Headache Flashcards
What are the types of headache available?
- Migraine
- Tension-type headache
- Cluster headache
- Intracranial mass lesion
- Low ICP state
- Meningitis/SAH
- Temporal arteritis/intracranial vasculitis
What is a migraine?
Neurally induced inflammation and dilatation of intracranial and extracranial vessels
How long does a migraine lasts?
4-72hrs
What are the pain characteristics for migraine?
- Often unilateral but can be bilateral
- Throbbing/pulsating pain
What intensity of pain does migraine have?
Moderate to severe (often debilitating)
What are the signs and symptoms of migraine?
- Nausea
- Vomiting
- Photophobia
- Phonophobia
- Aura/visual disturbances before migraine
(Flashing lights, zig zag/temp loss of vision)
What is a common migraine?
A migraine without aura
What is the criteria to diagnose a common migraine?
At least 5 attacks that fulfil the following criteria:
- each attack, either successful/unsuccessful, lasts for 4-72hrs
An attack has at least 2 of the following characteristics
1. Unilateral location
2. Pulsating quality
3. Moderate to severe intensity
4. Pain aggravated by exertion/routine physical activity
During an attack, at least one of the following symptom must be present:
1. Nausea
2. Vomiting
3. Photophobia
4. Phonophobia
+ No evidence from hx/PE of any other disease that might cause headaches
What is a classic migraine?
A migraine with aura
What is the incidence for classic migraine?
15%
How often do aura accompany migraine in a classic headache?
A few, most/all attacks
How long does an aura last for for classic migraine?
20-60mins
(*some may trespass first few minutes of a headache and mostly are visual)
What is the criteria for diagnosing classic migraine?
At least 5 attacks with the following criteria:
- each attack, whether successfully treated or not, lasts for 4-72hrs
Attack has at least 2 of the following characteristics:
1. Unilateral location
2. Pulsating quality
3. Moderate to severe intensity
4. Pain that aggravates upon exertion/routine physical activity
During the attack, at least one of the following symptoms must be present
1. Nausea
2. Vomiting
3. Photophobia
4. Phonophobia
+ no evidence from hx/PE of any other disease that might cause headaches
+ symptoms of neurological dysfunction b4/during an attack
What is a tension-type headache?
It is a headache of an unknown cause, may be an increase in sensitivity to pain-mediating systems in brain
How long does a tension-type headache last for?
30min to a few days
What are the pain characteristics of tension-type headache?
- Typically bilateral
- Steady, pressing/tightening quality - described as a band-like pressure around head
What is the intensity of pain for tension-like headache?
Mild to moderate (*not as severe as migraine/cluster headache)
What are the signs and symptoms of tension-type headache?
- Not so pronounced photophobia and Phonophobia
- Mild tenderness in neck, shoulders and scalp
What is a cluster headache?
A neurally induced inflammation and oedema of internal carotid artery
How long does a cluster headache lasts for?
15min-3hrs
What are the pain characteristics of cluster headache?
- Severe, excruciating, usually unilateral (focused around one eye/temple)
- Sharp/burning pain
What is the pain intensity of cluster headache?
Extremely severe (*described as most severe headache one could experience)
What are the signs and symptoms of cluster headache?
Signs and symptoms are ipsilateral
- Nasal congestion
- Rhinorrhoea/runny nose
- Ptosis (drooping of eyelid)
- Lacrimation/tearing
- Agitation
- Restlessness
What is an intracranial mass lesion headache?
It is a headache caused by brain tumor/hydrocephalus
It can be due to displacement/traction of pain-sensitive vessels
