Headache

Question 1

What is a primary headache?

Answer 1

a headache not caused by any other disease or condition

Question 2

What is a secondary headache?

Answer 2

headache caused by an associated disease or trauma

resolves when underlying cause is successfully treated

Question 3

There are no pain receptors in the _____________.

Answer 3

brain tissue itself

Question 4

What are examples of primary headache?

Answer 4

migraine with aura
migraine without aura
tension type headache

Question 5

What is a migraine?

Answer 5

persistent, unilateral pain in the head

Question 6

What are the criteria for migraines?

Answer 6

A. At least 5 attacks fulfilling B-D
B. Headache attacks lasting 4-72 hours
C. At least two of the following characteristics:
-unilateral location
-pulsating quality
- moderate or severe pain intensity
- aggravated by routine physical activity
D. during headache on of the following:
-nausea and/or vomiting
-photophobia and/or phonophobia

Question 7

New onset of migraine after age _______ is a red flag.

Answer 7

50

Question 8

What are the characteristics of a migraine without an aura?

Answer 8

dull throbbing
lasts 4-72 hours
photophobia
aggravated by routine physical activity
stiff neck
blurred vision

Question 9

______________ may also accompany aura.

Answer 9

Paresthesia in hands and face

Question 10

What would dizziness and vertigo indicate?

Answer 10

brainstem involvement or
change in blood flow around vestibular structures

Question 11

What are potential triggers for migraines?

Answer 11

sleep disturbances
caffeine and alcohol
stress
inadequate water intake

Question 12

What is commonly taken on onset of migraine?

Answer 12

abortives

triptans
NSAIDs
Acetaminophen
Caffeine
OTC migraine meds

Question 13

How do triptans work?

Answer 13

act on the serotonin receptor agonist

can cause rebound headache

Question 14

What are the side effects of triptans?

Answer 14

dizziness
fatigue
nausea

Question 15

When is a preventative indicated for pts with migraines?

Answer 15

> 2 migraines per month
typically last 48 hours or more
severity/frequency that critically impacts pt’s daily life
abortive therapies are contraindicated, ineffective, overused, not tolerated

Question 16

____________ appear to be the most common type of primary HA.

Answer 16

Tension type headaches

Question 17

How is pain described with tension type headaches?

Answer 17

dull (not throbbing)
mild to moderate

no nausea is present

Question 18

What is pharmacological treatment for TTH?

Answer 18

NSAIDS

limit to 2-3 times per week due to high risk of rebound headache

Question 19

What is the most common secondary headache?

Answer 19

cervicogenic

Question 20

Cervicogenic headaches do not have dysfunction in _____________.

Answer 20

Oculomotor control

Question 21

What is the hallmark of cervicogenic headaches?

Answer 21

Csp ROM is reduced and HA is made significantly worse by provocative maneuvers

Question 22

What levels do cervicogenic headaches originate from?

Answer 22

C1-3

Question 23

What are impairments that may cause cervicogenic headaches?

Answer 23

whiplash injuries
intervertebral disc disease
facet joint arthritis

Question 24

What are other symptoms of cervicogenic headaches?

Answer 24

dizziness
nausea
lightheadedness
inability to concentrate
visual disturbances

Question 25

What are typical interventions for cervicogenic headaches?

Answer 25

manual therapies
exercise
deep neck flexor training