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Med Yr2 > Headache > Flashcards

Headache Flashcards

1
Q

Meningism definition:

A
  • Irritation of the meninges
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2
Q

Meningsm: clinical signs (3)

A
  • Headaches
  • Neck stiffness
  • Photophobia
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3
Q

Kernig’s sign
- Test for?
- Positive test if???

A
  • Test for meningism
  • inability to straighten the leg where the hip is flexed to 90 degrees
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4
Q

Brudzinski’s sign:
- Tests for what?
- Positive test if?

A
  • Meningism
  • Patient’s hips and knees to flex when the neck is flexed
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5
Q

Encephalitis definition:

A
  • Inflammation of the brain parenchyma
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6
Q

Encephalitis symptoms:
- Specific symptoms (3)
- General symptoms

A
  • Personality/behavioural changes
  • Seizures
  • Focal neurological deficit (body function issues)
  • Fever, headache, confusion
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7
Q

Causes of viral encephalitis: (3)
H
E
T

A
  • HSV
  • Enteroviruses
  • travel related viruses
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8
Q

Meningitis definition:

A
  • Inflammation of the meninges
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9
Q

Causes of meningitis: (2)

A
  • Neissera meningitidis
  • Streptococcus pneumoniae
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10
Q

Meningitis symptoms:
- Specific (4)
- General

A
  • Rash
  • Neck stiffness
  • Vomiting
  • Shock
  • Fever, headache, confusion
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11
Q

Cerebral abscess definition:

A
  • Focal collection within the brain parenchyma, which can arise as a complication of a variety of infections, trauma, or surgery
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12
Q

Cerebral abscess: symptoms
H
S
F
C
F N

A
  • Headache
  • Seizures
  • Fever
  • Confusion
  • Focal neurology
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13
Q

Cerebral abscess: causes (2)

A
  • Staphylococcus aureus
  • Streptococcus spp
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14
Q

Cerebral malaria: definition

A
  • Severe form of P.falciparum malaria that causes cerebral manifestations
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15
Q

Cerebral malaria: symptoms
F
H
G M
GI
R C
S

A
  • Fever
  • Headache
  • General malaise
  • GI symptoms in children
  • Reduced consciousness
  • Seizures
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16
Q

Cerebral malaria: causes

A
  • P. falciparum (parasite) transmitted following bite from infected female anophele’s mosquito
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17
Q

Features of severe malaria:
H
A
S B
P O
S

A
  • Hypoglycaemia
  • Acidosis
  • Spontaneous bleeding
  • Pulmonary oedema
  • Shock
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18
Q

Clinical features of headache due to sinusitis:
- Pain
- At least 2 of these N…. symptoms

A
  • Frontal Headache
  • At least two of these nasal symptoms:
    1. Nasal blockage
    2. Rhinorrhoea/discharge
    3. Loss of smell
    4. Facial pressure/tenderness
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19
Q

Imaging modalities for cranial infections: (2)

A
  • CT scan for head
  • MRI for brain
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20
Q

Microbiological investigations for diagnosis of cerebral infections: (3)

A
  • Blood cultures (prior to antibiotics)
  • Bacterial and viral throat swabs
  • CSF (if safe)
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21
Q

Microbiological investigations for:
- Meningococcal
- Enterovirus

A
  • Meningococcal: blood
  • Enterovirus: pneumococcal PCR stool
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22
Q

What to do if meningococcal infection is suspected?: (3)

A
  • MEDICAL EMERGENCY
  • Treatment required before results of investigation
  • Immediately administer benzylpenicillin or ceftriaxone
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23
Q

What to do if HSV Encephalitis is suspected?:
- Drug : IV A…

A
  • NEUROLOGICAL EMERGENCY
  • Requires treatment before results of investigation
  • Administer IV Aciclovor 10mg/Kg TDS for 14-21 days
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24
Q

What factors enhance Antibiotic CSF entry?: (3)

A
  • High lipid solubility
  • Low molecular weight
  • Low protein binding
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25
Q

Which antibiotics cannot pass the blood brain barrier?: (2)
T
A

A
  • Tetracyclins
  • Aminoglycosides
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26
Q

Arterial supply: what does the Internal carotid artery supply

A
  • Anterior circulation of the brain
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27
Q

Arterial supply: What does the Vertibrobasilar artery supply?

