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neurology phase 1b > 1b Headaches > Flashcards

1b Headaches Flashcards

1
Q

What is a primary headache?

A

When the cause is the headache itself

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2
Q

What are the three main types of primary headaches?

A

Migraine
Tension-Type Headache
Cluster Headache (Trigeminal autonomic cephalalgias)

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3
Q

What is a secondary headache?

A

a headache precipitated by another condition / disorder

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4
Q

What is the main method of classifying primary headaches?

A

Long Lasting or short lasting

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5
Q

Which primary headache types are short lasting?

A

Trigeminal Autonomic Cephalalgia aka
Cluster headache

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6
Q

Which primary headache types are long lasting?

A

Migraine
Tension Type headache

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7
Q

What are the four key red flags suggesting secondary headaches?

A

Age - new onset in age 50+
Onset - sudden,abrupt onset (thunderclap)
Systemic Symptoms - fever, neck stiffness, rash,weight loss
neurological Signs

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8
Q

What are some neurological signs which are red flags for headaches?

A

confusion, impaired consiousness, focal neurology and swolen optic discs

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9
Q

what does a thunderclap headache suggest?

A

Sub arachnoid headache

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10
Q

What are the key characteristics of episodic migraines?

A

Unilateral Location
Pulsating Quality
Moderate pain
AGGREVATION BY PHYSICAL ACTIVITY
Vomiting / nausea
Photophobia / Phonophobia
Maybe - Aura

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11
Q

What is a migraine aura?

A

A complex array of symptoms reflecting focal cortical brain stem dysfunction

Usually before headache

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12
Q

What does a migraine aura look like?

A

Glimmering zig zag pattern which lasts between 5-30 minutes

Expanding C’s

Elemental Visual Disturbances

Combination of negative and positive sensory attributions

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13
Q

What is seen in the premonitory phase of a migraine?

A

Yawning, Polyuria, Mood, change, Irritable, neck pain, light sensitivity and concentration difficulty

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14
Q

What is see in the aura phase of a migraine?

A

Visual, sensory, weakness, and speech arrest

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15
Q

What is experienced in the headache phase of a migraine?

A

Head and body pain, nausea, photophobia

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16
Q

How are migraines resolved?

A

rest and sleep

17
Q

What might be experienced in the recovery phase of migranes?

A

Mood disturbed, food intolerances, feeling hungover, can take up to 48 hours

18
Q

What are the lifestyle factors which can be managed for migraines?

A

Diet, sleep, exercise, mindfulness

19
Q

What are the acute / abortive treatments for a migraine?

A

Paracetamol
NSAID’s
Prokinetics - anti-sickness medication
Triptans

20
Q

Which medication should be avoided when managing a migraine?

A

Opiate based and mixed analgesics should be avoided

21
Q

What does a tension type headache feel like?

A

Tight muscles around the head and the neck - as though the head is in a vice

22
Q

How long do Tension type headaches typically last?

A

30 mins - several days, depends

23
Q

Describe the distribution of tension type headaches?

A

Bilateral

24
Q

How are tension type headaches affected by movement?

A

Not affected

25
Q

how are tension type headaches treated?

A

Reassurance to patient
Give simple analgesics

26
Q

How are cluster headaches characterised?

A

Severe unilateral pain - one sided pain
Forehead or facial sweating
Miosis or ptosis
A sense of restlessness or agitation

27
Q

What are some common symptoms which are seen with patients who suffer from cluster headaches?

A

Ipsilaterally (Same side as the headache):
Conjunctival Redness or lacrimation
Nasal congestion
Eyelid Oedema

Forehead sweating
Ptosis (upper eyelid droop)

28
Q

What is the acute treatment for cluster headaches?

A

triptan - nasal or subcutaneous route
high oxygen flow

29
Q

How does a high oxygen flow help in the treatment of cluster headaches?

A

Oxygen inhibits neuronal activity in the trigeminocerevical complex

30
Q

What preventative measures can help a cluster headache?

A

Verapamil = calcium channel blocker - but important to get an ECG first as it can interfere with the heart
Greater occipital nerve block

31
Q

How does migraine compare to a tension type or cluster headache?

A

Migraine = Unilateral (often bilateral) , pulsating, moderate/severe, Aggrevated by physical movement, nausea and vomiting, attack lasts hours once or twice a month

Tension-type headache = bilateral, tightening, mild or moderate, no other symptoms, attacks last hours to days

Cluster hedache = always unilateral, very severe, restlessness, no aggrevation by physical activity, other symptoms, attacks last 15 mins- 3 hours and happen up to 8 times a day for 2-3 months at a time

neurology phase 1b (13 decks)

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