Headache Flashcards
What % of Americans experience some form of headache each year that requires at least OTC analgesics
80%
How many of the 80% of americans that experience some form of headache have severe headaches?
50%
What % of severe headache patients will have a chief complaint of headache?
10-20%
What areas can focal headaches affect?
Orbital/periorbital
Facial
What are some ocular findings with a focal orbital headache?
- Visual disturbances
- Ophthalmoplegia
- Pupillary inequality
What are some causes of a focal facial headache? (6)
- Sinusitis
- Rhinitis
- Nasopharyngeal diseases
- Otitis
- Dental infection
- Temporomandibular joint disorder
What are some worrisome history findings with a headache?(7)
1) Abrupt onset or very severe
- Often intracranial hemorrhage
2) Constant, progressively worsening
3) Seizures
4) Focal neurologic symptoms
5) Nausea and vomiting
6) Known cancer
7) Anticoagulant therapy
What are some worrisome exam findings with a headache? (5)
1) Abnormal mental status
2) Focal neurologic findings
3) Papilledema
4) Malignant hypertension
5) Meningismus
What are some findings with a recent trauma and headache? (5)
- CSF otorrhea or rhinorrhea
- Skull fracture
- Concussion
In the elderly, what could be the cause of headaches?
1) Elevated ESR
- Temporal arteritis
2) Vascular bruits
Is poorly controlled hypertension usually the cause of a headache?
• Usually not the cause of headache
What should smokers be assessed for if a new onset of headache occurs?
- Metastatic cancer
* Chest radiography
What does fever indicate with headaches??
• Systemic disease
What are some special circumstances that a headache may occur?
- Postlumbar puncture
- Altitude
- Drug induced and withdrawl
- Dietary
Onset of severe headache in a previously well patient represents what?
The onset of severe headache in a previously well patient is more likely than chronic headache to relate to an intracranial disorder such as subarachnoid hemorrhage or meningitis
What is the management for a person how is progressive headaches that are related to exertion and headaches that are associated with neurologic symptoms or focal neurologic deficits
usually require cranial MRI or CT scan to exclude an intracranial mass lesion.
What other findings would warrant a CT or MRI scan?
Signs of meningeal irritation and impairment of consciousness
What is the most common type of headache?
Tension (muscle contraction) headache
What headache is often confused with migraine without aura?
Tension (muscle contraction) headache
Can a tension headache be episodic or chronic?
Yes
How are tension headaches described?
• Bilateral aching, pressing or tightness (rather than throbbing)
How severe is the intensity of a tension headache?
• Mild to moderate intensity
Are tension headaches aggravated by physical activity?
• Not aggravated by physical activity
Do tension headaches cause nausea, photophobia or phonophobia?
• May cause anorexia but usually not nausea, photophobia, or phonophobia
What is the description of a migraine headache without aura?
• Unilateral (especially temporal) throbbing pain
How severe is the intensity of a migraine headache without aura?
• Moderate to severe in intensity
Are migraine headache without aura aggravated by physical activity?
• Aggravated by physical activity
Do migraine headache without aura cause nausea, photophobia or phonophobia?
• Accompanied by anorexia, nausea, photophobia, phonophobia
How long do migraine headache without aura last?
• Lasts hours to one or two days
How often do migraine headache without aura occur?
• Occurs once or twice per month
What is the most common prodrome to a migraine headache with aura?
• Visual (or neurologic) prodrome
- Usually precedes the headache by 20-30 minutes
- Scintillating scotoma on one side of the visual field
- Herringbone-like pattern
- Visual loss
- Metamorphopsia
What is the description of a migraine headache with aura?
• Unilateral throbbing, pulsatile pain
How severe is the intensity of a migraine headache withaura?
• Moderate to severe in intensity
Are migraine headache with aura aggravated by physical activity?
• Aggravated by physical activity
Do migraine headache withaura cause nausea, photophobia or phonophobia
• Accompanied by anorexia, nausea, photophobia, phonophobia
How long do migraine headache with aura last?
• Lasts hours
How often do migraine headache with aura occur?
• Occurs several times per year
How does a cluster headache present?
- Very severe pain within or around one orbit
* May start or spread to the temple or adjacent areas of the head or face
How long do cluster headaches last?
• Short duration of 15 minutes to 2 hours
How often do cluster headaches occur?
• Occurs once or more every day over a period of weeks or months
What are some associated autonomic symptoms of a cluster headache? (6)
- Ocular redness
- Tearing
- Ptosis or miosis
- Nasal congestion or discharge
- Forehead and/or facial sweating
- Eyelid edema
