• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • 1
    CommentGo Back
Download
 
 Red Flags for Potential Serious Conditions in Patients with Head and Neck Problems
Red Flags for the Head and Neck Region
ConditionRed FlagData obtained duringInterview/HistoryRed FlagData obtained duringPhysical Exam
SubarachnoidHemorrhage –Ischemic Stroke
1,2
Sudden onset of a severe headacheHistory of hypertensionConcurrent elevated blood pressureTrunk and extremity weakness, AphasiaAltered mental statusVertigo, VomitingVertebrobasilarInsufficiency
3-5
DizzinessHeadachesNauseaLoss of consciousnessVertigo that lasts for minutes (not seconds)Visual disturbancesApprehension with end range neck movementsUnilateral hearing lossVestibular function abnormalitiesMeningitis
6,7
HeadacheFeverGastrointestinal signs of vomiting andsymptoms of nauseaPositive slump signPhotophobiaConfusionSeizuresSleepinessPrimary BrainTumor
8-11
HeadacheGastrointestinal signs of vomiting andsymptoms of nauseaAtaxiaSpeech deficitsSensory abnormalitiesVisual changesAltered mental statusSeizuresMild TraumaticBrain Injury –Post ConcussionSyndrome –SubduralHematoma
12,13
Dangerous injury mechanismHeadacheNausea/vomitingSensitivity to light and soundsLoss of consciousness/dazed – an initial GlaslowComa Scale of 13 to 15Deficits in short term memoryPhysical evidence of trauma above the claviclesDrug or alcohol intoxicationSeizures
References:1. Hiroki O, Hidefumi T, Suzuki S, Islam S. Risk factors for aneurysmal subarachnoid hemorrhage in Aomori, Japan.
Stroke
.2003;34:34-100.2. Hong YH, Lee YS, Park S. Headache as a predictive factor of severe systolic hypertension in acute ischemic stroke.
Can J  Neurol Sci
. 2003;30:210-214.3. Grad A, Baloh RW. Vertigo of vascular origin. clinical and electronystagmographic features in 84 cases.
 Arch Neurology
.46:281-4, 1989.4. Szirmai A. Evidences of vascular origin of cochleovestibular dysfunction.
 Acta Neurol Scand.
2001;104:68-71.5. Silbert PT, Bahram M, Schievink WI. Headache and neck pain in spontaneous internal carotid and vertebral arterydissections.
 Neurology
. 1995;45:1517-1522.6. Hurwitz EL, Aker PD, Adams AH, et al. Manipulation and mobilization of the cervical spine: a systematic review of theliterature.
Spine
. 1996;21:1746-1760.7. Bruce, M, Rosenstein N, Capparella J, et al. Risk factors for meningococcal disease in college students.
 JAMA
. 2001;286:688-693.8. Berger JP. Buclin T. Haller E, et al. Does this adult patient have acute meningitis?
 JAMA
. 1999;282:175-181.9. Snyder H, Robinson K Shah D, et al. Signs and symptoms of patients with brain tumors presenting in the emergencydepartment.
 J Emerg Med 
. 1993;11:253-258.10. Zaki A. Patterns of presentation in brain tumors in the United States.
 J Surg Oncology
1993; 53:110-112.11. Forsyth PA, Posner JB. Headaches in patients with brain tumors: A study of 111 patients.
 Neurology
. 1993; 43:1678-1683.12. Sobri M, Lamont AC, Alias NA, Win MN. Red flags in patients presenting with headache: clinical indication forneuroimaging.
 Brit J Radiology
2003; 76:532-535.13. Borg J, Holm L, Cassidy JD, et al. Diagnostic procedures in mild traumatic brain injury: results of the WHO CollaboratingCentre Task Force on Mild Traumatic Brain Injury.
 J Rehabil Med.
2004; Suppl. 43: 61-75.
Joe Godges DPT, MA, OCS KP So Cal Ortho PT Residency
 
 
 
HEAD AND NECK SCREENING QUESTIONNAIRE
 NAME: __________________________________________ DATE: _____________Medical Record #: _________________________Yes No
1. Are you currently being treated for high blood pressure?2. Have you recently had difficulty with speaking?3. Have you noticed an increased clumsiness or weakness in your arms orlegs?4. Do you frequently have headaches?5. Have you noticed a recent decreased ability of concentrate?6. Do you experience dizziness?7. Have you noticed a recent change in your vision or ability to see?8. Have you recently experienced a blow to the head or a whiplash injury?9. Have you been experiencing nausea and/or vomiting?10. Do you currently have a fever, or have you had a fever recently?11. Have you recently been living in close quarters, such as in a dormitory?12. Do you have a depressed immune system?13. Are your eyes sensitivity to light?14. Have you recently had a seizure?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Joe Godges DPT, MA, OCS KP So Cal Ortho PT Residency
 
 
Cervical Spine Mobility Deficits 
 ICD-9-CM code:
723.1 Cervicalgia
 ICF codes
: Activities and Participation Domain code:
d4108
Changing a basicbody position, other specified - specified as: rotating thehead and neck, such as in looking to the left or to the rightBody Structure code:
s76000
Cervical vertebral columnBody Functions code:
b7101
Mobility of several joints
Common Historical Findings
:Neck pain, usually unilateral, pain referral from base of occiput to scapular region (locationof pain referral is dependent upon which segment or segments are involved)Strain; awkward, unguarded movement; or prolonged period of time in strained position("Woke up with pain")
Common Impairment Findings
-
Related to the Reported Activity Limitation or Participation Restrictions:
 Increase in pain at end range of rotation left or rotation rightSymptoms reproduced with palpation of the involved facetMotion limitation and pain at end range of either anterior/superior glide orposterior/inferior glide of the involved spinal segment
 
Physical Examination Procedures
:Cervical Accessory Movement TestAnterior/Superior Glide
Joe Godges DPT, MA, OCS KP So Cal Ortho PT Residency
 1
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
deshpandemathew

is there ay method of downloading this text it s so good

reply10 / 26 / 2009
You must be to leave a comment.
Submit
Characters: ...