Head Flashcards
headache without an identified underlying disease
Primary headache
headache WITH an identified underlying structural, systemic, or infectious diease
secondary headache
migraines, tension, cluster, chronic daily are what type of headaches?
primary
meningitis, mass lesion, subarachnoid hemorrhage are what type of headache
secondary
what does everyheadache warrant
EVALUATION FOR LIFE THREATENING SECONDARY CAUSES
important questions for headaches?
- unilateral or bilateral?
- Severe with sudden onset (thunderclap)
- steady or throbbing?
- continuous or intermittent
most important symptom attributes for headache
- severity
- chronological order
- associated symptoms (double vision, vision changes, numbness, weaknesss, N/V, fever, stiff neck)
what is an unusual feeling such as euphoria, craving for food, fatigue, dizziness, sensitivity to light or sound
Prodrome
what is neurologic symptoms such as change in vision, numbness, tingling, or weakness?
Aura
what are the 4 phases of a migraine?
- prodrome
- aura
- migraine headache
- post drome
what phase of a migraine has irritability, head throbbing, nausea/vertigo, sensitivity
migraine headache
what phase of migraines is hungover feeling and fatigue?
post drome
what are some headache warning signs?
- progressive frequent (3 mths)
- thunderclap feeling
- new onset >50yo
- aggravated/alleviated by change in position
- precipitated by valsalva maneuvar
- fever, night sweats, weight loss
- cofactors of cancer, HIV, pregnancy
- recent heard trauma
- changes
- no prior experiences
- papilledema, neck stiffness, focal neurologic deficits
sudden vertigo with rolling onto the affected side/tilting head; may have n/v or nystagmus
BPPV
spinning sensation within the patient or of the surroundings
vertigo
what disease has a trio of vertigo, sensorineural hearing loss, tinnitus
may also have ear pressure, n/v, nystagmus
Meniere’s Disease
what disease is from compression of cranial never VIII causing vertigo, tinnitus, loss of hearing in one ear
Acoustic neuroma
what happens to the hair with hyperthyroidism
thinning hair
what are the 5 components of a head examination
- hair
- scalp
- skull
- face
- skin
what should you exam the face for?
facial expressions, contours for asymmetry, involuntary movements, edema, masses
what to exam the hair for?
quantity, distribution, texture, pattern of hair loss
what should you exam the scalp for?
scaliness, lumps, nevi, lesions
what should you exam the skull for?
size & contour
deformities, depressions, lumps/tenderness
what should you exam the skin for?
color, pigmentation, texture, thickness, hair distribution, lesions
what is buildup of CSF in the ventricles deep in the brain?
common in children
hydrocephalus
what pathology is an enlarge head with hearing loss or headaches?
paget disease of the bone
what does cushing syndrome do to your face
moon face with red cheeks
may have excess hair growth on the face
what does nephrotic syndrome do to the face
edematous and pale face
swelling around the eyes in the morning
what is characterized by dull, puffy faces with dry skin; nonpitting edema around the eyes; dry coarse hair with loss of lateral eyebrowns
myxedma
when is myxedma seen?
in severe hypothyroidism
what happens to the eyebrowns in cases of severe hypothyroidism/myxedma
loss of the lateral 3rd of the eyebrow
what can cause parotid gland enlargement?
- mumps
- neoplasm
- Sialolithiasis
- Obesity
- diabetes
- cirrhosis
what do you tell a pt who has sialolithiasis
to eat warheads
what causes acromegaly
increased growth hormone
what pathology is an elongated head, bony predominance of the forehead/nose/lower jaw, and soft tissue of the nose/lips/ears?
acromegaly
what disease causes “mask-like” expressions
parkinson disease
what pathology is characterized by facial mobility, decreased blinking, staring, and possibly drooling
parkinson
what is the most common type of headache?
tension
what headache is bilateral or generalized to the back of head or neck
tension headache
how would somenone describe/rate a tension headache?
tightening, steady and mild-moderate
what is the onset of a tension headache
gradual onset lasting 30 min to 7 days
scalp or muscle tenderness are associated symptoms with
tension headache
what can trigger tension headaches
sustained muscle tension, stress, sleep disturbances
what relieves a tension headache
massage, relaxation
are migraines more common in men or women?
women
where are migraines typically located
unilateral is mc; bifrontal or global otherwise
what headache is throbbing with preceding aura
migraine
what is the onset of migraines?
rapid onset & recurrent
prodrome, n/v, photophobia and phonophobia are associated symptoms of
migraine headache
what can trigger migraine headaches
alcohol, certain foods, stress, menses
how do you relieve migraines
quiet dark rooms, sleep
what headache is more common in men
cluster headaches
what is the location of cluster headaches? bilateral or unilateral?
unilateral
behind/around the eye or temple
what headache is sharp, continuous and severe in intensity
cluster
what headache has abrupt onset that lasts 15min to 3hrs
cluster
why is cluster headache called cluster>
headaches are clustered to several each day for weeks
unilateral lacrimation, rhinorrhea, miosis, ptosis is what type of headache?
Cluster
what can aggravate cluster headaches?
alcohol
how do you alleviate cluster headaches?
oxygen
what eye disorders are associated with headaches?
astigmatism and farsightedness
where are headaches from eye disorders olocated?
around/over the eyes and radiates to occipital area
eye fatigue with a “sandy sensation” and redness of the conjunctiva describes
eye disorder headaches
what are the aggravator/alleviators of eye disorder headaches
Aggravator: close work
Alleviator: rest of eyes
what is a sudden increase in IOP causing sudden severe pain in/around one eye?
acute glaucoma
blurred vision, N/V, halos around lights, reddening of eyes is associated with . . .
acute glaucoma
local tenderness, nasal congestion, discharge, fever is associated with what headache?
sinusitis headaches
what sinuses typically cause sinusitis headaches
frontal/maxillary sinuses
what headache is aggravated by leaning forward, coughing, sneezign, jarrying head
sinusitis headache
what headache is generalized, steady, throbbing and severe
menigitis
what are some s/sx of meningitis headaches
- fever
- stiff neck
- photophobia
- change in mental status
thunderclap headache
subarachnoid hemorrhage
what is bleeding from ruptured cerebral aneurysm
subarachnoid hemorrhage
how would you describe a subarachnoid hemorrhage
- generalized and sudden/sever
- “worst headache of my life”
- n/v, loss of conciousness, neck pain
what is the cause of a headache that is progressive, achey, steady, dull, and worse on awakening
brain tumorr
what symptoms are associated with brain tumor headaches
- seizures
- hemiparesis
- field cuts in vision
- personality changes
- n/v
- vision changes
- gait changes
is giant cell arteritis more common in men or women
women older than 50
where is giant cell arteritis headaches located
localized over the temporal artery
what s/sx are associated with giant cell arteritis headaches
- tenderness of temporal artery
- fever
- fatigue
- weight loss
- jaw claudication
- visual loss
- polyarticular joint pain
how quickly is the onset of a post concussion headache
within 7days-3 months of an injury
how long can postconcussion headaches last
weeks-years
what s/sx are associated with post concussion headaches
- drowsiness
- poor concentration
- confusion
- memory loss
- blurred vision
- dizziness
- irritabilyt
- restlessness
- fatigue
*
what headache is shock like, stabbing, buring in the cheek/jaws/lips/gums that is paroxysmal and lasts seconds
trigeminal neuralgia (CN V)
what can trigger trigeminal neuralgia headaches
touching certain areas of the lower face/mouth, talking, brushing teeth
