Secondary Headache Case 2

A 74-year-old lady presents to the ED accompanied by her daughter. Recently, she has been more forgetful and has dropped a number of objects. On several occasions she has appeared to forget things ‘mid-task’ e.g wearing only one slipper, forgetting to close one of the french windows.

Her daughter reluctantly fears that these are the early signs of dementia. Past medical history includes controlled hypertension, glaucoma and Ca breast. She has been prescribed ramipril, timolol and tamoxifen.

On examination, it is noted that she is in atrial fibrillation.

Which of the following reduce the probability that this lady’s symptoms are due to dementia? Choose one or more options.

Of the following, select which two are the most probable cause of this lady’s symptoms?

After requesting and reviewing an ECG, CXR, baseline bloods and a urinalysis what is the next most appropriate ED investigation?