030415 headaches

Question 1

types of primary headache

Answer 1

migraine
cluster
tension-type

Question 2

causes of secondary headache

Answer 2

trauma
vascular
infectious (SINUSITIS)
metabolic (CO poisoning)
oncologic 
inflammatory

Question 3

recurrent migraines–you wouldn’t do CT or MRI except in cases

Answer 3

recent change in headache pattern
new onset seizures
focal neurologic signs

Question 4

cluster headache

Answer 4

circadian, also occur at certain time in year

attacks also occur in bunches

relatively rare

Question 5

diagnostic criteria for cluster headache

Answer 5

1 every other day to 8/day

and
severe, unilateral orbital/supraorbital/temporal location, lasts 15 minutes to 3 hrs

and one of the follwing:
-conjunctival injection, lacrimation, rhinorrhea, nasal congestion, forehead and facial sweating, miosis, ptosis, eyelid edema

Question 6

what would you see of pt w cluster headache vs migraine?

Answer 6

migraine-lying still

cluster-agitated, aggravated, pacing (autonomic activity)

Question 7

diagnostic criteria for migraine w aura

Answer 7

headache attack lasts 4-72 hrs

and two of the following:
-unilateral location, pulsating, moderate/severe intesnity affecting daily activities, aggravation by walking up stairs or similar routine physical activity

and one of the following:
-nausea, vomiting, photophobia and phonophobia

Question 8

clinical features most predictive of migraine

Answer 8

nausea
disability
photophobia

Question 9

diagostic criteria for tension type headache

Answer 9

15 days per month on average for MORE THAN 3 months

headache lasts hours or may be continuous

and two of the following:
-pressing/tightening, mild or moderate intensity (may inhibit but doesn’t prohibit activities), bilateral location, no aggravation by walking up stairs or similar routine physical activity

and no more than one of:
-photophobia, phonophobia or mild nausea, moderate or severe nausea or vomiting

Question 10

pts w migraine can have nasal stuffiness and pressure: true or false

Answer 10

true

Question 11

risk factors for chronic daily headache

Answer 11

non modifiable: migraine, female, low education, low socioeconimc status, head injury

readily modifiable: attack frequency, obesity, med overuse, stressful life events, snoring