monooxide (CO) poisoning
B) Subarachnoid hemorrhage
C) Meningitis
D) Giant cell (temporal) arteritis
E) Optic neuritis

Answer: A

Indeed all of the above conditions require immediate attention but carbon mono-oxide exposure is top on the list due to the fact that if not treated promptly or misdiagnosed, may result in a very rapid death of the patient. And, it is easy to treat with 100% oxygen therapy. CO diffuses rapidly across the pulmonary capillary membrane and binds to the iron moiety of heme with 240 times the affinity of oxygen. 



1. Hampson NB. U.S. Mortality Due to Carbon Monoxide Poisoning, 1999-2014. Accidental and Intentional Deaths. Ann Am Thorac Soc 2016; 13:1768.

2. Approach to the urgent evaluation of headache in an adult - © 2018 UpToDate, Inc. link here

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