approach to headache Flashcards
What are the general mechanisms of headaches?
Headaches can be caused by traction, tension, or displacement of pain-sensitive structures, distension of intracranial arteries, inflammation, abnormal intracranial pressure (ICP), or referred pain from diseases in areas like the eyes, orbits, or sinuses.
How are primary and secondary headaches different?
Primary headaches are benign and include migraine, tension-type headache, and trigeminal autonomic cephalgias. Secondary headaches are symptoms of another condition, like infection, inflammation, or brain pathology, and may be life-threatening.
What does the ‘SNOOP 10’ mnemonic represent in headache evaluation?
SNOOP 10 identifies red flags: Systemic features, Neurological symptoms, Onset, Older age, Pattern change, Positional headache, Precipitation, Papilledema, Progressive headache, Pregnancy, Painful eyes, Post-trauma, and Painkiller overuse.
What are some key features of primary headache disorders?
Migraines are often unilateral, throbbing, with nausea or photophobia; tension headaches are bilateral and pressing; cluster headaches are severe and unilateral with autonomic symptoms.
What conditions are associated with thunderclap headaches?
Thunderclap headaches, described as the “worst headache of life,” often indicate subarachnoid hemorrhage, cerebral venous sinus thrombosis, or reversible cerebral vasoconstriction syndrome.
How does intracranial pressure (ICP) relate to headache presentation?
Raised ICP may cause headaches that worsen with coughing, sneezing, or lying flat. Low ICP, often from CSF leaks, typically causes headaches that improve when lying down.
What are the typical symptoms of giant cell arteritis in elderly patients?
Patients with giant cell arteritis may present with unilateral or bilateral head pain, temporal tenderness, jaw claudication, and elevated ESR.
What physical exams are essential in assessing headache disorders?
Key exams include vitals, head and neck palpation (e.g., temporal arteries), and a focused neurological exam covering mental status, cranial nerves, and fundoscopic evaluation.