A
  • Posterior circulation of the brain
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28
Q

Arterial supply: what is the role of the circle of willis?

A
  • Anastomosis of ICA and basilar artery
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29
Q

What is the basic venous drainage of the brain?

A
  • Blood from veins drains into venous sinuses and eventually into the internal jugular vein
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30
Q

Munro-Kellie Doctrine’s Hypothesis:

A
  • The skull is a rigid box containing blood, brain and CSF. If volume of any of these increases so does ICP
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31
Q

Causes of increased ICP: (4)

A
  • Space occupying lesions
  • Cerebral oedema
  • Intracranial haematoma
  • Obstruction of CSF drainage
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32
Q

Cerebral Perfusion Pressure (CPP):

A
  • The net pressure gradient that drives oxygen to cerebral tissue
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33
Q

Relation of CPP, MAP, and ICP:

A
  • CPP = MAP - ICP
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34
Q

What can cause a catastrophic decrease in Cerebral Perfusion Pressure?:

A
  • A pathological increase in ICP and/or a pathological fall in MAP can lead to decreased CPP
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35
Q

How does hypoxia cause loss of consciousness and neuronal death?:

A
  • A fall in CPP can result in cerebral ischaemia and eventually neuronal death
  • Hypoxia = loss oxygen in blood, so decreased CPP
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36
Q

Effect of hypocapnia on cerebral resistance:

A
  • Hypocapnia -> cerebral vasoconstriction -> increased cerebral resistance
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37
Q

Effect of hypercapnia on cerebral resistance:

A
  • Hypercapnia -> cerebral vasodilation -> decreased cerebral resistance
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38
Q

Metabolic hyperaemia:
- Definition
- Relation to cerebral metabolic rate

A
  • The process by which the body adjusts blood flow to meet the metabolic needs of different tissues
  • Increased cerebral metabolic -> increased cerebral blood flow
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39
Q

Cerebral autoregulation in CPP maintenance
- Regular ranges of MAP

A
  • CBF remains fairly constant
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40
Q

Sympathetic innervation in vascular headaches:
- Ascends from ..
- Innervates and causes
- Reason for this ???

A
  • Ascend from superior cervical ganglion
  • Innervation of arteries on brain surface, causing cerebral vasoconstriction in response to sudden increase in MAP
  • Protects smaller downstream vessels from sudden surge in pressure
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41
Q

Sympathetic innervation and migraines:

A
  • Decreasing neuronal activity in cerebral cortex
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42
Q

Blood Brain Barrier (BBB): descriotion

A
  • A highly selective permeable barrier between capillary blood and ECF in the CNS
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43
Q

BBB structure:
- Endothelial
- Astrocytes

A
  • Formed by tight junctions between capillary endothelial cells
  • Astrocytes regulate permeability
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44
Q

BBB role:

A
  • Protects brain against harmful molecules and organisms
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45
Q

Diseases that disrupt the BBB: Eclampsia

A
  • Eclampsia:
    Increase in BBB permeability -> cerebral oedema
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46
Q

Diseases that disrupt the BBB: Meningitis

A
  • Meningitis
    Makes BBB more permeable to toxins and some antibiotics
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47
Q

Diseases that disrupt the BBB: HIV virus

A
  • Crosses barrier to hide in monocytes and causes encephalitis
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48
Q

Cerebral vein thrombosis:

A
  • Presence of a blood clot in the dural venous sinuses or/ and the cerebral veins
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49
Q

Optic lesions: location and effect
- Optic nerve

A
  • Optic nerve -> right/left anopsia (blind)
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50
Q

Optic lesions: location and effect
- Optic chiasm

A
  • Optic chiasm -> bitemporal hemianopsia
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51
Q

Optic lesions: location and effect
- Optic tract

A
  • Optic tract -> homonyous hemianopsia (same sided 1/2 blind)
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52
Q

Damage to optic radiation fibres: location and effect

A
  • Temporal lobe -> upper quadrantanopia
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53
Q

Direct light reflex:

