headache 🤕

Question 1

types of headache

Answer 1

migraine
tension type headache
thunderclap headache
dull headache

Question 2

ddx of headache

Answer 2

tension type dt stress
migraine
subarachnoid or intracranial hemorrhage
temporal arteritis
tumours that raise ICP (worse in the morning)
meningitis
encephelitis
glaucoma
refractive errors of the eye
sinusitis
opthaic herpes zoster
hypoglycemia
anemia
psychogenic disorder

Question 3

questions to ask?

Answer 3

acute?
episodic?
socrates
fever
neck stiffness
photophobia
trauma
aura?
blurring of vision?
n/v?
lacrimation/ rhinorrhea
jaw pain when chewing? GCA
progressively worsening?
halos around lights? glaucoma
confusion
dizziness
fainting
seizures
phonophobia

Question 4

ix

Answer 4

1. CT brain
2. MRI brain
3. LP
4. always measure BP!!!!

Question 5

managing migraine?

Answer 5

acutely:
1. paracetamol 1g/ NSAIDs (diclofenac 50mg, 100mg max one day)
2. metoclopramide 10mg
3. triptan
4. warm/cold packs
5. rebreathing into a bag to increase PaCO2 (vasodilatation)

long term management
1. propanolol SR 80-160mg daily
2.

Question 6

headache management

Answer 6

1. pcm, nsaids
2. relaxation, massage, ice packs