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Headache in an HIV positive patient: diagnostic challenges and approach to treatment

Creamer, A; Ioannidis, S; Wilhelm, T; Mahangu, T; Lipman, M; (2016) Headache in an HIV positive patient: diagnostic challenges and approach to treatment. Clinical Medicine , 16 (6) pp. 548-550. 10.7861/clinmedicine.16-6-548. Green open access

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Abstract

Headaches are a common complaint in HIV positive patients attending emergency services. A thorough understanding of the differential diagnoses, initial investigations and empirical management of this presentation is essential for the assessing physician. We discuss a case of a patient with known advanced HIV infection presenting with headache to the emergency department. Given the range of possible diagnoses, broad-spectrum antimicrobial therapy was initially commenced. This was stopped when magnetic resonance imaging confirmed a diagnosis of venous sinus thrombosis. Anticoagulation therapy was started in accordance with current clinical guidelines after discussing the rationale and options for treatment with the patient. Here, we review the guidelines and supporting evidence for management of venous sinus thrombosis, and consider the challenges and strategies for engaging a patient with previous poor attendance in their ongoing care.

Type: Article
Title: Headache in an HIV positive patient: diagnostic challenges and approach to treatment
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.7861/clinmedicine.16-6-548
Publisher version: http://doi.org/10.7861/clinmedicine.16-6-548
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Anticoagulation, HIV, headache, tumour, venous sinus thrombosis, Adult, Anticoagulants, Brain, Diagnosis, Differential, HIV Infections, Headache, Humans, Magnetic Resonance Angiography, Male, Sinus Thrombosis, Intracranial
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/1570414
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