A
  • Ipsilateral pupil constricts (same side of body as stimulus)
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54
Q

Consensual light reflex:

A
  • Contralateral pupil constricts (opposite side of body as stimulus)
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55
Q

Pathway of light reflex:

A
  • Stimulus causes optic nerve to send signal to occulomotor nerve
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56
Q

Cerebrospinal fluid (CSF) production:

A
  • Choroid plexus mainly in the lateral ventricles
  • 500 mls per day
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57
Q

Blood-CSF barrier structure:

A
  • Capillary endothelial cells joined by tight junctions to form blood-CSF barrier
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58
Q

Metabolic function of CSF: (3)

A
  • Helps maintain a constant environment for brain cell
  • Drains unwanted metabolites in to venous blood
  • Transports hormones around the brain
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59
Q

Intracranial idiopathic hypertension:
- Cause
- Exacerbating factors?
- Signs?
- Treatment

A
  • Unknown
  • Coughing, and sneezing
  • Headache, Papilloedema
  • Refer to neurologist, CT/MRI to exclude other ICP issues
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60
Q

Hydrocephalus:

A
  • Accumulation of CSF in ventricles in the brain, resulting in increased ICP
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61
Q

Non-communicating hydrocephalus:

A
  • A blockage within ventricles (between interventricular foramina and median aperture)
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62
Q

Communicating hydrocephalus:

A
  • Failure to drain CSF via arachnoid granulations
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63
Q

Features of a headache due to raised ICP: (7)
H
V D
S
D L
A P
C R

A
  • Headache, worse in morning
  • Nausea and vomiting
  • Visual disturbances
  • Seizure
  • Decreased level of consciousness
  • Abnormal posturing
  • Cushing response
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64
Q

Coup and contracoup pattern injuries:

A
  • Coup: brain collides with part of skull that has collided with object
  • Contracoup: bran rebounds and collides with side of skull opposite to trauma
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65
Q

How to spot papilloedema?:

A
  • Retinal disc is much blurrier
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66
Q

Temporal lobe herniation:
- Herniates where?
- Causes (2)

A
  • Herniation of part of the temporal lobe over the tentorium cerebelli
  • Causes ipsilateral CN III palsy and blown pupil
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67
Q

Uncal herniation:

A
  • Temporal lobe herbiates over the tentorium cerebelli
  • Causing ipsilateral CN III palsy and blow pupil
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68
Q

Cerebellar tonsil herniation:

A
  • Down through the foramen magnum, can be rapidly fatal (DO NOT LUMBAR PUNCTURE)
69
Q

Decorticate positioning:
- indication
- What is it?
- GCS
- Damage to….

A
  • Indicates severe brain injury
  • Flexor response spontaneously or in response to pain
  • GCS: M3
  • Damage to upper pons
70
Q

Decerebrate positioning:
- indication
- What is it?
- GCS
- Damage to….

A
  • Severe brain injury
  • Extensor response spontaneously or in response to pain
  • GCS: M2
  • Damage to upper pons
71
Q

Cushing response/reflex:

A
  • Attempts to raise MAP to increase CPP and CBF
  • Triggered by brainstem ischaemia due to +ICP
  • ## Indicates death may be imminent unless ICP reduced
72
Q

Acute subdural haematoma:
- Location
- Mechanism
- Source
- Shape
- Presentation

A
  • Between the dura and arachnoid
  • Trauma
  • Venous (bridging veins)
  • Crescent, hyperdense
  • May be insidious
73
Q

Extradural haematoma:
- Location
- Mechanism
- Source
- Shape

A
  • Between the dura and the bone
  • Fracture
  • Arterial, active bleeding
  • Bi-convex
74
Q

Contusion:
- Description
- Location
- Shape

A
  • Bruising of parenchymal brain tissue
  • Often frontal pole
  • Wedge shaped, hyperdense
75
Q

For CT scans of the brain:
- Dark structures
- Brighter structures

A
  • Dark = hypodense
  • Brighter = Hyperdense
76
Q

Epidural definition:

A
  • Bleed between skull and dura mater, expands rapidly
77
Q

Subdural definition:

A
  • Bleed between dura mater and arachnoid mater expands slowly
78
Q

Incidentaloma:

