Trong nghiên cứu Tây Ban Nha gọi (Sempere et al, 2005), một nhóm lớn gần 1900 bệnh nhân đã được nghiên cứu, hơn 99% người trong số này được khám thần kinh bình thường. Nghiên cứu hình ảnh (chủ yếu là CT, mặc dù khoảng 1 / 3 bệnh nhân có MRI) phát hiện tổn thương đáng kể | 112 E. 15 Correct Answer The correct answer is B. In the Spanish study referred to Sempere et al 2005 a large group of almost 1900 patients was studied over 99 of whom had normal neurological examinations. Imaging studies primarily CT although about one third of patients had MRI detected significant lesions in of patients however of the patients who had normal neurological examinations the rate of significant intracranial abnormalities was . Correct Answer Sempere AP Porta-Etessam J Medrano V et al. Neuroimaging in the evaluation of patients with non-acute headache. Cephalalgia 2005 25 30-35. 29. The risk of stroke in patients with a history of migraine although debated in several large epidemiological studies is felt to be higher than that of nonmigraineurs. Among women with migraine with aura who are under age 45 and smoke use of which of the following substances is felt to further increase the risk of stroke A. Beta-blockers B. Ergotamine C. Opioids D. Oral contraceptives E. Triptans Correct Answer The correct answer is D. Several large epidemiological studies regarding the relative risk of stroke in patients with a history of migraine have been undertaken not all of which have shown consistent results. However the data overall suggest that women under age 45 who smoke use oral contraceptives and have a history of migraine with aura have the highest relative risk of stroke among migraine patients and a significantly higher risk than those without migraine. Ergotamine has no known association to migraine-related stroke and there is no reason to expect this with opioids. Beta-blockers are used for migraine prevention. 30. A 45-year-old male engineer is seen in an urgent care clinic because of a severe headache that began when he awakened that day. He reports that 2 to 3 times a year he experiences a throbbing headache typically on the right side. Those headaches are associated with nausea vomiting and prostration he feels that they may be caused by stress.
