Headache Flashcards
Aspirin, nonsteroidal anti inflammatory drugs (NSAIDs), sumatriptans, ergot alkaloids, and opiates may be used as abortive therapy.
Migraine
Associated with nausea/vomiting (N/V), photophobia, phonophobia
Migraine
β-Blockers, calcium channel blockers, ergots, antidepressants, and depakote are used for prophylaxis.
Migraine
Classic symptoms include unilateral frontotemporal cephalgia with aura and visual symptoms (eg, scintillating scotoma).
Migraine
Ipsilateral tearing, conjunctival injection, Horner syndrome, and rhinorrhea
Cluster
Pulsatile or throbbing headaches
Migraine
May be precipitated by hormonal factors (eg, oral contraceptive pills [OCPs] or menses) and emotional or metabolic stress
Migraine
history of Allergies
Sinus Headache
Most common type of headache in adults
Tension headache
Pathophysiology may relate to the effect of serotonin on cephalic blood vessels.
Migraine headache
Patients often have a family history (FH) of headaches.
migraine
Symptoms are often eradicated by 100% O2 by facemask or serotonin agonists (sumatriptan).
cluster
Unilateral boring periorbital headache worst in the temporo-orbital region
cluster
Vise-like, tightening bilateral pain associated with photophobia, phonophobia, and neck tightness
tension
4/1 F/M incidence (headache)
Migraine
Approximately 95% of these headaches occur in males
Cluster
What are the seven red flags (suggesting serious underlying pathology) in the diagnosis of headache?
- Sudden onset of severe headache
- Headache beginning after straining, Valsalva, sexual activity, or awakens patient from sleep
- Headache that is persistent and worsening over a period of weeks or months
- Headache associated with focal neurologic findings or a change in mental status
- Headache associated with meningeal signs (including nuchal rigidity, Brudzinski’s or Kernig’s sign)
- Headache associated with fever
- Headache in a patient who has never experienced a headache before
What cause of headache is classically associated with the following:
Young, obese female w/ papilledema, negative CT/MRI
Pseudotumor cerebri (benign intracranial hypertension)
What cause of headache is classically associated with the following:
Positive Brudzinski’s sign
Meningitis
What cause of headache is classically associated with the following:
“Worst headache or my life”
Subarachnoid hemorrhage
What cause of headache is classically associated with the following:
Inflammatory systemic illness in elderly; symptoms include unilateral headache in temporal region, eye pain, and vision loss
Temporal arteritis (giant cell)
What cause of headache is classically associated with the following:
High number of polymorphonuclear cells in CSF
Meningitis (bacterial)
What cause of headache is classically associated with the following:
Blood in the CSF
Subarachnoid hemorrhage
What cause of headache is classically associated with the following:
Large doses of Vitamin A or tetracyclines
Pseudotumor cerebri
What cause of headache is classically associated with the following:
Medical emergency treated with steroids
Temporal arteritis
What cause of headache is classically associated with the following:
Brief episodes of pain in the fifth cranial nerve distribution
Trigeminal neuralgia
What cause of headache is classically associated with the following:
Initial treatment options include acetazolamide and diuretics
pseudotumor cerebri
What cause of headache is classically associated with the following:
polymyalgia rheumatica
temporal arteritis
What are the common situations in which a lumbar puncture (LP) is contraindicated?
Acute head trauma or signs/symptoms of intracranial hypertension—in these settings, a lumbar puncture should be performed only after a negative head CT or MRI.
What is the risk of performing an LP in the setting of acute head trauma?
Uncal herniation and death