A
  • A radiological neologism to denote a lesion found incidentally and of dubious clinical significance
79
Q

Sacular (berry) aneurysm:

A
  • Weakness in the wall of a cerebral artery or vein causes a localised dilation of the blood vessel
80
Q

Charcot-Bouchard aneurysm:

A
  • Microaneurysms in the brain that occur in small penetrating blood vessels
  • Cause hypertensive haemorrhages
  • Diameter less than 300 micrometers
81
Q

Intraparenchymal haemorrhage:
- definition
- Mechanism
- Presentations
- Source
- Appearance

A
  • Bleeding inside the brain
  • High BP, arteriovenous malformation, tumour trauma etc
  • Acute (nausea, headaches, vomiting)
  • Arterial or venous
  • Typically rounded bleed
82
Q

Subarachnoid haemorrhage:
- Mechanism
- Presentations
- Source
- Appearance

A
  • bleeding between the arachnoid and pia mater
  • Rupture of aneurysms, arteriovenous malformations or trauma
  • Acute (worst headache of life)
  • Predominantly arterial
  • White area that tracks along sulci and fissures
83
Q

Subdural Haemorrhage:
- Mechanism
- Cause
- Presentations
- Source

A
  • Bleed between dura and pia mater
  • Trauma
  • Insidious (worsening headache)
  • Bridging veins
84
Q

Acute subdural haemorrhage:
- Time
- Imaging

A
  • Developed over 72 hours
  • Hyperdense crescent/banana shape
85
Q

Chronic subdural haemorrhage:
- Time
- Imaging

A
  • Develop over the course of weeks
  • Hypodense crescent/banana shape
86
Q

Epidural Haematoma:
- Mechanism
- Presentations
- Source
- Imaging

A
  • Bleed between the dura mater and the skull
  • Trauma or after surgery
  • Skull fracture, altered mental status
  • Arterial
  • Convex/lemon shape collection of blood
87
Q

Epidemiology of patients presenting with headache:
- Primary
- Secondary

A
  • All headache presents to primary care
  • Serious cases referred to secondary care, 2 week cancer referral
88
Q

Benign thunderclap headache:
- Character
- Association
- Diagnosis

A
  • Sudden onset headache (<1minute), Maximum intensity
  • Associated with subarachnoid haemorrhage
  • Diagnosis of exclusion
89
Q

Migraine:
- Symptoms
- Duration
- Prevalence

A
  • Bad headache, nausea, photophobia, phonophobia, osmophobia
  • 3-72 hrs
  • women>men
90
Q

Cluster headache:
- Description
- Duration
- Unilateral …..
- Behaviour
- Timing
- Gender prevalence

A
  • Severe side locked headache
  • 30-90 mins
  • Unilateral (red eye, tearing, nasal stuffiness)
  • Pacing behaviour
  • Circadian, circannual
  • Men>women
91
Q

Temporal (Giant cell) Arteritis:
- Age range
- Symptoms
- Signs
- Treatment

A
  • Over 50 yrs
  • Tender scalp, thick temporal arteries, fever, blindness
  • Retinopathy, Raised inflammatory markers
  • Steroids and biopsy ASAP
92
Q

Acute glaucoma:

A
  • Increased occular pressure
  • Eye pain, rock hard eye, blurred vision, mid dilated pupil, vomiting
93
Q

Sinusitis:
- Description
- Symptoms
- Risks

A
  • Inflammated airway sinuses
  • Nasal discharge, Facial pain/pressure, frontal headache
  • Sphenoid sinusitis can be dangerous
94
Q

Tension headache:
- Description
- Prevalence

A
  • mild, featureless headache, Band around head
  • most common
95
Q

Analgesic headache:
- Cause
- How to avoid (2)

A
  • Caused by pain killers, e.g. opiates can turn migraines into chronic dull headaches
  • Avoid paracetamol/NSAIDS for 15 days/month
  • Avoid opiates/compound analgesics/triptans more than 10 days/month
96
Q

Trigeminal neuralgia:
- Cause
- Symptoms
- Duration

A
  • Occurs in old people, skin sags, causing blood vessel to rub on the trigeminal nerve roots
  • Severe, unilateral, electric pain. Cheek + jaw > forehead
  • Usually less than 2 mins
97
Q

