ECR 11.29.12 Headach History and Diagnosis Flashcards

1
Q

What are primary headaches (4)

A

Migraine
Tension Type (TTH)
Cluster
Other (benign cough headache)

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2
Q

What are secondary types of headaches

A

Infection
Hemorrhage
Increased ICP (intracranial P -DO NOT MISS)
Brain Tumor

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3
Q

What Questions should you ask when taking Headach History (5)

A
  1. Ask how many different types of headaches you have
  2. How long have you had it?
    (if chronic, okay; if sudden worst ever–> CAT scan)
  3. What do you think it’s due to?
  4. Where is it lcoated?
  5. What is it like?
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4
Q

What is temoporal pattern of Migraine

A

lasts 203 days

Episodic headaches

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5
Q

What is temporal pattern of Tension Headache

A

constant

~6 months

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6
Q

What is temporal pattern for cluster headache

A

painful stimulus ;

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7
Q

What is temporal pattern for Tumor/inracranial neoplasm

A

progressive with time

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8
Q

What are migraine triggers (7)

A

Phsyical exertion

Diet

Hormonal changes

Head Trauma

Stress and anxiety

Sleep deprivation or excess

Environmental factors

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9
Q

Why is pain localized to front of head (referred pain>

A

TRIGEMINAL N. above tentonum

If stretched–> Trigeminal N.

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10
Q

When do you have pain back of head

A

T9-T10

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11
Q

how deos IHS determine if its migraine?

A

> 5 attacks lasting 4-72h

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12
Q

What is timing of migrains (IHS)

A

> 5 attacks lasting 4-72 h

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13
Q

What are qualities of migraines (IHS)- need >2

A

Unilateral
Puslating
Moderate to severe intensity
Aggravation by routine physical activity

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14
Q

What are >1 needed for migraine (IHS)

A

nausea

photopobia and phonophobia

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15
Q

Rate /timing of Tension headache (IHS)

A

> 10 attacks lasting 30 mins-7 days

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16
Q

> 2 of the following 4 tension headaches (IHS)

A

Bilateral
Not pulsating
Mild or moderate intensity
Not aggravated by routing physical activityIs

17
Q

Is nausea/vomiting ass. with tension headaches?

A

NO!

18
Q

Is photophobia or phonoboia ass with headaches

A

only ONE or NEITHER

19
Q

What is the attack profile of a cluster headache

A

unilateral orbital/temporal severe pain

Rapid onset (5-15 mins)
Short duration (45-90 mins)

Agitation/restlessness (90%)

Migrainous syptoms (nausea, photophobia, phonobobia, aura)

Autonomic features

Rest doesn’t help, position doesn’t help
Pace in agitated/colicky staet

20
Q

Worrisome headache RED FLAGS “SSNOOP”

A

Systemic symptoms (fever, weight loss)
or
SECONDRARY risk factors (HIB, Systemic cancer)

NEUROLOGIC SYMPTOMS or abnormal signs (confusion, impaired alertness, or consciousness)

ONSET- sudden, abrupt, or split-second

OLDER: new onset and progressive headache, esp.in middle-age >50 (giant cell arteritis)

PREVIOUS HEADACHE Hx: First headache or different (change in attack frequency, severeity, or clinical feature)

21
Q

Acute Subdural Hematoma (pic)

A

Head injurty iwthout fraction of skull

Blood in subdural space, will be filled with density of CSF

Brain is shifted to opposite side
;ventricular system on the side of the hematoma is compressed

22
Q

How can you treat Acute Subdual Hematoma (and what happens if you don’t treat it)

A

Burr hole in skull to relieve pressure

If not treated, patient may herniate

23
Q

What is the timing of Acute Subdural Hematoma

A

Cresendao headache from days to weeks; generally in frontal region

24
Q

Epidural hematoma

A

. But as the epidural hematoma grows, symptoms will develop, including severe headache, nausea and vomiting.

The term epidural hematoma means blood buildup between the dura mater and the skull; hematoma translates to blood mass.

Natasah Richardson

25
Q

Intracerebral Hemorrhage

A

~10% f all strokes

Starts suddenly, then cresendo

first and worst headache

When exercising or lifting weight

26
Q

Primary Headaches- Sudden onset headaches (4)

A
  1. Idiopathic thudnerclap headach (TCH)
  2. Sexual Headache
  3. Exertional Headache
  4. Cough Headache
27
Q

Seocndary headaches- Sudden onset-

A
SAH
Venous Sinus Thrombosis
Pituitary Apoplexy
Arterial Dissection
Meningoencephalitis
Acute Hydrocephalus
Acute hypertension
Spontaneous intracranial hypotension
28
Q

What is SAH (subarachnoid hemorrhage)

A

Acute thunderclap as a prsentaitno of SAH

Rupture in aneurysm of anterior circle of willis

29
Q

WHAT ARE CAUSES OF LOW PRESSURE HEADACHES

A

HANGOVER, dehydrateion

anxiety, fracture of dura’ spontaneous rupture of dura