Headache Flashcards
how many people have experienced a HA in a 12 month period
90%
primary HA
migraine, tension type, cluster
secondary HA
head trauma, vascular, substance, metabolic, etc/
what does the headache exam look like>
general exam centered around the head and neck, neurologic centered around neurologic complaints and screening for occult path.
migraine without arua
at least five attacks with the following criteria:
- lasts 4-72 hr.
- at least two of these: unilateral, pulsating, moderate or severe intensity, aggravated with exertion.
- nausea/vomiting
- photophobia and phonophobia
prevalence
28 mil. 3X as many females. 25% of households have 1 migraineur. highest prevalence 25-55 age group.
phases of migraine
prodrome > aura > HA > resolution
aura
complex of focal neurologic symptoms (+/-) that precedes, accompanies or follows a migraine. these usually precede.
how common are aura
15% of migraines
how long is aura
5-20 min. less than 60,in
can the aura occur alone?
yes
most common type of aura
visual. paresthsias is second most common -the jacksonian march
diagnosis of migraine with aura
at least two attacks with the HA lasts 4-72 hr.
additionally…
2. at least three of these:
one or more fully reversible aura symptoms indicating focal cerebral cortical and or brainstem dysfunction.
at least 1 aura symptom develops gradually over more than 4 min. or they can occur in succession.
no aura last more than 60 min. multiple following each other can extend the time.
HA follows aura with interval of less than 60 min.
tension type HA general comments concerning etiology
strong evidence that muscle contraction has nothing to do with it. platelet GABA and 5HT are found dysregulated. there is no evidence of depression and anxiety.
episodic tension-type
at least 10 previous episodes fulfilling criteria. less than 180 days of the year.
HA lasts 30 min - 7 days.
at least two of: pressing/tightening non pulsating quality, mild-to-moderate intensity, bilateral, no exertional aggravation.