High ICP causing headache:

A
  • High ICP stretches the dura, causing pain
98
Q

Low ICP causing headache:

A
  • Low ICP stretches nerves and blood vessels causing pain
99
Q

Carbon monoxide poisoning in headache:
- Symptoms
- Index of suspicion
- Consequence

A
  • low level CO poisoning can cause headache, fatigue, confusion
  • High index of suspicion, esp. when multiple people
  • Multiple deaths can occur if missed
100
Q

Subarachnoid Haemorrhage (SAH): symptoms (4)

A
  • SUDDEN ONSET (thunderclap) that persists
  • Neck stiffness
  • Altered consciousness
  • Photophobia
101
Q

Subarachnoid haemorrhage (SAH): clinical features (2)
- Main cause
- Tests

A
  • Aneurysm in 77%
  • CT, LP after 12 hrs
102
Q

SAH grading: grade 1
- State of consciousness
- Symptoms (2)
- Mistaken for ..,

A
  • Alert
  • mild headache
  • stiff neck
  • mistaken for benign thunderclap
103
Q

SAH: grade 2
- State of consciousness
- Symptoms (3)

A
  • Alert
  • Vision problems
  • Moderate to severe headache
  • Stiff neck
104
Q

SAH grades: grade 3
- Consciousness
- Symptom

A
  • Lethargy/confusion
  • Weakness or partial paralysis on one side of body
105
Q

SAH grades: grade 4
- Consciousness
- Symptoms

A
  • Stupor
  • Moderate to severe paralysis on one side of body
106
Q

SAH grades: grade 5

A
  • Comatose
107
Q

Acute meningitis: clinical signs
H
F
N
R
C
F N

A
  • Headache
  • FEVER
  • Neck stiffness
  • Rash
  • Confusion
  • Focal Neurological signs
108
Q

Chronic meningitis clinical signs: (3)
C N …
R
I E

A
  • Cranial nerve palsy
  • Radiculopathy
  • Ischaemic events
109
Q

Chronic meningitis causes: (3)
I
M
A

A
  • Infection: TB, lyme, fungal
  • Malignant
  • Autoimmune: sarcoidosis, behcet’s syndrome
110
Q

Low pressure headaches: causes (3)

A
  • Iatrogenic: post trauma, post LP
  • Lesional
  • Postural/diural
111
Q

Low pressure headache: treatment

A
  • Seal the leak of CSF
112
Q

Harmless headaches:
- Duration
- Occurence
- Location

A
  • Long duration
  • Most are episodic
  • Many lateralised
113
Q

What is tested in a lumbar puncture?: (5)
O
M & C
V
P
G

A
  • Opening pressure
  • Microscopy and culture
  • Viruses (PCR)
  • Protein
  • Glucose (paired serum)
114
Q

Diagnostic use of lumbar puncture:
Used for suspected ……. (4)

A
  • neurological infection
  • Subarachnoid haemorrhage
  • Neuroinflammatory disease
  • CNS malignancy
115
Q

Therapeutic use of lumbar puncture: (2)

A
  • Lowers ICP in people with idiopathic intracranial hypertension
  • Intrathecal administration of drugs e.g. methotrexate
116
Q

Contraindications of lumbar puncture:
intracranial imaging (what may cause you to scan before LP?)
- Examples (5)

A

CT or MRI used prior to LP especially if:
* Altered mental state (reduced GCS or fluctuating conscious level)
* Papilloedema
* Headache (suggestive of raised ICP)
* Focal neurological signs
* Recent seizure

117
Q

Complications of lumbar punctures and how to prevent them:
Headache
Pain
Bleeding
Infection
Spinal damage
Cerebral herniation

A
  • Post LP headache (atraumatic needles)
  • Pain (local anaesthesia)
  • Bleeding (check clotting, anticoagulants/platelets)
  • Infection (aseptic technique)
  • Spinal damage
  • Cerebral herniation (Avoid raised ICP)
118
Q

Anatomical landmarks for a lumbar puncture:
- Key positioning
- Key layers

A
  • Left lateral position, LP needle L3/4
  • Ligamentum flavum (pop), subarachnoid space (CSF)
119
Q

