I'm amazed by the effort you put in on a daily basis to teach med students from around the world. I'm from Germany and your lectures are so motivating. Thank you so much man!
I have had extreme cluster headaches since I was 21, and I was a non-smoker and only a occasional drinker. For approximately 36 years they would come once maybe twice a year duration for a month several headaches a day. Occasionally I had to use too much sumatriptan (injections 6mg is and was the only medication that aborts the headache) and would have to visit the ER very from overuse. I found it extremely frustrating when doctors think I’m there for drugs (opiates) I would go because I would be almost at the point of suicide during these times. As far as a prophylactic; I’ve tried verapamil, oxygen, you name it and the only medication that helped was 4 mg of Decadron daily however the side effects are extremely dangerous and I developed medically induced Cushing’s from it. I found that many physicians have zero compassion or knowledge of this rare disorder and many people are misdiagnosed,that’s all I have to say about it…thank you
AKA: Alarm clock headaches. People afflicted with them are very restless, pace, scream, punch themselves in the head, bang their head into walls, etc!! They come on within minutes and usually peak within 15 minutes.
Cluster headache, but I'd be wary of mass effect, ICH since first time + extreme pain + acute onset. Definitely requires imaging, potentially CT + contrast? If primary headache IV fentanyl loading dose max 50mcg IV, may consider IN if nasal secretions not obtrusive. would consider NRB 10-15 min but would be cautious with his COPD, depending on severity.
He has COPD (do not stat what grade) but he have a RR of 18 og sats of 98% so probably not that severe… Q: hi-flow oxygen can cause hyper-kapnia? Due to hypoventilation.. Does that complicate the first line management of this patient? Any toughts?
I'd like to hear your thoughts about microdosing Psilocybin? As a chronic daily cluster headache victim, I know there isn't any effective pharmaceutical preventative, yet everyone I know with chronic clusters that microdoses with Psilocybin gets relief and it prevents attacks. I'd love to see more research into this, do you think it would get funding? What others areas can you see it expanding to?
I missed the livestream about 3/4 in so my question is , even though it presents as partial horners syndrome would ruling out a pancoast tumor be out of line? Due to the sympathetic activity that would not show in a ct scan? Especially being a smoker?
That’s an amazing thought!! Definitely a good test. Get a CXR and look for elevated hemidiaphragm and follow up CT it still suspicious. Awesome DDX!!!!
Could you start a CGRP receptor antagonist instead of Verapamil for long term preventative, assuming that the manufacturers will still provide it with a zero co-pay?
Hello… I watched some of your videos and like them very much..very informative. I have a question; I suffer from headaches since I was in my 20’s, now I’m 60 but been trying to get rid of them all this time. I’ve gone to see different doctors but they can seem to figure out why the headaches. They are sinus related because I feel a lot of sinus pressure. Advil will get rid of the headache in 20-30 minutes. Aleve prevents the headaches for long periods of time. I’ve seen an allergist and nothing there. They have seems MRIs and act scans of my head but nothing. As soon as I lay down I start feeling a side of my sinus block up. It feels like it swells up and block drainage which seems my sinus produce quite a bit of. Would you have any input as to where I can get a good evaluation or a type of doctor that can do a good evaluation and hopefully get rid of my headaches. Thank you again for yours videos. Looking forward to her your input.
Hes not going to give medical advice here sorry. There's usually, depending on your country, places that specialise in headaches, Google headache clinic. Do you use a nasal rinse for your sinuses? Not the spray, but the gentle cleanse wash. Good luck.
Also, let all the Drs. out there know that women and children DO get clusters!! I literally had an ER Dr. tell me that women don’t get clusters. My Dr. was the chief of neurology at the same hospital and had dx me several years prior, as did Mayo Clinic. That kind of thinking is completely ignorant.
I'm amazed by the effort you put in on a daily basis to teach med students from around the world. I'm from Germany and your lectures are so motivating.
Thank you so much man!
I am a resident physician and I must say that this series of case presentations are extremely helpful to me. Thank you so much.
Best lecturer ever!
Best wishes from Kabul - Afghanistan 🇦🇫
what's going on now in Kabul?
I missed the live session. But I can't fail to watch it when it's here.
Thank you.
You are amazing! As an NP student you are a HUGE help!
just awatched the headache videos so got this aced!! and ordered a t shirt!!
Talk about hooked up, amazing! 🙌
Best lecturere ever ❤
I have had extreme cluster headaches since I was 21, and I was a non-smoker and only a occasional drinker. For approximately 36 years they would come once maybe twice a year duration for a month several headaches a day. Occasionally I had to use too much sumatriptan (injections 6mg is and was the only medication that aborts the headache) and would have to visit the ER very from overuse. I found it extremely frustrating when doctors think I’m there for drugs (opiates) I would go because I would be almost at the point of suicide during these times. As far as a prophylactic; I’ve tried verapamil, oxygen, you name it and the only medication that helped was 4 mg of Decadron daily however the side effects are extremely dangerous and I developed medically induced Cushing’s from it. I found that many physicians have zero compassion or knowledge of this rare disorder and many people are misdiagnosed,that’s all I have to say about it…thank you
AKA: Alarm clock headaches. People afflicted with them are very restless, pace, scream, punch themselves in the head, bang their head into walls, etc!! They come on within minutes and usually peak within 15 minutes.
