GP Vivas · neurological-presentations
Headache red flags and secondary headache — structured viva
Structured oral on headache red flags: defending the SNOOP framework with evidence, thunderclap headache SAH workup (Ottawa rule, CT timing, LP xanthochromia), GCA emergency steroids, IIH revised criteria, CVST, and medication-overuse headache management.
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Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Headaches are all just migraines — why do you waste time screening for red flags?' The viva branches through the SNOOP framework, SAH workup, GCA emergency management, IIH diagnosis, CVST, and medication overuse.
Stem
A colleague says headache red-flag screening is unnecessary because 'you can always tell a migraine'. The examiner asks you to present the counter-argument. [1]
References5ShowHide
- [1]Masuhr F, Mehraein S, Einhäupl K Cerebral venous and sinus thrombosis. J Neurol, 2004.PMID 14999484
- [2]Perry JJ, Stiell IG, Sivilotti ML, Bullard MJ, Lee JS, et al. High risk clinical characteristics for subarachnoid haemorrhage in patients with acute headache: prospective cohort study. BMJ, 2010.PMID 21030443
- [3]Friedman DI, Liu GT, Digre KB Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology, 2013.PMID 23966248
- [4]Waller A, Jawad AM CRP and ESR in giant cell arteritis. J R Coll Physicians Edinb, 2017.PMID 29465111
- [5]Vincent A, Pearson S, Pickering JW, Weaver J, Toney L, et al. Sensitivity of modern multislice CT for subarachnoid haemorrhage at incremental timepoints after headache onset: a 10-year analysis. Emerg Med J, 2022.PMID 34819306