Visual appearance of CSF:
- Healthy

A
  • Clear and colourless
120
Q

Investigation of idiopathic intracranial hypertension:
- Diagnosis

A
  • Diagnosis of exclusion - other causes need to be sought with history, imaging and CSF
121
Q

Idiopathic intracranial hypertension: symptoms (4)

A
  • Raised pressure headache
  • Pulsatile tinnitus
  • Visual loss
  • Diplopia
122
Q

Idiopathic intracranial hypertension: signs (3)

A
  • Papilloedema
  • VF defect and 6th palsy
  • LP shows a raised opening pressure (>25cm H20)
123
Q

LP as a therapeutic treatment for idiopathic intracranial hypertension:

A
  • CSF drained to a closing pressure of less than 20 cm H20
  • Aim is the preservation of vision/alleviation of symptoms
124
Q

Multiple sclerosis:

A
  • Damage to insulating cover of nerve cells of brain and spinal cord
125
Q

Diagnosis of MS: (1 of 3)

A
  • Clinical presentations alone (2 or more relapse/signs)
  • Clinical presentations & MRI
  • Clinical presentation and CSF (+/-MRI)
126
Q

How to test for MS in CSF: (2)
- Electrophoresis
- CSF

A
  • Oligoclonal bands of IgG on electrophoresis
  • Posistive if proteins present in CSF not serum
127
Q

Use of CSF in bacterial meningitis:

A
  • Identification of pathogen allows for tailoring of antimicrobial therapy
128
Q

Diagnostic sign of viral meningitis in CSF:

A
  • CSF clear with high White cell count
129
Q

CSF positive test for subarachnoid haemorrhage: (2)

A
  • RBC must be high in all tubes to distinguish from trauma
  • Xanthochromia (presence of bilirubin)
130
Q

LP not performed in suspected SAH if: (2)

A
  • CT Positive
  • CT negative within 6hrs onset + low index of suspicion
131
Q

Definition of domestic violence and abuse:

A

Any incidents or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality

132
Q

Types of headache associated with domestic violence: (3)

A
  • Tension headache
  • Migraine headache
  • Traumatic brain injury
133
Q

Response to headache and current domestic violence: (4)

A
  • Enquire about immediate safety
  • Refer to specialist domestic violence service
  • Tackle underlying stress
  • Follow up
134
Q

Response to headache and past domestic violence:

A
  • Enquire about safety
  • Tackle underlying stress
  • Follow up
135
Q

Questions to identify domestic violence during history taking: (3)

A
  • How are things at home?
  • Is that something that might be affecting you?
  • Could that be something that’s…..
136
Q

Treatment of migraine - step1: over the counter analgesics (2)

A
  • Paracetamol: inhibits central prostaglandin production
  • NSAIDS: inhibition of prostaglandin synthesis on COX-1/2 enzymes
137
Q

Treatment of migraines - step 2: Triptans (5-HT1B agonist)

A
  • Stimulation of 5-HT1B receptors on smooth muscle cells causes cranial vasoconstriction, relieving migraine
138
Q

Treatment of migraines - step 2: triptans (5-HT1D agonist)

A
  • Stimulation of 5-HT1D receptors blocks the release of vasoactive peptides from
    the trigeminal nerve, which convey nociceptive information to the thalamus
139
Q

Triptan effectiveness:
- Tension
- Migraines

A
  • Not effective for tension headaches
  • Not a cure for migraines
140
Q

Migraine treatment - Step 3:

A
  • Triptans + NSAIDs
141
Q

Prophylaxis of migraines: Tricyclic antidepressants (2)

A
  • Inhibits reuptake of Noradrenaline and 5-HT (serotonin)
  • NMDA receptor antagonist
142
Q

Tricyclic antidepressants: examples (2)
Amit….
Desip….

