**_🧠Neurology🧠 - Headache Flashcards
How common are headaches?
One-year prevalence of headache disorders is 50%
20% of what neurologists see and care for
100,000 people absent from work or school every day
How can headaches be broadly subdivided?
Primary and secondary headaches?
What is the difference between a primary and secondary headaches?
Primary headache have no underlying cause, while secondary headaches are a result of other conditions (can be serious but serious causes are rare e.g. subdural haemorrhage)
What are the two subtypes of primary headache?
Long lasting (>4 hrs) and short lasting (<4 hours)
What headaches fall under the category of long-lasting headaches?
Migraines
Tension type headaches
(some medication overuse headaches, such as paracetamol)
What headaches fall under the category of short-lasting headaches?
Trigeminal autonomic cephalalgia (e.g. cluster headaches as the most common form)
What are the red flags for the clinical approach to headaches?
Secondary headache
Preliminary diagnosis of primary headache, however meets one of the SNOOP criteria - suggesting secondary headache
What is the SNOOP criteria?
Systemic
Neurologic
Onset (sudden)
Onset (age)
Pattern change
Papilledema
Pregnancy
Phenotype of rare headache
Elaborate on “systemic” as part of the SNOOP criteria
History of malignancy, immunosuppression, HIV, complaints of fever, chills, night sweats, myalgias, weight loss etc…
Abnormal systemic examination, incl. blood pressure and temperature
Elaborate on “neurologic” as part of the SNOOP criteria
Focal or global neurologic symptoms, such as changes in personality/behaviour, visual abnormalities, motor weakness, sensory loss etc…
Abnormal neurologic examination
Elaborate on “onset” as part of the SNOOP criteria
Onset, sudden - headache reaches peak intensity extremely quickly (<1 minute) - thunderclap headache
Onset, age - new-onset headache before age 5 or over age 65
Elaborate on “pattern change” as part of the SNOOP criteria
Progressive headache (changes in frequency to daily) or change in headache characteristics
Precipitated by the Valsalva manoeuvre
Postural aggravation
Elaborate on “papilledema” as part of the SNOOP criteria
The swelling of both optic discs in your eyes due to increased intracranial pressure (intracranial hypertension)
Elaborate on “pregnancy” as part of the SNOOP criteria
New-onset headache during pregnancy
Change in headache during pregnancy
Elaborate on “phenotype of rare headache” as part of the SNOOP criteria
Patient presents with symptoms consistent with that of trigeminal autonomic cephalalgia, hypnic, exercise-,cough-,or sex-induced