Figure 1057

The Migraine And Headache Program

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Causes of headache in the transplant recipient. ACE—angiotensin-converting enzyme; CNS—central nervous system; ATG—antithy-mocyte globulin.

History

Character, pattern, positional relationships Fever, duration of headache and fever Location of headache Visual, movement, sensory impairment Bowel or bladder incontinence Trauma

Medications old and new

Time of medications and relationships to headache Physical examination Eye

Neurological

Complete the rest of the examination If no papilledema or focal neurological deficit—> lumbar puncture If papilledema or focal deficit—> CT first if no mass lesion-» lumbar puncture Cerebrospinal fluid is sent for Cell count and differential Protein Glucose Gram's stain Fungal stains Acid fast stain Fungal culture Mycobacterial cultures Bacterial cultures Cryptococcal antigen

Save cerebrospinal fluid in addition for other tests including

Histoplasma capsulatum or Coccidiodes immitis antibody titers

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