Headach Flashcards

1
Q

Types of headache

A

1) intracranial
(1ry +2ry)
2ry
-irritatve (meningitis +subarachnoid hge)
-ICP(tumour, hydrocephalus, subdural hge)
2) extracranial
(Local +systemic)
Local (eyes ears and nose)
Systemic (Anemia, hypoglycaemia,depression)

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2
Q

Normal ICP

A

Term infants: 1.5-6
Young children: 3-7
Older children: 10-15

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3
Q

Red Flags:

A
Abnormal neurological exam 
New/ unusual headache 
Worst headache 
Immunocompromised
Stiff neck and fever
Early morning headache 
Seizure
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4
Q

Triptans

A

Rizatriptan (6-17)

Almotriptan (adolescent)

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5
Q

Preventive meds indication

A
has four days or more of disabling headaches per month 
Beta blocker
Calcium channel blocker
TCA 
Valporic acid (sodium channel blocker)
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6
Q

Which headache is related to psychiatric illnesses?

A

Tension headache

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7
Q

What are complex aura with migraines

A

hemiparesis, monocular blindness, ophthalmoplegia, vertigo, confusion)

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8
Q

if the headache and associated vomiting are worse when lying down or on first awakening; awaken the child from sleep; remit on arising; or are exacerbated by coughing, Valsalva maneuver, or bending over. Papilledema or focal neurological deficits

A

Icp

caused by a mass (tumor, vascular malformation) or intrinsic increase in pressure (pseudotumor cerebri).

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9
Q

Contraindications of triptans

A

patients with focal neurological deficits associated with their migraines or signs consistent with basilar migraine (syncope) because of the risk of stroke.

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10
Q

Types of visual aura

A

1) negative phenomena, such as hemianopia (loss of half the visual field) or scotoma
2) positive phenomena such as fortification spectra (seeing zigzag lines).

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11
Q

What is the most affected nerve in ICP

A

The VIth (abducens) cranial nerve has a long intracranial course and is often affected when there is raised pressure, resulting in a squint with diplopia and inability to abduct the eye beyond the midline. It is a false localising sign

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12
Q

Red flags for space occupying lesion

A

Squint ,torticollis, papilloedema , bradycardia

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13
Q

Forms of migraine

A
Familial hemiplegic migraine (Ca channel defect)
Sporadic hemiplegic migraine 
Basilar type (vomiting with nystagmus +/ cerebellar signs
Periodic syndrome (cyclic vomiting, Abdominal migraine, benign vertigo of childhood)
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