6- headache Flashcards
1
Q
main HA in ER
A
tension - 50% migraine -10% benign non-specific - 30% potentially serious 8% life threatening -1%
2
Q
Sx of migraine
A
- gradual onset that may wake from sleep - may have aura
- mod- severe
- typically unilateral
- pounding or throbbing
- N/V, photo/phono phobia
- may last 1-2 days
3
Q
migraine triggers
A
- foods
- stress
- sleep changes
- OCP
- menstrual
4
Q
3 main classes of migraine Tx
A
- neuroleptics - haloperidol, chlorpromazine
- Dopa antag. - metoclopramide, prochlrperazine
- vasoactives
+ non specific pain mgmt
5
Q
common migraine approach
A
5-10mg prochloroperazine again in 30 minutes if needed and IV ketrolac (NSAID)
6
Q
ways to diff. tension from migraine
A
- never occur during sleep
- gradually over the day
- may occur daily
- posterior often
- less bad then mingraine
- associated with stressors
- no N/V photophobia
7
Q
11 serious causes of non-trauma HA
A
- subarachnoid
- temporal arteritis
- HT encephalopathy
- pseuodtumor cerebri
- CO poisoning
- tumoir
- meningitis
- pre-eclampsia
- cervical artery dissection
- central venous thrombosis
- acute angle closure
8
Q
Sx of subarachnoid
A
- sudden
- occurs with exertion (excercise, sex)
- worst headache of life
- worst at onset
- N/V
- look for: pupil changes, meningismus, alter LOC, focal deficit
9
Q
how helpful is CT in subarachnoid
A
great if done quickly
10
Q
what to do if suspect and CT normal
A
LP - may find red cells, xanthochromia
11
Q
causes of raised ICP
A
mostly tumors, but also
- abscess
- hemmorage
- subdural hematoma
12
Q
Sx of ICP
A
gradual onset - days-months
- worse when lying/bending
- neuro and focal Sx
- sublte changes in cog., mood, memory
- no N/V photophobia
13
Q
what to do for suspected ICP
A
CT, maybe MRI
14
Q
5 Sx of meningitis
A
- gradual HA
- fever
- altered LOC
- focus of infection
- meningisus
15
Q
how to Dx meningitis
A
LP
