16. Headache Flashcards

1
Q

What are the pain sensitive areas of the brain?

A

Meninges’s
Arteries, and veins.
Various tissues lining the cavities within the skull

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2
Q

Which cranial nerve mediates thought of headache

A

Cranial nerve five

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3
Q

Name eight causes of emergent headache

A

Carbon monoxide poisoning, meningitis/encephalitis/abscess, temporal arthritis, glaucoma, increased, intracranial, pressure, cerebral Venus, sinus thrombosis, reversible, cerebral, vasoconstriction syndrome, intracranial, hemorrhage, including subarachnoid, subdural, epidural

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4
Q

Who is at risk for meningitis/encephalitis/abscess

A

History of sinus or ear infection, or recent surgical procedure, immuno compromised, general debilitation with decreased immunologic function, acute viral illness of any type, extremes of age, impacted living conditions, including military, or college dorms, lack of primary immunization

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5
Q

What are risk factors for carbon monoxide poisoning?

A

Breathing in an enclosed confined space with engine, exhaust or ventilation of heating equipment, multiple household members with same symptoms, wintertime and working around machinery or equipment, producing carbon monoxide

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6
Q

Temporal arthritis risk factors

A

Age greater than 50 females greater than males.
History of other collagen, vascular disease, including lupus.
Previous chronic meningitis
Previous chronic illness, including TB, parasitic or fungal infection

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7
Q

Risk factors for acute angle closure glaucoma

A

Not associated specifically with any usual or customary headache pattern.
History of previous glaucoma
Age greater than 30
History of pain in increasing in a dark environment

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8
Q

Risk factor is for increased intracranial pressure

A

History of previous benign, intracranial, hypertension
Presence of cerebral spinal fluid shunt.
History of congenital brain or skull abnormalities
Female gender.
Obesity

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9
Q

Risk factors for cerebral Venus, sinus thrombosis

A

Female gender.
Pregnancy, peripartum, hormone replacement therapy, or OCP.
Prothrombotic conditions

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10
Q

Risk factors for reversible cerebral vasoconstriction syndrome

A

Episodic sudden severe pain with or without focal Neuro deficits or seizure.
Recurrent episodes over period up to several weeks.
Exposure to adrenergic or serotonergic drugs.
Postpartum state

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11
Q

Risk factors for SAH

A

Sudden and severe pain “worst headache of life”
Acute severe pain after intercourse or exertion.
History of SAH or cerebral aneurysm.
History of polycystic kidney disease
Family, history of SAH.
Hypertension, severe.
Previous vascular lesions and other areas of the body
Young and middle age

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12
Q

What type of haematoma is associated with anisocoria

A

Epidural

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13
Q

List 10 differential diagnosis of headache causes in the CNS neurologic or vessels

A

SAH, carotid dissection, Venus, sinus thrombosis, shunt failure, traction, headache, tumor, mass, subdural, hematoma, reversible, cerebral, vasoconstriction syndrome, migraine, vascular headache, trigeminal, neuralgia, post traumatic, i.e. concussion, post LP headache

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14
Q

List two causes of headache that are considered toxic/metabolic or environmental

A

Carbon monoxide poisoning.
Mountain sickness

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15
Q

What type of headache falls under the collagen vascular disease category?

A

Temporal arthritis

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16
Q

What four ocular or ENT causes can cause headache

A

Glaucoma
Sinusitis
Dental problems.
TMJ disease

17
Q

What muscular skeletal causes can cause headache

A

Tension headache
Cervical strain

18
Q

What type of headaches fall under the allergy diagnosis?

A

Cluster

19
Q

Name four headache causes that fall under infectious disease

A

Meningitis.
Encephalitis
Brain abscess.
Headaches, man, neurologic source

20
Q

What type of headache falls under the pulmonary or oxygen criteria?

A

Anoxic headache

21
Q

What type of cardiovascular cause can cause a headache?

A

Hypertensive crisis

22
Q

What are four miscellaneous causes under the category of unspecified, causing headaches?

A

Preeclampsia
Idiopathic, intracranial, hypertension
Effort, dependent, or coil headache
Medication, overuse or rebound

23
Q

Keith physical exam categories for assessment of headache

A

General appearance.
Vital signs
HEENT
Neurologic

24
Q

What timing is sufficient to rule out cerebral venous thrombosis

A

MRV or t venogram

25
Q

How many hours since the onset of headache has been shown to be sufficient to exclude the diagnosis of SAH when using a third generation CT scan scanner?

A

Six hours

26
Q

What two diagnosis in particular are useful for using an LP

A

Concern for SAH greater than six hours
IIH with an opening pressure and CSF analysis

27
Q

What tests are helpful for diagnosing temporal arthritis?

A

Yes, SR or CRP

28
Q

Which two kinds of headaches or causes of headaches might an ECG be helpful with

A

SAH
Increased intracranial pressure.
I.e. nonspecific ST/T wave changes

29
Q

What is the inclusion criteria for the Ottawa subarachnoid haemorrhage rule?

A

Patient’s age 15 and over, non-traumatic headache, peak intensity within one hour onset

30
Q

Ottawa subarachnoid haemorrhage rule: exclusion criteria

A

New neurologic deficits, prior aneurysm, prior SAH, known intracranial mass, recurrent chronic headaches

31
Q

Ottawa subarachnoid rule, which of the following must all be negative in order to rule out (six)

A

Age greater than 40 years
neck, pain or stiffness.
Witness loss of consciousness.
Headache during exertion.
Thunderclap headache with immediate peak pain.
Limited neck flexion

32
Q

What type of symptoms might carbon monoxide poisoning present with?

A

Gradual, subtle, non-focal throbbing wax and wane

33
Q

Recommendations for in Eric treatment of headache example primary

A

Oral NSAIDs, including 500 mg naproxen
Medical clopamide 10 mg
Can treat with sumatriptan 6 mg
Intramuscular or IV and said including Coac 15 mg

34
Q

Recommendations for in Eric treatment of headache example primary

A

Oral NSAIDs, including 500 mg naproxen
Medical clopamide 10 mg
Can treat with sumatriptan 6 mg
Intramuscular or IV and said including Coac 15 mg

35
Q

A CT NegGram is relatively contraindicated in what condition due to not been shown to be safe

A

Pregnancy