Watched the video thanks for all other videos which l have found useful as a third year student nurse
Great case as always 👌🏻
Amazing Amazing Amazing Amazing Amazing Amazing Amazing Amazing
Your so great Zach
Awesome!!!
I missed the live. Lecture of this Case ☹️☹️☹️……thanks for the upload!!
very inormative
Cluster headache, but I'd be wary of mass effect, ICH since first time + extreme pain + acute onset.
Definitely requires imaging, potentially CT + contrast?
If primary headache IV fentanyl loading dose max 50mcg IV, may consider IN if nasal secretions not obtrusive. would consider NRB 10-15 min but would be cautious with his COPD, depending on severity.
He has COPD (do not stat what grade) but he have a RR of 18 og sats of 98% so probably not that severe…
Q: hi-flow oxygen can cause hyper-kapnia? Due to hypoventilation.. Does that complicate the first line management of this patient? Any toughts?
I love these videos put please do a delta variant video soon 🙏🏼
Excellent lecture.. love from Pakistan
Prednisone can help alot
Thanks
Thanx a lot ninja you are the best🤙🏾
I'd like to hear your thoughts about microdosing Psilocybin?
As a chronic daily cluster headache victim, I know there isn't any effective pharmaceutical preventative, yet everyone I know with chronic clusters that microdoses with Psilocybin gets relief and it prevents attacks.
I'd love to see more research into this, do you think it would get funding? What others areas can you see it expanding to?
If you don’t have a podcast you need one asap. If he does lmk?!
How do we get notifications or turn on notifications for livestream sessions? Been missing livestream, please help
helpful!
You are the best
I missed the livestream about 3/4 in so my question is , even though it presents as partial horners syndrome would ruling out a pancoast tumor be out of line? Due to the sympathetic activity that would not show in a ct scan? Especially being a smoker?
That’s an amazing thought!! Definitely a good test. Get a CXR and look for elevated hemidiaphragm and follow up CT it still suspicious. Awesome DDX!!!!
@@NinjaNerdOfficial thank you!
Could you start a CGRP receptor antagonist instead of Verapamil for long term preventative, assuming that the manufacturers will still provide it with a zero co-pay?
Please more neurology videos
I'm very interested in your teaching. But can you please add physiotherapy interventions to various conditions where is needed
Oxygen inhalation Sumatriptan and CCB
Red eye and rhinorea
how can I join in to those case study sessions>
Have had chronic clusters x42 years.
Legends on Fire mode. .
Cluster head ache
TACs ...Give oxygen Worst headache!! AKA: Suicide headaches!
Tension headache
Verapamil
Hello…
I watched some of your videos and like them very much..very informative.
I have a question; I suffer from headaches since I was in my 20’s, now I’m 60 but been trying to get rid of them all this time. I’ve gone to see different doctors but they can seem to figure out why the headaches. They are sinus related because I feel a lot of sinus pressure. Advil will get rid of the headache in 20-30 minutes. Aleve prevents the headaches for long periods of time. I’ve seen an allergist and nothing there. They have seems MRIs and act scans of my head but nothing. As soon as I lay down I start feeling a side of my sinus block up. It feels like it swells up and block drainage which seems my sinus produce quite a bit of.
Would you have any input as to where I can get a good evaluation or a type of doctor that can do a good evaluation and hopefully get rid of my headaches.
Thank you again for yours videos.
Looking forward to her your input.
Hes not going to give medical advice here sorry. There's usually, depending on your country, places that specialise in headaches, Google headache clinic. Do you use a nasal rinse for your sinuses? Not the spray, but the gentle cleanse wash. Good luck.
See a ENT, ear nose throat doctor.
One alcoholic drink can trigger a cluster attack!
100% oxygen via nonrebrathable mask isn't used in COPD?
On the COPD patient who is CO2 retainer 100% O2 will stop his breathing drive in 1-2 hours. Patient will became lethargic.
NCCT
CCB
Virapimil
Smoking
Redce alcohol intake
You're welcome to check out my attack video including eye scans. PCCH. (side effects may include watching Ninga Nerd) Thanks Ninja
Hello
Injectable sumatriptan
Usually starts in 4th decade and more predominant in men than woman.
MRI
Cluster headaches
Also, let all the Drs. out there know that women and children DO get clusters!! I literally had an ER Dr. tell me that women don’t get clusters. My Dr. was the chief of neurology at the same hospital and had dx me several years prior, as did Mayo Clinic. That kind of thinking is completely ignorant.
C T
Flunarizine