The Clinical Problem Solvers Episode 179: Neurology VMR – Headache and blurry vision
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May 31, 2021 In this insightful discussion, Doug Pet, a neurology resident at UCSF, presents a complex case of headache and blurry vision to his fellow contributors, Dhruv Srinivasachar and Hannah Roberts. Doug emphasizes the importance of thorough patient history and neurological assessments in diagnosing serious conditions. The trio explores the distinctions between primary and secondary headaches, and how social history can influence diagnosis. They also discuss anatomical challenges, like the cavernous sinus's role in cranial nerve function, while highlighting critical teaching points for medical students.
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Headache and Blurry Vision Insight
- Headache with blurry vision can suggest a global brain problem or a primary eye issue causing secondary headache.
- Red flags like worsening headache, positional changes, and new blurry vision hint at elevated intracranial pressure.
Primary vs Secondary Headaches
- Primary headaches are benign but disabling, like migraine and tension headaches.
- Secondary headaches arise from intracranial, skull components, neck, or systemic diseases and often accompany red flags.
Blurry Vision Differential
- Blurry vision requires careful history to distinguish acuity loss, diplopia, or visual field defects.
- Different types of blurred vision localize to optic nerve, eye, or extraocular muscle/nerve problems.
