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Neuro 2 > Headache > Flashcards

Headache Flashcards

1
Q

What are the 2 types of headaches?

A
  1. Primary headaches
  2. Secondary headaches
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2
Q

What are primary headaches?

A

Headaches that occur idiopathically with no underlying cause

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3
Q

What are secondary headaches?

A

Headaches caused by an underlying cause

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4
Q

What are examples of primary headaches?

A

-Migraines
-Tension type headaches
-Trigeminal autonomic cephalalgias= cluster headache

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5
Q

How can we separate primary headaches?

A

-Long lasting headaches >4 hours
-Short lasting headaches <4 hours

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6
Q

What are examples of long lasting primary headaches?

A

-Migraines
-Tension type headache

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7
Q

What are examples of short lasting headaches?

A

-Trigeminal autonomic cephalalgia= cluster headache

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8
Q

What are the 4 key red flag symptoms indicative of secondary headache?

A

-Age
-Onset
-Systemic symptoms
-Neurological signs

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9
Q

What is the red flag about age relating to secondary headache?

A

New onset different headaches in a person >50 years

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10
Q

What is the red flag about onset relating to secondary headache?

A

Sudden, abrupt onset of severe headache (thunderclap headache)

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11
Q

What is the red flag about systemic symptoms relating to secondary headache?

A

-Fever
-Neck stiffness
-Rash
-Weight loss

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12
Q

What is the red flag about neurological signs relating to secondary headache?

A

-Confusion
-Impaired consciousness
-Focal neurology (muscle weakness)
-Swollen optic discs (inter cranial pressure)

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13
Q

What are the 2 types of migraines you can have?

A

Episodic or chronic

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14
Q

What are characteristics of a migraine?

A

-Unilateral location (can be bilateral)
-Pulsating quality
-Moderate/severe pain intensity
-Aggravation by routine physical activity
-Lasts hours/days
-Nausea/vomiting
-Photophobia/phonophobia (sound)
-Auras (severe cases)

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15
Q

What are migraine auras?

A

Complex array of symptoms reflecting focal cortical brainstem dysfunction usually occurring before a headache

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16
Q

What are characteristics of an aura?

A

-Starts small and gets bigger
-Expanding Cs

17
Q

What are the 5 phases of migraines?

A
  1. Premonitory= yawning, polyuria, mood change, irritable, light sensitive, neck pain, concentration difficulty
  2. Aura= visual, sensory (numbness), weakness, speech arrest
  3. Headache= head and body pain, nausea, photophobia
  4. Resolution= rest and sleep
  5. Recovery= mood disturbed, food intolerance, feeling hungover, can take up to 48 hours
18
Q

What is the order of management of migraines?

A
  1. Lifestyle changes
  2. Pharmacological therapy
19
Q

What are lifestyle changes that can be made?

A

-Avoid triggers
-Follow routine

20
Q

What are the 2 types of pharmacological therapy given?

A
  1. Acute/abortive
  2. Long term preventative
21
Q

What are examples of acute/abortive pharmacological therapy?

A

-Paracetamol
-NSAIDs (high dose)
-Prokinetic (prevents vomiting)
-Triptans (serotonin receptor agonists)

22
Q

How does long term preventative pharmacological therapy work?

A

Low and slow with doses until optimal dose found and continue that regularly

23
Q

What are characteristics of a tension type headache?

A

-Lasts 30 min - hours
-Bilateral
-Mild/moderate
-Not aggravated by movement
-No nausea/vomiting
-No photophobia/phonophobia

24
Q

What are treatments for tension type headaches?

A

-Reassurance may be enough
-Simple analgesics (aspirin, paracetamol)

25
Q

How does tension type headaches usually present as?

A

Tight muscles around head and neck and though head is in a vice

26
Q

What are characteristics of a cluster headache?

A

-Severe unilateral pain
-Lasts 15 to 180 mins if untreated
-Sense of restlessness/agitation

27
Q

What are potential symptoms of cluster headaches ipsilaterally?

A

-Conjunctive redness, lacrimation
-Nasal congestion, rhinorrhoea
-Eyelid oedema
-Forehead, facial sweating
-Miosis, ptosis

28
Q

What is acute treatment for cluster headaches?

A

-Triptan (subcutaneous)
-High flow oxygen= oxygen inhibits neuronal activity

29
Q

What is prevention for cluster headaches?

A

-Verapamil

Neuro 2 (10 decks)

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