Headache Flashcards
What are the major types of primary headaches?
Migraine, Tension Headache, and Cluster Headache.
How do primary headaches differ from secondary headaches?
Primary headaches are the main feature of a disease, whereas secondary headaches are symptoms of another, underlying disease.
What are signs suggestive of secondary headaches?
- First time this kind of headache
- Sudden onset of headache
- Focal (negative) neurological symptoms
- Fever, signs of infection
- Anamnesis for drugs, exercise
What is the prevalence of migraines?
5–20% of the population
How long do migraines typically last?
4 to 72 hours
What is the first-line treatment for acute migraine attacks?
Aspirin (1000 mg), Paracetamol (1000 mg), or Ibuprofen (600 mg)
What are second-line treatments for migraines if first-line medications fail?
Combine aspirin or paracetamol, or ibuprofen with MCP (Metoclopramide)
What are the treatments for migraines if aspirin/paracetamol/ibuprofen with MCP does not work?
1000 mg Aspirin intravenously or Triptane (e.g. Sumatriptane, naratriptane) or CGRP receptor antagonist (Rimegepant, Ubrogepant)
What is the “game-changer” drug for the prevention of migraine attacks?
Monoclonal antibody against CGRP Receptor: Erenumab (injected once in 4 weeks)
Why should strong painkillers be avoided for tension headaches?
Overuse can lead to secondary drug-induced headaches.
What are the hallmark features of cluster headaches?
Unilateral, severe retro-orbital pain lasting 15–180 minutes, often occurring in clusters.
How are cluster headaches treated?
Acute treatment with oxygen masks or sumatriptan; prevention with calcium antagonists like verapamil or corticosteroids.
What does “CSD” stand for in migraine pathophysiology?
Cortical Spreading Depression
What neurotransmitters interact with CGRP in migraine pathophysiology?
CGRP interacts with 5-HT1 (serotonin) receptors
What is the male-to-female ratio for cluster headaches?
The male-to-female ratio for cluster headaches is approximately 10:1
