Headache Flashcards

1
Q

The primary headache syndromes include :

A
  1. Cluster
  2. Migraine
  3. Tension
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2
Q

Secondary causes of headache include:

A

▪️Meningitis
▪️Intracranial bleeding (SAH)
▪️Neoplasia
▪️Hydrocephalus / IIH
▪️Acute sinusitis
▪️ Giant cell (Temporal) arteritis
▪️Medication overuse

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3
Q

Headache with fever & stiff neck

A

CNS infection “Meningitis”

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4
Q

“The worst headache of my life”

A

Subarachnoid hemorrhage

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5
Q

Headache with pain/fullness behind the eyes or over the cheeks or forehead + Tenderness + worse with straining / coughing / leaning forward

A

Sinusitis

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6
Q

Headache Pain over the occiput + neck stiffness

A

Cervical spondylosis

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7
Q

Generalized headache in obese female,
worse in the morning ☀️+ papilledema + drowsiness & vomiting + worse with coughing

A

Idiopathic intracranial hypertension

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8
Q

Headache unilateral lancinating pain over V2/V3 triggered by light touch

A

Trigeminal neuralgia

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9
Q

What are the features of Migraine headache ?

A

Pulsitile
One day (4-72 hr)
Unilateral
Nausea / vomiting
Disabling (photophobia/phonophobia)
“Aura” - before headach

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10
Q

What are the features of cluster headache ?

A

Unilateral
15 min - 3 hr [repetitive]
Excruciating periorbital pain
Awaken patient from sleep
+ autonomic symptoms (lacrimation, rhinorrhea..)
+ Horner syndrome

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11
Q

What are the features of Tension headache ?

A

Bilateral
Steady “band-like”
Stress
+ Neck / shoulder tenderness
عادي يكتب في السؤال throbbing

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12
Q

Acute treatment of Cluster headache […]

A

100% Oxygen
Triptans

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13
Q

Acute treatment of Migraine headache […]

A

1st (mild): NSAIDs
2nd (N/V): Triptans (N/V » nasal / SC Triptan)
3rd: Ergotamine
Antiemetics

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14
Q

Acute treatment of Tension headache […]

A

NSAIDs
Acetaminophen

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15
Q

Prophylactic treatment of Cluster headache […]

A

Verapamil (CCB)

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16
Q

Prophylactic treatment of Migraine headache […]

A

ß-blockers
TCA (amitriptaline)
Topiramate / Valproate
Botulinum toxin
anti-CGRP monoclonal antibody

17
Q

Prophylactic treatment of Tension headache […]

A

«TCA for Tension»
Behavioral therapy

18
Q

First line treatment of Trigeminal neuralgia

A

Carbamazepine

19
Q

The first step for diagnosis of patient presenting with headache

A

Full history and examination

20
Q

If you suspect SAH what is the first diagnostic test ?

A

CT head

21
Q

What diagnostic test confirm SAH if CT was negative?

A

LP .. “xanthochromia”

22
Q

What diagnostic test confirms sinusitis ?

A

CT paranasal sinuses

23
Q

Elderly with Unilateral headache at temporal area + visual changes + “jaw claudication” + 🔺ESR
Jaw pain during eating & weight loss

A

Temporal arteritis

24
Q

Headache + 🔺 ESR
What is your next step

A

High dose steroids
(Dont wait for biopsy!)

25
Q

How to confirm diagnosis of Temporal arteritis ?

A

Biopsy

26
Q

Which primary headache syndrome present with autonomic symptoms ?

A

Cluster
sweating, facial flushing, nasal congastion, lacrimation

27
Q

Which primary headache syndrome associated with trigger ?

A

Migraine
certain food, hunger, sleep disruption

28
Q

Use of over the counter pain medication for 10-15 days

A

Medication overuse headache