Cluster / Trigeminal Autonomic Cephalalgias Headaches Flashcards
Primary headaches = no known cause
Secondary headaches = have a known cause
Which of these is more common?
- Primary
When looking at different types of headaches, which of the following is the least common?
1 - migraines
2 - Trigeminal autonomic cephalgias (TACs)
3 - tension headaches
2 - Trigeminal autonomic cephalgias (TACs)
Trigeminal autonomic cephalgias (headaches) (TACs) are primary headaches. Although the exact pathophysiology is unknown, the theory is that afferent stimulation of a cranial nerve simulates pain and delivers this to the higher brain centres where we perceive pain. What cranial nerve is this linked with?
1 - hypoglossal nerve (12)
2 - vestibulocochlear nerve (8)
3 - trigeminal nerve (CN 5)
4 - glossopharyngeal nerve (9)
3 - trigeminal nerve (CN 5)
- provides sensory and motor info
- afferent receptors trigger trigeminal nucleus in the medulla oblongata
Trigeminal autonomic cephalgias (headaches) (TACs) are primary headaches. Although the exact pathophysiology is unknown, the theory is that afferent stimulation of the trigeminal nerve simulates pain and delivers this to the higher brain centres where we perceive pain. What typically is hypothesised to occur once these higher brain regions receive this information?
1 - increased parasympathetic activation
2 - increased sympathetic activation
3 - increased parasympathetic and sympathetic activation
4 - all of the above
3 - increased parasympathetic and sympathetic activation
Typically patients with Trigeminal autonomic cephalgias (headaches) (TACs) will experience pain (afferent CNV) and specific autonomic features from the parasympathetic innervation. Which of the following is NOT a typical feature patients can present with due to parasympathetic activity?
1 - ipsilateral symptoms
2 - ptosis and miosis
3 - lacrimation
4 - nasal congestion
5 - pupil constriction
2 - ptosis and miosis
- occur due to sympathetic activity
Typically patients with Trigeminal autonomic cephalgias (headaches) (TACs) will experience pain (afferent CNV) and specific autonomic features from the parasympathetic innervation. Which of the following is NOT a typical feature patients can present with due to sympathetic activity?
1 - ipsilateral symptoms
2 - ptosis
3 - miosis
4 - lacrimation
5 - pupil dilation
4 - lacrimation
Which part of the brain has been identified as governing the symptoms Trigeminal autonomic cephalgias (headaches) (TACs)?
1 - hypothalamus
2 - thalamus
3 - brain stem
4 - cerebellum
1 - hypothalamus
- linked due to the following festures of TACs:
- cyclic nature of symptoms
- relapsing remitting course
- seasonal variation
All of the these are associated with the biological clock
Trigeminal autonomic cephalalgias (headache) (TAC) is a type of primary headache. Which of the following is NOT a symptom that occurs in patients with TAC?
1 - pain on one side of the head (typically orbital, supraorbital, and/or temporal)
2 - pain felt throughout face
3 - autonomic systems on the same side of head (eye watering and redness or drooping eyelids)
4 - all of the above
2 - pain felt throughout face
- pain is felt over the trigeminal nerve only
Do Trigeminal autonomic cephalalgias (headache) (TAC) typically occur unilaterally or bilaterally?
- unilaterally
How long can Trigeminal autonomic cephalalgias (headache) (TAC) last for?
1 - 30 mins to 1 week
2 - 15-180 minutes
3 - 4-72h
4 - all of the above
2 - 15-180 minutes
How long can Trigeminal autonomic cephalalgias (headache) (TAC) typically have a number of autonomic symptoms. But what is the sensation patients describe the headache as?
1 - stabbing eye pain
2 - throbbing
3 - squeezing/tightening
4 - can be all of these
1 - stabbing eye pain
- described as excruciating pain
Although there are a number of triggers that have been suggested to cause Trigeminal autonomic cephalalgias (headache) (TAC), which of the following is most commonly linked?
1 - cigarettes and alcohol
2 - stress and dehydration
3 - food and weather
4 - can be all of the above
1 - cigarettes and alcohol
There are 4 main types of Trigeminal autonomic cephalalgias (headache) (TAC). Which is most common?
1 - Cluster headache
2 - Paroxysmal hemicrania
3 - SUNCT/SUNA
4 - Hemicrania continua
1 - Cluster headache
Cluster headaches are the most common form of Trigeminal autonomic cephalalgias (TAC), a primary headache. What is the prevalence of cluster headaches?
1 - 0.1% of the population
2 - 1% of the population
3 - 10% of the population
4 - 25% of the population
1 - 0.1% of the population
10 cases per 100,000
What age do Cluster headaches, the most common form of Trigeminal autonomic cephalalgias (TAC), a primary headache typically occur in?
1 - 15-30
2 - 20-40
3 - 30-40
4 - 50-60
3 - 30-40
Are cluster headaches, the most common form of Trigeminal autonomic cephalalgias (TAC), a primary headache more common in men or women?
- men
- 4x more likley