Headache

Question 1

What is a migraine with aura?

Answer 1

Headache is preceded by more than one neurologic symptom. 99% of the time visual. Starts small, gets bigger, and goes way.

Question 2

What causes aura?

Answer 2

blood flow depression to the area.

Question 3

What is abortive treatment for migraine?

Answer 3

Stop the pain once the headache has already started.

1. Aspirin, acetaminophen, NSAIDs
2. Combination:
3. Triptans
4. Ergotamine derivative (DHE)

Question 4

What preventive treatments are there for migraine?

Answer 4

1. Antihypertensives
2. antidepressants
3. Anti-epileptics
4. Other
   Botox
   Devices (Cefaly, TMS)

Question 5

What alternative treatments are there for migraine?

Answer 5

1. Sleep
2. biofeedback
3. acupuncture
4. OTC/herbal- vitamin B2, Mg, Butterbur (liver damage)

Question 6

What preventive treatments are there for tension h/a?

Answer 6

?

Question 7

What is a cluster headache?

Answer 7

Severe, unilateral, periorbital and/or temporal. Must also have at least one of the following features:
conjunctival injection, lacrimation, nasal congestion, rinorrhea, eyelid edema, ptosis, miosis, facial swelling, ear fullness

Question 8

What is the treatment for cluster h/a?

Answer 8

Abortive: Oxygen, triptans inj, ergots
Transitional: steroids, nerve block
Preventive:?????

Question 9

What is Trigeminal Neuralgia?

Answer 9

?????

Question 10

What causes trigeminal neuralgia?

Answer 10

Mostly idiopathic. If a cause is found, it is usually vascular compression of the nerve- may require surgery

Question 11

What is the treatment for trigeminal neuralgia?

Answer 11

Antiepileptics, baclofen

Surgery

Question 12

What are secondary headaches?

Answer 12

Look for systemic symptoms, neurologic symptoms, onset, older, positional, papilledema ?????

Question 13

What is the most common cause of severe rapid onset h/a?

Answer 13

Subarachnoid hemorrhage

Question 14

What is the mechanism of subarachnoid hemorrhage?

Answer 14

Trauma, aneurysm, AVM

Question 15

What is giant cell arteritis/temporal arteritis?

Answer 15

Inflammation of vessel wall- can lead to vision loss.

Associated w/ jaw claudication???????????

Question 16

How is giant cell arteritis/temporal arteritis diagnosed?

Answer 16

Inflammation- increased CRP and ESR

Question 17

What are the symptoms and signs of elevated ICP?

Answer 17

Exertional h/a, retrobulbar pain, nausea/vomiting, pulsatile intracranial noises, ??????????????
Papilledema- optic disc edema

Question 18

What is the differential diagnosis for ICP?

Answer 18

??????????????

Question 19

What is pseudotumor cerebri?

Answer 19

Elevated ICP

?????????????????