Deck 1 Flashcards
Migraine with aura and use of COCPs
Increased risk of ischemic stroke due to vasospasm or neuronal hyperexcitability
Hence CI
RF that causes IIH
Women of child bearing age
Recent weight gain /obesity
Growth hormone
Tetracycline
Excessive vit A and derivatives (isotretinion)
Mech of IIH
Impaired CSF resorption and intracranial venous hypertension
C/F of IIH
Headache
Nausea
Vomiting
Visual changes -transient obscurations ,vision loss, diplopia due to 6th nerve palsy
Pulsatile tinnitus
Retrobulbar pain neck pain back pain
How to diagnose IIh
Fundoscopy ( papilledema and enlarged blind spots)
MRI (to rule out mass lesions /hydrocephalus)
MRV. (to rule out cerebral venous thrombosis)
LP: elevated opening pressure
Ttt of IIH
Weight loss (bariatric surgery)
Acetazolamide
Topiramate
Progressive visual defects -
Shunting
Optic nerve fenestration
Identify cluster headache
Excruciating periorbital oain
I/L autonomic sympyoms
Restlessness
Acute
Lasts 15-90 mins
Several times a day for weeks
Followed by long period of remission
Circadian or seasonal
Ttt of cluster headache
Abortive:
100% O2
Triptans
Prophylactic:
Verapamil
Most common complication of IIH
Blindness
Acute compression of optic nerve in periods of increased ICP
Straining bending
Chronic compression leads to optic nerve atrophy - permanent vision loss
Tension headache identification
Constant pressure
Can perform daily activities
B/L
Band like
Muscle tenderness
30min to months /years
Related to stress
Tension headache ttt
Abortive : Analgesics
Prophylaxis
Amitriptylline
Biofeedback
CBT
