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Headache > Conditions > Flashcards

Conditions Flashcards

1
Q

What are primary headaches?

A

Refer to disorders with no secondary underlying pathology e.g. migraine

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2
Q

What are secondary headaches?

A
  • Space occupying lesion - increased pressure
  • Intracranial hypertension
  • Vasculitis/arteritis
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3
Q

What is cortical spreading depression?

A

Initiated by slowly propagated wave of depolarization in neurones and glial cells. This is followed by a sustained suppression of spontaneous neuronal activity.

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4
Q

What conditions does cortical spreading depression occur in?

A
  • Cerebrovascular accident
  • SAH
  • Traumatic brain injury
  • Epilepsy
  • Migraine
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5
Q

What are some trigger factors for migraines?

A
  • Relaxing after stress
  • Menstruation - triggered by oestrogen decline
  • Jet-lag - change in sleep pattern
  • Cheese - food containing tyramine, red wine, cheese, chocolate, citrus fruits
  • Flickering lights on tv screen - bright lights, loud sounds
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6
Q

What are the causes of meningitis?

A
  • Encephalitis: most common cause is herpes simplex virus (HSV). This is inflammation of the brain and causes confusion, disorientation, drowsiness. seizures, changes in personality and behaviour e.g. agitated.
  • Non-infectious causes (blood, trauma, drugs) of meningeal irritation
  • Subdural empyema
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7
Q

What are the risk factors for meningitis?

A
  • Extremes of age
  • Living in close proximity - outbreaks can occur in student halls and boarding schools
  • Vaccination history (absence of)
  • Immune suppression/deficiency
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8
Q

Who is most at risk of meningitis?

A
  • Immunocompromised people to infections caused by less common organisms
  • Neonates and children under 1 year of age are particularly vulnerable to meningitis, as their BBB is not fully developed
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9
Q

What do you need to ask in a history for meningitis?

A

Recent travel history as some countries have high rates of pneumococcal penicillin resistance.
e.g. Canada, Greece, Italy, Mexico, Poland, Spain, Turkey, USA

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10
Q

What are the causes of intracranial space occupying lesions?

A
  • Tumours - primary: benign, malignant or secondary
  • Infection
  • Vascular
  • Hydrocephalus
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11
Q

What are the infectious causes of intracranial space occupying lesions?

A
  • Brain abscess
  • Subdural empyema
  • Granuloma e.g. tuberculosis
  • Parasitic
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12
Q

What are the vascular causes of intracranial space occupying lesions?

A
  • Extradural haemorrhage - acute/trauma
  • Subdural haemorrhage - acute/trauma
  • Subarachnoid haemorrhage - spontaneous
  • Parenchymal brain haemorrhage - spontaneous
  • Caveroma or vascular malformations
  • Brain infarction
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13
Q

What are the hydrocephalus causes of intracranial space occupying lesions?

A
  • Non-communicating or obstructive - tumours, cysts, intra-ventricular haemorrhage
  • Communicating - meningitis, SAH
  • Overproduction (rare) - choroid plexus papilloedema
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14
Q

What is the WHO grading of glioma?

A

Grade I: pilocytic astrocytoma (least malignant)
Grade II: low grade astrocytoma
Grade III: anaplastic astrocytoma
Grade IV: glioblastoma multiforme (most malignant)

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15
Q

What is meningioma?

A
  • Arises from arachnoid cap cells
  • Generally benign
  • Trauma, radiation, oncogenic virus and hormones are implicated in their causation but still unclear
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16
Q

What is vestibular schwannoma?

A
  • Benign tumour arising from the nerve sheath of vestibular nerves, typically in CP angle
  • Usually presents with ipsilateral hearing problems and tinnitus
  • 5th, 7th and lower cranial nerves can be affected
17
Q

What is the normal and pathological ICP?

A

Normal - <15mmHg

Pathological - >20mmHg

18
Q

What influences ICP?

A
  • ICP is lower in children and can be negative in newborns
  • Transient elevations occur when coughing/sneezing etc
  • Can be negative standing up because of rigid venous sinuses
  • Can be influenced by intra-thoracic pressures
19
Q

What are the causes of raised ICP?

A 
Increase in brain/tissue/mass volume
- Cerebral oedema
- SOL - tumour, haematoma, abscess
Increase in CSF volume
- Obstruction to CSF circulation
- Reduced CSF absorption
- Increased CSF production
Increase in blood volume
- Raised arterial pCO2
- Venous obstruction
- Increased temperature
20
Q

What is a cluster headache?

A

Most severe pain ever lasting 30-120mins. Unilateral, side-locked. Agitation, pacing.

21
Q

What is triptan overuse headache?

A
  • Can be migrainous +/- or tension type
  • Triptan intake > 10 days/month for >3 months or analgesics
  • Treatment: stop triptan for 2-3 months
  • Triptans can cause drowsiness

Headache (4 decks)

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