Tag Archives: meningitis

Straight, No Chaser: When Your Headache is Life-Threatening

Brain-Aneurysm-Prognosis-Factors

All headaches are not created equal. Earlier we discussed migraines, but there’s a lot more to headaches than those. In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we aren’t thinking about migraines first. The ER is all about the life-threats.

The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms. In other words, alcohol, cocaine and cigarettes increase  your risk for life-threatening causes of headaches.

Secondary headaches are those related to some other illness or condition that produces headaches as a symptom. These are much more common causes of headaches than migraines. They’re even more important because they could represent life-threatening conditions. So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and “brain-freeze.” (Yes, “ice-cream headaches” are a real thing!) Today we’ll point you to some conditions about which you should be concerned. (I’m intentionally leaving out especially uncommon ones and otherwise esoteric conditions. I wouldn’t want to encourage any hypochondriacs out there.)

  • AVM (arteriovenous malformation): an abnormal formation of blood vessels inside your brain
  • Concussions and post-concussive syndrome
  • Brain aneurysm: a ballooning of one of your brain’s arteries that can steal blood away from needed areas

unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning: from breathing exhaust fumes
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid and other intracranial hemorrhage: bleeding inside various parts of the brain

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms that may suggest your headache is different enough to get evaluated for a possible life-threat.
Consider this a “headache plus this symptom = go to the emergency room” list.

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)
  • Worse headache of your life

Unfortunately, defenses go down in (and when evaluating) those with a history of headaches. This places you at additional risk. Even if you have had headaches before, if you have new symptoms or something seems different about a new episode, the decision to get evaluated could save your life.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Questions and Answers about Meningitis

meningitis

When you hear or make references to a “pain in the neck,” you likely aren’t very aware of the one disease that makes the reference no joking matter at all. For many, all they know about meningitis is it causes neck pain, it may involve a spinal tap and kids can die. The easy way to appreciate the danger of meningitis is to understand that it involves the brain. As such, depending on the severity of the disease, meningitis places everything that the brain does at risk,. Let’s approach this Straight, No Chaser with some basic questions and answers about meningitis.
What exactly is meningitis?
Specifically, meningitis is a disease caused by inflammation of the protective membranes (the meninges) that cover the brain and spinal cord. This inflammation is usually caused by an infection of the fluid surrounding these areas.
How does someone get meningitis?
Meningitis is usually caused by bacteria or viruses, but it can also be caused by other infections (e.g. fungal, parasites, tuberculosis, Lyme’s disease) or anything else able to inflame the meninges (e.g. injury, cancer or certain drugs). For practical purposes, your concern should be with avoiding infections that can cause it.
meningitissymWhat are the typical symptoms?
If you can remember the classic triad of fever, headache and neck stiffness, that’s an excellent prompt to visit your local emergency room. There’s also often a pretty suggestive rash. There are many other symptoms that may or may not be present (e.g. nausea, vomiting, excessive sleepiness/fatigue, irritability, delirium, coma), but this speaks more to the difficulty in diagnosing meningitis and is not a list that should scare you into thinking every illness is meningitis. There are many other conditions and disease with some combinations of the above symptoms. Your task is to learn to engage the healthcare symptoms promptly instead of “waiting to see” if things get better. If and when meningitis is the disease, that strategy can have the worst of long-term consequences.
Who is most likely to get meningitis?
Anyone can get meningitis, but there are groups at higher risk, including the following:

  • Children under age five are the most at risk group, especially those that haven’t received the vaccine for meningitis.
  • Teenagers, young adults and others congregating in especially large groups (high schools, colleges) are also at higher risk.
  • Adults over age 55 are also at higher risk.

Meningitis is most commonly spread by prolonged close contact and exposure to coughing, sneezing and intimate kissing in an infected individual.

spinaltap

What’s with the spinal tap?
Giving the consequences of undiagnosed meningitis, it is imperative to not only make a clinical diagnosis but a laboratory diagnosis as well. Important differences exist in the treatment of different causes of meningitis. A lumbar puncture (aka spinal tap) is a procedure in which a needle is placed between lumbar vertebrae (back bones) and inserted into the column that holds spinal fluid, which circulates between the brain, meninges and spinal cord). Some of the fluid is extracted, and based on chemical composition, organisms can be identified and other measures, a definite diagnosis can often be made. In experienced hands, it is a very safe procedure, although risks do exist. It’s certainly a more dramatic procedure that a traumatic one.
How is meningitis treated?
Depending on the cause, treatment measures include intravenous (IV) fluid support, steroids, antibiotics, oxygen, other supportive measures and treatment of complications. Successful treatment is enhanced with early diagnosis.

meningitiscord

What’s the prognosis of meningitis?
Most cases of viral meningitis are benign and self-limited. Some patients will only need a few days of hospitalization, and others may need a prolonged stay in an intensive care unit (ICU). The majority of those infected with make a full recovery, although some may suffer from brain damage. This can include difficulties in learning, hearing, sight, concentration, memory, behavior and other symptoms. The keys for success include seeking care early and making sure your children have received the vaccine for meningitis.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When Your Headache is Life-Threatening

Brain-Aneurysm-Prognosis-Factors

All headaches are not created equal. Earlier we discussed migraines, but there’s a lot more to headaches than those. In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we aren’t thinking about migraines first. The ER is all about the life-threats.

The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms. In other words, alcohol, cocaine and cigarettes increase  your risk for life-threatening causes of headaches.

Secondary headaches are those related to some other illness or condition that produces headaches as a symptom. These are much more common causes of headaches than migraines. They’re even more important because they could represent life-threatening conditions. So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and “brain-freeze.” (Yes, “ice-cream headaches” are a real thing!) Today we’ll point you to some conditions about which you should be concerned. (I’m intentionally leaving out especially uncommon ones and otherwise esoteric conditions. I wouldn’t want to encourage any hypochondriacs out there.)

  • AVM (arteriovenous malformation): an abnormal formation of blood vessels inside your brain
  • Concussions and post-concussive syndrome
  • Brain aneurysm: a ballooning of one of your brain’s arteries that can steal blood away from needed areas

unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning: from breathing exhaust fumes
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid and other intracranial hemorrhage: bleeding inside various parts of the brain

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms that may suggest your headache is different enough to get evaluated for a possible life-threat.
Consider this a “headache plus this symptom = go to the emergency room” list.

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)
  • Worse headache of your life

Unfortunately, defenses go down in (and when evaluating) those with a history of headaches. This places you at additional risk. Even if you have had headaches before, if you have new symptoms or something seems different about a new episode, the decision to get evaluated could save your life.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress