Headache Flashcards
what is the one-year prevelence of headache disorders?
50%
what are the two types of headache syndrome?
primary and secondary
What are examples of a primary headache syndrome?
migraine, tension-type headache and cluster headache
How are primary headaches classified?
long-lasting or short-lasting
what duration is a short-lasting headache?
less than 4 hours
What two types of primary headache fall under long-lasting?
migraine and tension-type
what type of primary headache falls under short-lasting?
trigeminal autonomic cephalalgia - a cluster headache
What are the common features of migraines?
headache disorders, tendency for repeated headaches, visual vertigo, motion sickness
What causes migraines?
spreading electrical depression across the cerebral cortex
What is a migraine attack?
pain and focal symptoms - aphasia, paraesthesia, weakness
what is an ‘aura’?
sensation that precedes a migraine, can have positive and negative symptoms
what are the positive symptoms of an ‘aura’ ?
bright flashes, zig-zags, expanding Cs
what are the negative symptoms of an ‘aura’ ?
darkness, loss of vision, blindspot
What are the five migraine stages?
prodrome - changes in mood, urination, food craving. Aura - visual, sensory and weakness. Headache - head and body pain, nausea, photophobia. Resolution - rest and sleep. Recovery - mood disturbed, food intolerance, feeling hungover
What types of drugs should be avoided in headache management?
opiate-based and mixed analgesics - can cause a medication overuse headache
When assessing a headache disorder, what red flag symptoms should cause you to consider secondary headache?
Age - new or different headaches in a person 50+. onset - sudden, abrupt, onset of a severe headache (thunderclap headache). Systemic symptoms - fever, neck stiffness, rash, weight loss. Neurological signs - confusion, impaired consciousness, focal neurology, swollen optic discs.
How should migraines be managed?
Avoid triggers, diet, sleep, exercise, mindfulness.
In terms of medication, how should migraines be treat?
Hard and fast. Paracetamol, NSAIDs, prokinetics, Triptans
How do patients describe tension type headaches?
Tight muscles around head and neck as though head is in a vice
How do tension type headaches present?
Bilateral, mild or moderate pain that is not aggravated by movement
Nausea and vomiting is a feature of tension type headaches, true or false?
False
How are tension type headaches treated?
Preventative medications rarely required
How does a cluster headache present?
Severe unilateral pain with ipsilateral conjunctival redness and/or lacrimation, nasal congestion and eyelid oedema
Forehead or facial sweating is a feature of what type of headache?
Cluster headaches
A sense of restlessness or agitation is suggestive of which type of headaches?
Cluster headaches
How are cluster headaches treated acutely?
Nasal or subcutaneous Triptan, high flow oxygen
Why is high flow oxygen prescribed for the acute management of cluster headaches?
Oxygen inhibits neuronal activation in the trigeminocervical complex
Which type of headache is never bilateral?
Cluster headaches
Do migraines show unilateral or bilateral pain?
Unilateral but sometimes bilateral
Pulsating pain is a feature of what type of headache?
Migraine
Which type of headaches are aggravated by or causing avoidance of, routine physical activity?
Migraines
Rhinorroea is a feature of what type of headache?
Cluster headaches
Photophobia and phonophobia are features of what type of headache?
Migraines
How long does a tension-type headache usually last?
Hours to days
How long does a cluster headache normally last?
15 minutes to 3 hours
What is a secondary headache?
Headache is spercipitated by another condition / disorder - local os systemic. Serious causes of secondary headache are uncommon.
