Cervicogenic HA CSPE Flashcards
Red flags for serious secondary headache (godwin)
Sudden abrut onset
>50
Neurologic Signs Sx’s
5 Ds & 3 Ns
Diziness Diploplia Dysphagia Dysarthria Drop Attacks Ataxia Nausea Nystagmus Numbness
Sudden onset of headache with excruciating pain DDX
Subarachnoid Hemorrhage
Vertebral Artery Dissection
Quick Screening Questions for Serious Pathology
Is the HA of recent onset
Any neurological deficits
Any cognitive changes
Any progression in freq or severity?
Thunderclap Headache
Subarachnoid Hemmorhage
Extremely Severe Occipiatal HA that may run down neck
Vertebral Artery Dissection
Change in vision
Glaucoma Vertebral aa Temporal arteritis Post Traumatic Intracranial lesion Intracranial Hypertension
New headache after 50
SOL
Glaucoma
Temporal Arteritis
Younger than 10
SOL
Headache associated with postural change
SOL
Progressive/worsening HA
SOL
Oral contraceptives
Stroke
3 DDX with HA associated with head trauma
Post Concussive
Subarachnoid Hemorrhage
Subdural/Epidural Hematoma
Components of T4 Syndrome
T4 joint dysfunction
Glove Paresthesia
Headache (uni or bi)
Jolt, Brudzinski & Kernigs test are associated with what?
Which is the best?
Meningitis
Jolt= best
5 constitutional symptoms to ask patient about
Faver Malaise Weight Loss Fatigue Change in appetite
+ Flexion rotation test is associated with
Cervicogenic Headache
Location of a cervicogenic HA
Unilateral
Starts in neck
Moves to back of head
Can skip to affect over eye
Key questions to ask to differentiate CGA from Migraine
Where does HA start?
- neck= CGH
Does it move side to side?
- side to side= Migraine
If HA is bilateral, does one side hurt more?
- Yes= CGH
Location of Migraine HA
Unilateral
Eye
Supraorbital
Hx questions to rule in tension HA
Mild/moderate
Bilateral
Pressing/tightneing
Pertinent negatives in Hx to rule out Tension HA
Nausea Vomiting
Photophobia/Phonophobia (may be one, but not other)
Quick screening questions for serious pathology
Is the headache of recent onset?
Is there any progression in sevarity/frequency
Was onset sudden and severe?
Any cognitive changes?
3 warning flags for serious disease associated with headache
Sudden/severe onset
Age >50
Associated neurologic signs
