headache

Question 1

name the 7 causes of headache and its mechanism

Answer 1

1. migraine: neurally induced inflammation and dilation of intracranial and extracranial vessel
2. tension type headache: increase in sensitivity of pain mediating system
3. cluster: neurally induced inflammation and oedema of internal carotid artery
4. intracranial mass lesion (brain tumor, hydrocephalus): displacement of pain sensitive vessels
5. low ICP: traction through brain sagging on dural attachment; intracranial vasodilation
6. meningitis, SAH: inflammation of vessels in the meninges and perivascular dura
7. temporal arteritis and intracranial vasculitis: inflammation of scalp and intracranial vessels

Question 2

what are the investigations done for headache (4)

Answer 2

1. blood test
2. CSF
3. imaging
4. biopsy

Question 3

what are the criteria for common migraine

Answer 3

without aura:
- 5 attacks lasting 4 to 72hr with at least 2 characteristics (unilateral, pulsating, moderate to severe, pain aggravated by exertion or physical activity)
- during an attack must have at least one the symptom (nausea/vomiting, photophobia, phonophobia)

Question 4

what is the difference between common and classic migraine

Answer 4

classic has aura and symptoms of neurological dysfunction occurring before or during the attack

Question 5

what are the types of aura (3)

Answer 5

1. visual
2. sensory
3. others - monoparesis, hemiparesis, dysphagia and cognitive changes