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Magnetic resonance imaging brain scan with contrast. (A) Axial view showing (arrow) transverse and sigmoid sinus venous thrombosis. (B) Axial view showing (arrow) left ophthalmic vein thrombosis. (C) Sagittal view showing (arrow) left ophthalmic vein thrombosis. (D) Axial view showing (arrow) focal perichiasmatic enhancement of the left optic nerve.

Lesson Learned Through a Case of Pneumococcal Meningitis: Sometimes Doing Less Is More Harmful

Pneumococcal meningitis is commonly associated with intracranial complications. We present a case of pneumococcal meningitis leading to partial loss of vision in the left eye secondary to vascular complications. A 62-year-old African American female with a past medical history of breast cancer and hypothyroidism presented with complaints of altered mental status, neck pain, headache, and […]

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Headache, an almost universal human experience, is one of the most common complaints encountered in medicine and neurology. Described and categorized since antiquity, with the first classification by Aretaeus of Cappadocia, other classifications followed. The evaluation of this condition may be straightforward or challenging, and, though often benign, headache may prove to be an ominous […]

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The Green Cerebrospinal Fluid

A sample of cerebrospinal fluid from a 52-year-old-woman told an interesting tale. The patient reported a 1-week history of worsening headache, shortness of breath, and fatigue but denied any fever, chest pain, orthopnea, paroxysmal nocturnal dyspnea, nausea, vomiting, abdominal pain, or diarrhea. She had experienced a subarachnoid hemorrhage 7 months earlier, and at that time, […]

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Patterns of Care and Outcomes After Computed Tomography Scans for Headache

Due to the potential risk of cancer from exposure to ionizing radiation, efforts should be made to avoid CT scanning for headache when the likelihood of serious illness is low. Evidence-based decision rules that identify which patients with headache do not require neuroimaging may decrease the use of CT scans in situations of little benefit. […]

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Migraine Headache and Ischemic Stroke Risk: An Updated Meta-analysis

A history of migraine headache is associated with a 2-fold increased risk of ischemic stroke. Ischemic stroke risk may be further increased in patients with aura and in women. Risk factor reduction should be considered in high-risk patients who have other modifiable stroke risk factors. Abstract Background Observational studies, including recent large cohort studies that […]

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