11-01-2014, 04:37 PM
A 27 year old man presents to the ED with severe retrorbital pain of one days duration. He says the pain is really severe and came on somewhat suddenly. The pain is primarily concentrated behind his left eye. He also noted that his eyes, especially the left, is tearing and that his nose is also dripping. He says he has had these "attacks" before. In the ED, he denies a history of trauma, neck stiffness, recent illness or URI, or vision loss. Opthalmic exam is conducted and is found to be normal. A CT scan of the head and lumbar puncture are normal. He is afebrile. What is the most likely diagnosis?
a. cluster headache
b. glaucoma
c. migraine headache
d. meningitis
e. subarachnoid bleed
a. cluster headache
b. glaucoma
c. migraine headache
d. meningitis
e. subarachnoid bleed