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DDX > Headache > Flashcards

Headache Flashcards

1
Q

What % of Americans experience some form of headache each year that requires at least OTC analgesics

A

80%

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2
Q

How many of the 80% of americans that experience some form of headache have severe headaches?

A

50%

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3
Q

What % of severe headache patients will have a chief complaint of headache?

A

10-20%

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4
Q

What areas can focal headaches affect?

A

Orbital/periorbital

Facial

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5
Q

What are some ocular findings with a focal orbital headache?

A
  • Visual disturbances
  • Ophthalmoplegia
  • Pupillary inequality
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6
Q

What are some causes of a focal facial headache? (6)

A
  • Sinusitis
  • Rhinitis
  • Nasopharyngeal diseases
  • Otitis
  • Dental infection
  • Temporomandibular joint disorder
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7
Q

What are some worrisome history findings with a headache?(7)

A

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

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8
Q

What are some worrisome exam findings with a headache? (5)

A

1) Abnormal mental status
2) Focal neurologic findings
3) Papilledema
4) Malignant hypertension
5) Meningismus

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9
Q

What are some findings with a recent trauma and headache? (5)

A
  • CSF otorrhea or rhinorrhea
  • Skull fracture
  • Concussion
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10
Q

In the elderly, what could be the cause of headaches?

A

1) Elevated ESR
- Temporal arteritis
2) Vascular bruits

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11
Q

Is poorly controlled hypertension usually the cause of a headache?

A

• Usually not the cause of headache

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12
Q

What should smokers be assessed for if a new onset of headache occurs?

A
  • Metastatic cancer

* Chest radiography

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13
Q

What does fever indicate with headaches??

A

• Systemic disease

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14
Q

What are some special circumstances that a headache may occur?

A
  • Postlumbar puncture
  • Altitude
  • Drug induced and withdrawl
  • Dietary
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15
Q

Onset of severe headache in a previously well patient represents what?

A

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

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16
Q

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

A

usually require cranial MRI or CT scan to exclude an intracranial mass lesion.

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17
Q

What other findings would warrant a CT or MRI scan?

A

Signs of meningeal irritation and impairment of consciousness

18
Q

What is the most common type of headache?

A

Tension (muscle contraction) headache

19
Q

What headache is often confused with migraine without aura?

A

Tension (muscle contraction) headache

20
Q

Can a tension headache be episodic or chronic?

A

Yes

21
Q

How are tension headaches described?

A

• Bilateral aching, pressing or tightness (rather than throbbing)

22
Q

How severe is the intensity of a tension headache?

A

• Mild to moderate intensity

23
Q

Are tension headaches aggravated by physical activity?

A

• Not aggravated by physical activity

24
Q

Do tension headaches cause nausea, photophobia or phonophobia?

A

• May cause anorexia but usually not nausea, photophobia, or phonophobia

25
Q

What is the description of a migraine headache without aura?

A

• Unilateral (especially temporal) throbbing pain

26
Q

How severe is the intensity of a migraine headache without aura?

A

• Moderate to severe in intensity

27
Q

Are migraine headache without aura aggravated by physical activity?

A

• Aggravated by physical activity

28
Q

Do migraine headache without aura cause nausea, photophobia or phonophobia?

A

• Accompanied by anorexia, nausea, photophobia, phonophobia

29
Q

How long do migraine headache without aura last?

A

• Lasts hours to one or two days

30
Q

How often do migraine headache without aura occur?

A

• Occurs once or twice per month

31
Q

What is the most common prodrome to a migraine headache with aura?

A

• 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
32
Q

What is the description of a migraine headache with aura?

A

• Unilateral throbbing, pulsatile pain

33
Q

How severe is the intensity of a migraine headache withaura?

A

• Moderate to severe in intensity

34
Q

Are migraine headache with aura aggravated by physical activity?

A

• Aggravated by physical activity

35
Q

Do migraine headache withaura cause nausea, photophobia or phonophobia

A

• Accompanied by anorexia, nausea, photophobia, phonophobia

36
Q

How long do migraine headache with aura last?

A

• Lasts hours

37
Q

How often do migraine headache with aura occur?

A

• Occurs several times per year

38
Q

How does a cluster headache present?

A
  • Very severe pain within or around one orbit

* May start or spread to the temple or adjacent areas of the head or face

39
Q

How long do cluster headaches last?

A

• Short duration of 15 minutes to 2 hours

40
Q

How often do cluster headaches occur?

A

• Occurs once or more every day over a period of weeks or months

41
Q

What are some associated autonomic symptoms of a cluster headache? (6)

A
  • Ocular redness
  • Tearing
  • Ptosis or miosis
  • Nasal congestion or discharge
  • Forehead and/or facial sweating
  • Eyelid edema

DDX (4 decks)

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