3- Headache (Sandhouse) Flashcards
A 38 yo f patient comes complaining about an abrupt onset of pain that started less than 1 week ago. They used to get headaches every now and then, but now he gets a headache every day. She also complains about a stiff neck with some vomiting before the headache. What are the warning signs of a headache?
- abrupt onset of pain that started less than 1 week ago - change in frequency of headache - stiff neck - vomiting before headache -altered consciousness -neurological deficit
If a patient presents with a sudden sever headache w/ some ptosis (neurological sign). What should you do? a) Give them a hug b) OMT c) Prescribe 200mg Hydralazine d) Call super hot EMT Bill to take them to ER
GET THEM TO THE ER!
Name all of the following that are not a serious cause of a headache? a) mass lesion b) aneurysm c) AV malformation d) hemorrhage e) Temporal arteritis
They are ALL serious causes of a headache.
A 42 yo m patient presents with headache. He says that it has gotten worse and longer even though it is in the same place. He also causally mentions that his wife says that he is more forgetful than usual and blames his headache. What do you think could be the cause of his headache? a) mass lesion b) aneurysm c) AV malformation d) hemorrhage e) Temporal arteritis
a) mass lesion (tumor, subdural hematomas)
A 82 yo f patient presents with a headache that she describes as “The worst headache eva!” She is constantly stretching her neck, complaining that it is so stiff. When you shine a light on her you notice her pupils are dilated. She cringes and asks you to turn off the light. What do you think could be the cause of her headache? a) mass lesion b) aneurysm c) AV malformation d) hemorrhage e) Temporal arteritis
d) hemorrhage - subarachnoid hermorrhage
A 51 yo f patient presents with a headache. She gets increased pain and tenderness at night when she is in bed. She also presents with fever, weight loss, night sweats and joint pain. What do you think could be the cause of her headache? a) mass lesion b) aneurysm c) AV malformation d) hemorrhage e) Temporal arteritis
e) Temporal arteritis
Pain increases when flat.
What are the common triggers for a migraine?
Unilateral Vasoconstriction (migraines are vascular headaches!)
Head Injury, stress, hormone flux, fasting, sleep, vasoactive substances, weather/temperature.
A 20 yo f and a 40 yo f come in with nonthobbing pressure or tightnesss feeling in their head. Both of them work in the same office. One complains of a nonthrobbing pressure and tightness, the other complains of anxiety, depression, and a gradual onset. You diagnose them with tension headache. What is the mechanism of tension headache?
Sustained muscle contraction w/ reflex dilation on extracranial vessel
Migraine w/o aura symptoms?
“Common migraine”. Rapid onset, unilateral, throbbing, photophobia, phonophobia, N/V
What are some characteristics of a Migraine WITH Aura?
Visual disturbances (scintillating scotoma), ascending parethesias, weakness, aphasia, other migraine symptoms.
What causes a cervicogenic headache?
Myodural bridge between rectus capitus posterior minor and intracranial dura.
What is a good OMT technique to treat a cervicogenic headache?
OA decompression
What kind of headache presents with a constant throbbing pain WITH tightness and pressure? a) benign exertional headache b) cluster headache c) mixed headache d) cervicogenic headache e) migraine
c) mixed headache!
It is a combo of muscular contraction and vascular dysfunction.
A patient presents with a headache that came on very abruptly. It is severe, but didn’t last very long. She says that might have started from coughing. What kind of headache is this? a) benign exertional headache b) cluster headache c) mixed headache d) cervicogenic headache e) migraine
a) benign exertional headache
A 22 yo m presents with multiple issues. He has pstosis, facial sweating, unilateral headache that happens abruptly at night. He says that at first he thought it was just hangovers from all the partying and drinking he does since they only last from 15 minutes to hours. But his girlfriend told him to go to the clinic since it also happened again after he had been running outside when it was hot and humid and his eye swelled up. So now he is here. What could be his diagnosis? a) benign exertional headache b) cluster headache c) mixed headache d) cervicogenic headache e) migraine
b) cluster headache
Precipitated by alochol, wind, and heat. More common in men, episodic reoccurances.
Who is the prettiest girl in the world?
Karin Hwang
