Dizzy 2

A 16 year old boy presents with a severe, throbbing headache which started suddenly and has lasted for around an hour.

The headache started at the back of his head and then extended frontally. He also experienced nausea, dizziness and blurring of vision.

He had experienced a similar headache twice in the past 2 months.

His medical history is unremarkable and he has no allergies. His father has had episodic headaches in the past.

Select Relevant Investigations
MRI + MRA Brain

Performed

The MRI + MRA is normal, with no evidence of space occupying lesions, hemorrhages or aneurysms.
Lumbar puncture

Performed

Xanthochromia: absent
WBC: 3/mm3 (0 - 5)
Protein: 47 mg/dL (15 - 60)
Glucose: 73 mg/dL (50 - 80)
EEG

Performed

No epileptiform activity is noted.
Toxicology Screen

Performed

The toxicology screen is completely unremarkable.

Select Relevant Management
Sumatriptan
Indomethacin
Antiemetics
Verapamil