Headache Flashcards
What is the most common type of headache seen in primary care settings?
Answer: Primary headache syndromes (most patients presenting with headache have primary headache).
What is the characteristic location of migraine headaches?
Answer: Migraine headaches are typically unilateral (affecting one side of the head) in 60% of cases.
What is the prevalence of migraine in males, females, and children?
Answer: Migraine affects 6% of males, 18% of females, and 4% of children.
What are the two subtypes of migraine?
Answer: Migraine can be classified as either “migraine with aura” (where a neurologic event precedes the headache) or “migraine without aura” (no aura or warning symptoms).
What is chronic migraine?
Answer: Chronic migraine starts as episodic migraine but eventually progresses to having 15 or more attacks per month.
What are the characteristics of tension-type headaches?
Answer: Tension-type headaches often present as a “bandlike” pain that is bilateral (affects both sides of the head). Referred pain from the neck to the head may contribute to the pain.
How do cluster headaches differ from other types of headaches?
Answer:
Cluster headaches are characterized by cycles or clusters lasting weeks to months, repetitive headaches during a cluster, unilateral pain, focal facial and eye pain, and associated symptoms like lacrimation and rhinorrhea.
What is the treatment of choice for paroxysmal hemicranias?
Answer: Paroxysmal hemicranias are uniquely sensitive to indomethacin,
making it the preferred treatment.
How can cervicogenic headaches be differentiated from other headache syndromes?
Cervicogenic headaches should be distinguished from migraines or other syndromes.
Analgesics can be tried, but triptans and ergots should be reserved for refractory cases.
Neck-focused therapies such as facet blocks, trigger point injections, nerve blocks, TENS, and physical therapy may be beneficial.
What is medication overuse headache?
Medication overuse headache is a persistent, recurring headache that occurs due to regular analgesic use. It often leads to the transformation of episodic headaches into chronic headaches.
What are some red flags associated with headaches that require further investigation?
Red flags include neurologic symptoms or signs such as weakness, ataxia, disturbed consciousness, and seizures, as well as general symptoms like fever, repeated vomiting, high blood pressure, and lymphadenopathy.
What are the basic principles of headache management?
The basic principles of headache management include taking a thorough history and physical examination, ruling out potentially dangerous (secondary) headaches, diagnosing the specific headache type, implementing appropriate treatment, and monitoring the outcome.
What are the treatment options for acute management of headaches?
Acute treatment options include simple analgesics, ergots, and migraine-specific medications such as triptans.
What lifestyle modifications can help in managing headaches?
Lifestyle modifications that can help include maintaining good sleep habits, having regular meals, staying hydrated, and minimizing caffeine intake.
What are some preventive medications used for headaches?
Preventive medications can include anti-epileptics, anti-hypertensives, tricyclic anti-depressants, and migraine-specific medications such as anti-CGRP (calcitonin gene-related peptide) drugs.
