HA Flashcards
examples of primary HAs
Migraine Common (without aura) Classical (with aura) Tension Cluster
best way to evaluate a HA pt
careful history and physical examination is your most important diagnostic tool
tension HA
band/vice like
bilateral
ESR is most useful for
GCA, give steroids!
Worst headache of life Nausea and vomiting Focal neurological signs Transient LOC Increased BP
subarachnoid hemorrhage
Severe eye and brow pain Blurred vision, decreased acuity Halos and rainbows N/V, cornea hazy Pupil mid dilated and non-reactive
acute glucoma
Headache most common sx.
CO levels> 10
Usually group presentation
carbon monoxide
Affects Serotonin reuptake in the brain
Chronic- decreased Serotonin uptake
Acute- increased Serotonin uptake
Headaches rebound phenomena
cocaine
initial tx for HAs
tylenol/motrin
how does cluster HA present
Episode: 3 weeks to 3 months in length
Increased spring/fall
One sided, severe, tearing (eye symptoms)
how to tx abortive HA
- 100% O2 for 10-15 min
- steroids
- imitrex
- 4% lidocaine
how to prevent HAs
- CCB verpamil 1st line
- TCA
- topiramate
- valproic acid
migraine criteria
-episodic recurrent HA lasting 4-72 hours plus
2 pain qualities (throbbing, worse w/movement,mod/severe pain, unilateral)
1 associated symptom (N,V, photophobia, phonophobia)
common complaint that goes along with migraine
neck pain
Treatment of choice for pain and symptoms of moderate-to-severe attacks
triptans, work on serotonin (5-HT) causing vasoconstriction
