Conditions - headaches

Question 1

What are the two classifications of headaches?

Answer 1

Primary - headache is an independent pathomechanism

Secondary - headache is a secondary symptom to another condition

Question 2

Which organization publishes the classification of headaches?

Answer 2

International Headache Classification - currently using IHC-3 (3rd edition)

Question 3

What are the 4 types of primary headache?

Answer 3

1 - migraine with or without aura
2 - tension type headache (TTH)
3 - trigeminal autonomic cephalgias (TAC) - cluster
4 - other

Question 4

What are the 13 red flags for headaches?

Answer 4

• sudden onset (thunderclap)
• new type of headache

Populations:

• older (new onset)
• pregnant or post partum
• substance abuse (cocaine, meth)

SSX:

• worsening or keeping patient awake at night
• meningeal (fever, neck stiffness)
• seizures in non-epileptic

History:

• trauma
• malignancy
• immunosufficiency

Question 5

Describe a migraine

Answer 5

Primary Headache Type 1
(can be with or without aura)

Last 4-72 hours, recurrent.
Pain is unilateral, pulsating / throbbing, moderate - severe and aggravated by movement.

Associated SSX may include:

• nausea
• photophobia
• phonophobia
• aura

Question 6

Describe a tension type headache

Answer 6

Primary Headache Type 2

Last minutes - days
Pain is bilateral, tight, mild-moderate, and not aggravated by movement.

May include photo- or phono- phobia

Question 7

Describe a trigeminal autonomic cephalgia

Answer 7

Primary Headache Type 3
Also known as TACs or cluster headache

Last 15-180 minutes, recurrent in clusters of up to 8 per day.

Pain is unilateral, severe, and in orbital, supraorbital and temporal regions.

SSX include:

• conjunctival injection
• lacrimation
• nasal congestion & rhinorrhea
• sweating
• miosis
• ptosis
• eyelid oedema
• restlessness