Headache Flashcards
Examples of PRIMARY Headaches (3 total)
Migraine
Tension
Cluster (Trigeminal Autonomic Cephalgias)
Examples of SECONDARY Headaches (4 total)
Trauma
Vascular
Substance use/overuse/withdrawal
Infection
Symptoms of migraine that are diagnostic criteria
POUND
Pulsatile hOurs (at least 30 mins) Unilateral (either side) Nausea (+/- vomiting) Disabling
True or False: Most migraines are preceded by an aura (flashing lights)
False; 75% are without an aura
These are examples of
Visual (scintillation or loss)*
Tinnitus
Paresthesias
Inability to move
*visual most common
“Auras” for migraines
Noise, Exercise, Diets, Stress, Hormones (women), Alcohol, Smells, Changes in altitude, and Caffeine are triggers for
migraines
Treatments for Migraines (Abortive)
- Triptans (affect the serotonin system)
- NSAIDs
Treatments for Migraine (PROPHYLAXIS)
Cardio: Beta and Ca Channel Blockers
Epilepsy: Valproic acid and Topiramate
Psych: TCAs and Venlafaxine
Botox (botulinum)
- mab (monoclonal antibodies)
Migraine treatment; 5HT agonist (potential for serotonin syndrome); CONTRAINDICATED in history of MIs and Stroke
Triptans
You would want to avoid prescribing a patient with Triptans who also takes what classes of drug
MAOi (cause Serotonin Syndrome)
Triptans can cause what life-threatening condition
Serotonin Syndrome
*also want to avoid in pts with MIs and Strokes
PRIMARY Headache; MOST COMMON; diffuse, circumferential, mild to moderate pain like there is a “tight band around their head”; due to the Trigemino-Vascular system
Tension
Treatment for Tension Headaches
NSAIDs Behavioral adjustments (avoid triggers)
PRIMARY Headache; UNILATERAL; occur everyday at the same time with symptom-free periods in between; exacerbated by ANY amount of alcohol; NOT relieved by rest;
Cluster
Which type of Primary Headache is NOT relieved by rest
Cluster
Which type of Primary Headache is exacerbated by ANY amount of alcohol
Cluster
Treatments for Cluster Headaches
Oxygen Triptans Prednisone Avoid Alcohol Prophylaxis: -mab (monoclonal antibody)
The red flag symptoms for headaches
SNOOP
Systemic symptoms Neurological signs Onset abrupt Older Positional/Papilledema
Signs/Symptoms of Intracranial HTN
Headache
Papilledema
Tinnitis
Visual obscurations
Intracranial HTN is usually in (young/old) (males/females)
Young Females
*usually also obese
Treatments for Intracranial HTN
topiramate (also aid with weight loss)
Shunts
Weight loss
Secondary Headache; caused by low CSF pressure; worse when sitting and standing but BETTER when lying flat
Intracranial HYPOtension (“Spinal Headaches”)
Intracranial Hypotension, or “Spinal Headaches”, are worse with __________ and better with ___________
Worse:sitting/standing
Better: lying flat
Treatment for Intracranial Hypotension (“Spinal Headaches”)
Lie flat
Analgesics
Caffeine
Secondary Headache; due to the daily use of pain relievers for headaches; need more and more medication to achieve relief
Analgesic Rebound Headaches
Excruciating UNILATERAL pain in the Trigeminal nerve distribution; intense, stabbing, and electric shock-like; caused by blood vessel pressing on the trigeminal nerve
Trigeminal Neuralgia (Tic Doloureux)
Treatment for Trigeminal Neuralgia
Carbamazepine (anticonvulsant)
Surgery
