What is jolt accentuation of headache?

Jolt accentuation of headache is a new and less well-recognised physical examination, which assesses meningeal irritation. It is judged as positive if the headache is exacerbated by rotating the head horizontally two or three times per second.

What is a positive jolt sign?

Jolt accentuation is regarded as positive if the patient’s headache is worsened by turning his or her head actively, leftward and rightward, intermittently in a rate of 2–3 per second [2], [6], [7]. All of the exams were done by an academic attending physician of Emergency Medicine.

What is a jolt maneuver?

Jolt accentuation of headache (Jolt) is an easy clinical maneuver that can be used to diagnose meningitis, but its diagnostic accuracy is controversial.

What is brudzinski sign?

Overview. One of the physically demonstrable symptoms of meningitis is Brudzinski’s sign. Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed.

When to check for jolt accentuation of headache?

If jolt accentuation is noted in a febrile patient associated with recent onset headache, the CSF should be examined even in the absence of neck stiffness or Kernig’s sign.

Can a jolt accentuation of headache rule out meningitis?

Jolt accentuation of headache (Jolt) is an easy clinical maneuver that can be used to diagnose meningitis, but its diagnostic accuracy is controversial. We aimed to assess the “Jolt maneuver” in diagnosis of suspected acute meningitis patients admitted to the emergency ward of Imam-Khomeini Hospital Complex in Tehran, Iran.

Can a jolt accentuate a migraine or migraine?

Jolt accentuation of headache can occur in some other intracranial pathologies. For example, in patients with migraine, the headache exacerbates during the Jolt maneuver, and also 67% of intracranial space occupying lesions have positive Jolt maneuver results [14].

Which is more sensitive jolt accentuation or neck stiffness?

They underwent lumbar puncture (LP) on suspicion of meningitis. The relation of each sign to cerebrospinal fluid (CSF) pleocytosis was estimated. Among 34 patients with pleocytosis, 33 had jolt accentuation (sensitivity: 97.1%), while only 5 of them had neck stiffness or Kernig’s sign.