Headache Flashcards

1
Q

What is the difference between a primary and a secondary headache?

A

Primary - headache is primary problem (tension, cluster)

Secondary - headache is secondary to mass, etc

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2
Q

What are the typical Sx of migraine headache?

A

Throbbing pain, associated nausea and vomiting; commonly an aura

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3
Q

What is the pathophysiology of migraine headache?

A

Cortical spreading depression affects parts of cortex 2-3 mm/min, activates trigeminal afferents

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4
Q

What is the mainstay abortive therapy for migraines?

A

Triptans

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5
Q

What therapies should be offered for tension headaches?

A

Not many good ones, but avoid caffeine, NSAID overuse, etc to prevent rebound headaches

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6
Q

Described typical cluster headaches

A

Unilateral, accompanied by autonomic symptoms like lacrimal ion, eyelid edema, rhinorrhea

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7
Q

What treatments can be offered for cluster headache?

A

high flow oxygen, Triptans, steroids can shorten, avoid alcohol

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8
Q

What is paroxysmal hemicrania? How does it differ from cluster headaches?

A

Similar to cluster headaches except shorter in duration and greater frequency

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9
Q

Thunderclap headache is…

A

SAH

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10
Q

Headaches that improve when lying down are..

A

Low pressure headaches, usually iatrogenic (LP) but can be due to rupture of a CSF pouch

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11
Q

A patient has a headache worse in the morning with pulsatile tinnitus and visual obscurations (blurring of vision for a few seconds) this is…

A

Idiopathic intracranial hypertension

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12
Q

What is a possible complication of IIH?

A

Loss of vision from compress e optic neuropathy

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13
Q

What is the classic population of patients with IIH?

A

Young overweight women

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14
Q

An older patient presents with tender scalp, headache and jaw claudication. Think…

A

Temporal arteritis- tx with high dose steroids

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15
Q

What are the neurological causes of facial pain?

A

Trigeminal neuralgia, glossopharygeal neuralgia, post herpetic neuralgia

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16
Q

What is the treatment of choice for trigeminal neuralgia?

A

Carbamazepine or another anticonvulsant

17
Q

What is the treatment of choice for post herpetic neuralgia?

A

Tricyclics, gabapentin

18
Q

What is an Important mimic of IIH?

A

Venous sinus thrombosis

19
Q

What tx options exist for IIH?

A

Carboni anhydrase inhibitors, optic nerve fenestration, repeated LP, limbo peritoneal shunting

20
Q

What are ideal screening questions for migraine?

A

have headaches bothered you for >1 day in last 3 months
associated with nausea/vomiting?
worsened with light?

21
Q

A patient presents with insomnia, lots of fatigue, emotionality etc. after a head trauma during driving. This is likely…

A

post concussive state

22
Q

In what population of patients should triptans not be used?

A

people with heart disease, elderly

23
Q

A patient presents with severe intermitten right sided cheek pain while brushing her teeth. This is..

A

trigeminal neuralgia

24
Q

A patient presents with headaches for severeal years - she was just involved in a car accident in whch she hit the front of her head. CT shows a hyperdense left frontal parasagittal mass that enhances with contrast. This is..

A

meningioma

25
Q

A 16 year old girl had wisdom tooth extraction and drainage of an abscess and presents with headache and fever with proptosis and erythema of the eyelid. This is..

A

cavernous sinus thrombosis