Headache in the Emergency Centre, intra-cranial haemorrhage from arteriovenous malformation

Abstract

Headaches are a common cause for presentation to Emergency Centres (ECs). Emergency physicians need to be aware of the red flags on history and examination that point towards serious underlying causes. Case report: We present the case of a young woman who presented to the EC with a severe headache. The diagnosis of subarachnoid haemorrhage was suspected on history and strengthened on the lumbar puncture results. A high-grade arteriovenous malformation was subsequently diagnosed on computed tomography (CT). Conclusion: In emergency medicine, all new onset of severe headaches should be evaluated with potential disabling or life threatening diagnoses in mind, even if symptoms should resolve with time and analgesia. CT imaging and LP as investigations in the workup of headache in Africa should be utilised appropriately as access to CT may be limited.