5 10 11 12 13 14 Prognosis is most favourable when patients are

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pandora jewellery Typically, these headaches have a sudden onset and are severe.5 Neurological deficits, including coma at presentation, make the decision to investigate some patients relatively straightforward. It is particularly important, however, If you want to save on the buying of your benadryl, you should find someone reliable. We’ve got the best deals, and you can buy your benadryl for 2.41 at our store! to investigate alert neurologically intact patients who present with headache alone and who account for up to half of all patients with subarachnoid haemorrhage because they benefit most from prompt diagnosis.6 Misdiagnosis occurs in a small number of patients with subarachnoid haemorrhage on the initial visit, when appropriate investigations are not performed.7 8 9 Missing a subarachnoid haemorrhage in an otherwise alert patient can lead to catastrophic morbidity or death.5 10 11 12 13 14 Prognosis is most favourable when patients are treated early, while they are clinically well (that is, alert with no neurological deficits), and untreated patients can have abrupt clinical worsening because of re bleeding.15 Such patients epitomise the challenges of emergency medicine; the condition is uncommon and difficult to diagnose and yet they have the most to lose by a missed diagnosis.12 14 16 17Patients with suspected subarachnoid haemorrhage are typically investigated with unenhanced computed tomography and a lumbar puncture if the scan result is negative. Not surprisingly, current use of these investigations in alert patients with non traumatic headache is inefficient.3 Computed tomography is a high volume imaging technology, which adds considerably to healthcare costs and involves radiation that can increase the risk of cancer.18 Over 95% of scans to rule out subarachnoid haemorrhage, however, yield negative results, and traditionally all of these patients then undergo lumbar puncture.3 11 12 13 Lumbar puncture can be painful and can result in a headache that might be worse than the original headache.19 Although it would be ideal to investigate only high risk patients, no previous research has safely and rigorously identified this high risk population.We prospectively assessed clinical characteristics of neurologically intact patients in emergency departments with a headache peaking within an hour to determine which variables are predictive for subarachnoid haemorrhage and are reliable between physicians pandora jewellery.

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