Headache and Inability to Headache and Inability to Solve Quadratic Equations Solve Quadratic Equations Jonathan A. Edlow, MD, FACEP Associate Chief, Department of Emergency Medicine Beth Israel Deaconess Medical Center Assistant Professor of Medicine Harvard Medical School Boston, MA
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Headache and Inability to Solve Quadratic Equations Jonathan A. Edlow, MD, FACEP Associate Chief, Department of Emergency Medicine Beth Israel Deaconess.
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Headache and Inability to Solve Headache and Inability to Solve Quadratic EquationsQuadratic Equations
Jonathan A. Edlow, MD, FACEPAssociate Chief, Department of Emergency Medicine
Beth Israel Deaconess Medical Center
Assistant Professor of Medicine
Harvard Medical School
Boston, MA
Jonathan A. Edlow, MD
HistoryHistory
• 32 yo male with headache for 3 weeks.• A mathematics grad student at MIT, he has
noticed increasing problems at work, such as his ability to solve complex differential calculus problems and quadratic equations
• Both the HA and the math difficulty have increased gradually over the 3 weeks
Jonathan A. Edlow, MD
History of Present IllnessHistory of Present Illness
• Look for signs and symptoms of• Chronic ear infection• Sinusitis• Odontogenic infection• Endocarditis (or bacteremia of any cause)• Lung abscess• Recent body piercing
Jonathan A. Edlow, MD
More CluesMore Clues
• HIV infection• Other immune
defects• History of cancer
(especially lung, breast, melanoma)
Jonathan A. Edlow, MD
Brain Abscess: ImagingBrain Abscess: Imaging
• CT (with and without contrast)
• MR (superior when available)
Jonathan A. Edlow, MD
Brain Abscess – LP?Brain Abscess – LP?
• While the risk is quite low, transtentorial herniation may occur
• More importantly, an LP in brain abscess rarely is diagnostically useful
• Cultures are almost always negative• The CSF formula is non-specific• Pressure is usually elevated