Headache

Question 1

Primary vs. Secondary Headache

Answer 1

Primary: migraine, tension, trigeminal autonomic cephalalgias

Secondary: infection, vascular disorder, inc. ICP, trauma

Question 2

Migraine Criteria

Answer 2

• 5 episodes
• 4-72 hours
• 2 of following: unilateral, pulsating, mod or severe, inc. w/ physical activity
• 1 of following: nausea, vomiting, photo/phonophobia
• no other explanation

Question 3

Migraine Aura Criteria

Answer 3

• 2 episodes
• 1 reversible sx of following: sensory, language, motor, brainstem, retinal
• 2 of following: homonymous visual field or unilateral sensory change, gradual development >5 min, sx last 5-60 min

Question 4

Tension Head Ache Criteria

Answer 4

• 10 episodes
• 30 min-7 days
• 2 of following: pressing/tighening, mild/mod, bilateral, not aggravated by physical activity
• no N/V
• only one or none: photo/phonophobia

Question 5

Cluster Headache Criteria

Answer 5

• 5 episodes
• severe, unilateral periorbital and/or temporal, 15-180 min
• 1 every other day up to 8/day
• 1 of the following: lacrimation, nasal congestion, rhinorrhea, eyelid edema, ptosis, miosis, facial swelling, ear fullness, agitation

Question 6

Cluster Headache

Answer 6

• alcohol

- vasodilators

Question 7

Trigeminal Neuralgia Criteria

Answer 7

-

Question 8

Trigeminal Neuralgia Cause

Answer 8

• idiopathic
• vascular compression (secondary)
• demyelination- MS (secondary)

Question 9

Signs of Infectious Meningitis Signs/Sx

Answer 9

• headache
• fever
• stiff neck
• altered consciousness

Question 10

Giant Cell Arteritis/Temporal Arteritis

Answer 10

• inflammation of vessel wall
• > age 60 typically
• jaw claudication
• temporal artery tenderness
• vision loss
• joint pain
• fever, malaise, weight loss

Question 11

Elevated Intracranial Pressure Symptoms

Answer 11

• N/V
• pulsatile intracranial noises
• photopsia
• diplopia
• retrobulbar pain
• exertional headache

Question 12

Pseudotumor Cerebri

Answer 12

• elevated ICP
• normal spinal fluid constituents
• normal neuroimaging
• obese women

Question 13

Pathophysiology of Migraine

Answer 13

• trigeminal neurovascular dysfunction -> trigeminal neurovascular activation -> release of vasoactive peptides
• > neuroinflammation and vasodilation -> pain