A
  • Amitriptyline
  • Desipramine
143
Q

Prophylaxis of migraines: topiramate
- Blocks ….
- Inhibits ….
- Enhances ….
- Inhibits …

A
  • Blocks voltage-dependant na+ and K+
  • Inhibits excitatory glutamate pathway
  • Enhances inhibitory effects of GABA
  • Inhibits carbonic anhydrase
144
Q

Prophylaxis of migraines: Candesartan
- Role
- Action

A
  • Angiotensin II type 1 receptor antagonist
  • Inhibits vasoconstriction by blocking AT1 receptors in smooth muscle
145
Q

Prophylaxis of migraines: propanolol
- Action

A
  • Beta blocker
146
Q

Treatment of tension type headaches: (2)

A
  • Analgesics
    -TCA’s
147
Q

Acute treatment of cluster headaches: (2)

A
  • Oxygen
  • Triptans
148
Q

Preventative treatment of cluster headaches:
- Ca
- C
- L C

A
  • Calcium channel blockers
  • Corticosteroids
  • Lithium carbonate
149
Q

Classification of rebound headache (med overuse): (3)

A
  • Headache occurs 15 or more days a month
  • Overuse for more than 3 months (10+ days a month)
  • Marked worsening of headache during overuse
150
Q

Pathophysiology of rebound headache: (3)
G
R & E
P

A
  • Genetic disposition
  • Receptor and enzyme physiology regulation
  • Physical dependency
151
Q

Incidence and significance of brain tumours:
- New cases per year
- Deaths per year
- Survival rate
- Preventable %
- Child population

A
  • 12,000 +
  • 5,000+
  • 12% survive
  • 3%
  • 2nd most
152
Q

Primary brain tumours:
- Defintion
- Examples of cells (5)
A
O
C P
E
N

A
  • Intrinsic, originates from cell types native to the brain
  • Astrocytes, oligodendrocytes, choroid plexus, ependymal cells, neurons
153
Q

Secondary brain tumours:

A
  • Metastatic, derived from cell that have spread from elsewhere in the body
154
Q

Most common primary tumours in:
- Adults
- children (0-14) & (15-19)

A
  • Meningioma
  • Pilocytic astocytoma (0-14)
  • Pituitary (15-19)
155
Q

General brain cancer symptoms: (4)
- H
- S
- C
- N

A
  • Headaches
  • Seizures
  • Cognitive decline
  • Nausea
156
Q

Symptoms for frontal brain mass: (3)
P
I
L

A
  • Personality/behaviour/emotional changes
  • Impaired judgement
  • Loss of vision
157
Q

Symptoms for temporal brain mass: (4)
P
A
C P S
M

A
  • Personality changes
  • Auditory hallucinations
  • Complex partial seizures
  • Memory difficulties
158
Q

Symptoms for occipital brain mass: (2)

A
  • Visual loss
  • Visual hallucinations
159
Q

Symptoms for parietal brain mass: (4)

A
  • Receptive aphasia (L)
  • Spatial disorientation (R)
  • Impaired speech
  • Lack of recognition
160
Q

Symptoms of brainstem mass: (5)

A
  • Difficulty speaking or swallowing
  • Drowsiness
  • Headache
  • Hearing loss
  • Unilateral facial muscle weakness
161
Q

Brain biopsy:

A
  • Removal of a small sample of brain tissue for neuropathological examination to establish a diagnosis
162
Q

Common primary sources for secondary brain tumours: (6)

A
  • Lungs
  • Breasts
  • Colon
  • Melanoma
  • Kidney
  • Choriocarcinoma
163
Q

Size classifications of pituitary tumours: Ring enhancements

A
  • Ragged ring
  • Smooth ring
  • C shaped
164
Q

Which brain cancers are?: ragged ring (2)

A
  • Glioblastoma
  • Metastasis
165
Q

What brain cancer type is a smooth ring?:

A
  • Abcess
166
Q

Which brain cancer type is C shaped?:

A
  • Demyelination in MS
167
Q

Which brain cancer types have a cyst with a nodule?: (3)
p a
H
G

A
  • pilocytic astrocytoma
  • Haemangioblastoma
  • Ganglioma
    ALL IN CEREBELLUM
168
Q

Brain cancer types with solid enhancements: (3)
M
S
C

A
  • Meningioma
  • Schwannoma
  • CNS lymphoma
169
Q

Infiltrative brain tumour:

A
  • Astrocytoma

Med Yr2 (12 decks)

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