headache Flashcards
made worse by foods containing tyramine (rotting foods, cheese, meat, wine, chocolate, caffeine)
migraine
made worse by foods containing tyramine (rotting foods, cheese, meat, wine)
migraine
obese female with papilledema (↑ICP)
pseudotumor cerebri or hydrocephalus
jaw muscle pain when chewing
temporal arteritis (vasculitis - jaw claudication)
periorbital pain with ptosis and miosis
cluster
photophobia and/or phonophobia
migraine
bilateral frontal/occipital pressure
tension
using topical retinoic acid for acne
pseudotumor cerebri
lacrimation and/or rhinorrhea
cluster
elevated ESR
temporal arteritis
headache + extraocular muscle palsies
cavernous sinus thrombosis (CN 3, 4,V1/V2,6)
scintillating scatomata (visual aura) prior to headache
migraine with aura
headache before or after orgasm
postcoital cephalogia
responds to 100% O2
cluster
trauma to head → headache begins days after event (low pressure veins), persists over a week (doesn’t go away)
subdural hematoma
severe headache + fever or neck stiffness
meningitis
constant headache (all day, night), progressively worsening and/or focal neuro deficits + seizures
brain tumor
periorbital pain with partial horner’s (ptosis and miosis)
cluster
ipsilateral eye redness, lacrimation, rhinorrhea, and/or nasal congestion
cluster
scintillating scatomata (visual aura) prior to headache
migraine with aura (↑ risk of stroke)
headache common in young men who smoke
cluster
UNILATERAL, piercing, constant pain in retroperitoneal or periorbital area
cluster
headache is daily (at same time) lasts for 15 min - 3 hrs for weeks → stops for months → returns
cluster
at least 2 of: unilateral throbbing, pulsating mod-severe (prohibits daily activities) aggravated by activity (stairs) at least 1 of: N and/or V photophobia and/or phonobobia
migraine
is an aura a diagnostic criteria for migraine?
no.
aura (scintillating scotomata - light around periphery of visual field or smell)
headaches more common in women
tension (by small amount)
migraine
BILATERAL, constant in frontal or occipital region
can feel like a band squeezing the head
NO: photophobia, phonophobia, aura, N/V, focal neuro deficits
tension
how long are migraines?
4 hrs - 3 days
how long are tension headaches?
4-6 hrs - up to 1 week
at least 2 of: unilateral throbbing, PULSATING mod-severe (prohibits daily activities) aggravated by activity (stairs) at least 1 of: N and/or V photophobia and/or phonobobia
migraine
abortive treatment for migraine
NSAIDs: ibuprofen, naproxen
-triptans (sooner used - during aura or prodrome, better work)
abortive treatment for cluster
fastest effect: inhaled 100% O2
-triptan
NSAIDs
acetaminophen
treatment for tension
NSAIDs
acetaminophen
MOA of -triptan
5HT agonist:
vasoconstriction
inhibit neurotransmission in CN 5
contraindications of -triptans
CAD - constrict coronary vessels prinzmetal angina (vasospasms of coronary arteries) pregnancy - constrict placenta
MOA of -triptan
5HT 1B/1D R agonist:
vasoconstriction
inhibit neurotransmission in CN 5
treatment of pseudotumor cerebri
acetazolamide: use
pseudotumor cerebri
glaucoma
altitude sickness
