Headache

Question 1

thunderclap headache, worse headache of my life

Answer 1

SAH

Question 2

indomethacin responsive headache

Answer 2

hemicrania continua, paraoxysmal hemicrania

Question 3

headache w/ jaw claudication, scalp sensitivity, visual complaints in age > 50 y, ESR > 50

Answer 3

temporal (ginat cell) arteritis

Question 4

bilateral trigeminal neuralgia or trigeminal neuralgia in a young pt

Answer 4

MS, sarcoidosis, lyme’s disease

Question 5

CADASIL = cerebral autosomal dominant arteriorpathy with subcortical infarcts and leukoencephalopahty

Answer 5

AD - CH 19 - NOTCH 3 mutation

Question 6

FHM1 = familial hemiplegic migraine

Answer 6

AD - CH 19p13 - CACNA1A gene - defective P/Q Calcium channel

Question 7

FHM2

Answer 7

AD - CH1q23 - ATP1A2 gene - defective A1A2 sodium-potassium ATPse channel

Question 8

FHM3

Answer 8

AD - CH 2q24 - SCN1A gene - defective pre & post synaptic voltage gated Na channels

Question 9

headache RED flags

Answer 9

• systemic s/s = fever, chills, WL
• hx of prior cancer
• immunodeficiency
• FND
• thunderclap HA
• new onset headaches after 50 years of age
• precipitation by exertion/strain/positional changes
• increasing HA frequency and severity
• new onset seizures