1b Headaches Flashcards
What is a primary headache?
When the cause is the headache itself
What are the three main types of primary headaches?
Migraine
Tension-Type Headache
Cluster Headache
What is a secondary headache?
a headache spercipitated by another condition / disorder
What is the main method of classifying primary headaches?
Long Lasting or short lasting
Which primary headache types are short lasting?
Trigeminal Autonomic Cephalalgia aka
Cluster headache
Which primary headache types are long lasting?
Migraine
Tension Type headache
What are the four key red flags suggesting secondary headaches?
Age
Onset
Systemic Symptoms
neurological Signs
What are some neurological signs which are red flags for headaches?
confusion, impaired consiousness, focal neurology and swolen optic discs
what does a thunderclap headache suggest?
Sub arachnoid headache
What are the key characteristics of episodic migraines?
Unilateral Location
Pulsating Quality
Moderate pain
AGGREVATION BY PHYSICAL ACTIVITY
Vomiting / nausea
Photophobia / Phonophobia
Maybe - Aura
What is a migraine aura?
A complex array of symptoms reflecting focal cortical brain stem dysfunction
What does a migraine aura look like?
Glimmering zig zag pattern which lasts between 5-30 minutes
Expanding C’s
Elemental Visual Disturbances
Combination of negative and positive sensory attributions
What is seen in the premonitory phase of a migraine?
Yawning, Polyuria, Mood, change, Irritable, neck pain
What is see in the aura phase of a migraine?
Visual, sensory, weakness, and speech arrest
What is experienced in the headache phase of a migraine?
Head and body pain, nausea, photophobia
How are migraines resolved?
rest and sleep
What might be experienced in the recovery phase of migranes?
Mood disturbed, food intolerances, feeling hungover, can take up to 48 hours
What are the lifestyle factors which can be managed for migraines?
Diet, smoking, exercise, mindfulness
What are the acute / abortive treatments for a migraine?
Paracetamol
NSAID’s
Prokinetics - anti-sickness medication
Which medication should be avoided when managing a migraine?
Opiate based and mixed analgesics should be avoided
What does a tension type headache feel like?
Tight muscles around the head and the neck - as though the head is in a vice
How long do Tension type headaches typically last?
30 mins - several days, depends
Describe the distribution of tension type headaches?
Bilateral
How are tension type headaches affected by movement?
Not affected
how are tension type headaches treated?
Reassurance to patient
Give simple analgesics
How are cluster headaches characterised?
Severe unilateral pain - one sided pain
What are some common symptoms which are seen with patients who suffer from cluster headaches?
Ipsilaterally (Same side as the headache):
Conjunctival Redness or lacrimation
Nasal congestion
Eyelid Oedema
Forehead sweating
Ptosis (upper eyelid droop)
What is the acute treatment for cluster headaches?
triptan - nasal or subcutaneous route
high oxygen flow
How does a high oxygen flow help in the treatment of cluster headaches?
Oxygen inhibits neuronal activity in the trigeminocerevical comples
What preventative measures can help a cluster headache?
Verapamil = calcium channel blocker - but important to get an ECG first as it can interfere with the heart
Greater occipital nerve block
How does migraine compare to a tension tyoe?
Migraine = Aggrevated by physical movement, Tension Type Headache is not
Migraine = Nausea, vomiting, photophobia and phonophobia, Tension Type Headache = None
Migraine = unilateral, Tension Type = bilateral
What is the acute treatment for cluster headaches?
triptan - nasal or subcutaneous route
high oxygen flow
