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Neurology > Headache > Flashcards

Headache Flashcards

1
Q

What could fever, photophobia or neck stiffness be indicative of?

A

Menignitis

Encephalitis

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2
Q

What could new neurological symptoms be indicative of?

A

Haemorrhage

Malignancy

Stroke

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3
Q

What could dizziness be indicative of?

A

Stroke

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4
Q

What could visual disturbance be indicative of?

A

Temporal arteritis

Glaucoma

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5
Q

What could sudden onset occipital headache be indicative of?

A

Subarachnoid haemorrhage

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6
Q

What could headache worsening on coughing or straining be indicative of?

A

Raised ICP

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7
Q

What could postural headache worse on standing, lying or bending over be indicative of?

A

Raised ICP

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8
Q

What could vomiting with headache be indicative of?

A

Raised ICP

Carbon monoxide posoning

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9
Q

What could headache with history of trauma be indicative of?

A

Intracranial haemorrhage

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10
Q

What could headache be indicative of during pregnancy?

A

Pre-eclampsia

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11
Q

What could headache with papilloedema be indicative of?

A

Raised ICP

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12
Q

What is a secondary headache?

A

Similar presentation to tension headache but with a clear cause

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13
Q

Causes of secondary headache

A

Underlying medical conditions e.g. infection, obstructive sleep apnoea or pre-eclampsia

Alcohol

Head injury

Carbon monoxide poisoning

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14
Q

Symptoms of migraine

A

Unilateral throbbing headache preceded by an aura, such as visual or sensory (paraesthesia spreading from fingers to face) symptoms

4-72hrs

Photophobia & phonophobia

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15
Q

Diagnosis of migraine

A

Presence of aura confirms diagnosis

When no aura, following criteria required:
At least 5 headaches lasting 4-72 hours with nausea/vomiting or photo/phonophobia

AND 2 of:
Unilateral headache
Pulsating character
Impaired or worsened by daily activities

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16
Q

Management of migraine

A

Avoid triggers

Prophylaxis with propanolol or topiramate

17
Q

Symptoms of tension headache

A

Bilateral, non-pulsatile headaches

Tight band around head

May be associated scalp muscle tenderness

18
Q

Management of tension headache

A

WHO pain ladder

19
Q

Symptoms of cluster headache

A

Recurrent attacks of sudden-onset unilateral periorbital pain

Watery and bloodshot eye, lacrimation, rhinorrhoea, miosis, ptosis, lid swelling, and facial flushing

Last 15 minutes to 3 hours, occur once or twice a day, over a period of 4-12 weeks

Followed by a pain-free period of months before the next cluster begins

20
Q

Management of cluster headache

A

Avoid triggers

Prophylaxis with verapamil

21
Q

Management of cluster headache acute attack

A

100% oxygen via non-rebreathable mask

Subcutaneous or nasal triptan

22
Q

Management of migraine acute attack

A

Triptan (+ paracetamol or NSAID)

23
Q

Symptoms of trigeminal neuralgia

A

Recurrent short episodes of severe stabbing pain, affecting one side of the face, in the trigeminal nerve distribution

Pain may be triggered by touching the face, eating, or talking

24
Q

Investigations in trigeminal neuralgia

A

MRI to exclude secondary causes e.g. tumour/aneurysm

25
Q

Management of trigeminal neuralgia

A

Carbamazepine first-line

Surgery: microvascular decompression

26
Q

Symptoms of raised ICP

A

Headaches which are worse in the morning and upon bending over, and improve after vomiting and lying down

May be associated with neurological deficits due to compression of cranial structures by a space-occupying lesion, such as a tumour or haemorrhage

27
Q

Diagnosis of raised ICP

A

CT head

28
Q

Management of raised ICP

A

Treat underlying cause e.g. surgery and chemo for cancel, clot evacuation for haemorrhage

29
Q

Sinusitis symptoms

A

Inflammation in the ethmoidal, maxillary, frontal or sphenoidal sinuses

Facial pain behind nose, forehead and eyes

Often tenderness over affected sinus

Usually resolves within 2-3 weeks

30
Q

Management of sinusitis

A

Nasal irrigation with saline can be helpful

Prolonged symptoms can be treated with steroid nasal spray

Antibiotics are occasionally required

31
Q

Occipital, sudden onset, high intensity headache

A

Subarachnoid haemorrhage

32
Q

What is meningism a red flag symptom for?

A

Haemorrhage

Meningitis

33
Q

Present on waking, worse on laying down, social neurological signs, higher cortical dysfunction, autonomic instability, papilloedema

A

Raised ICP

SOL

34
Q

What are visual changes and red eye red flag symptoms for?

A

Acute glaucoma

Surgical 3rd nerve palsy

35
Q

Temporal with associated changes

A

GCA

Neurology (20 decks)

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