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Neuro > Headache > Flashcards

Headache Flashcards

1
Q

What are things to ask about in regards to a headache?

A 
Onset/Peak
Relieving factors
Exacerbating factors
Assoc. features
Demographics
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2
Q

What are red flags for headaches?

A 
New onset headache >55
Known/previous malignancy
Immuno-suppressed 
Early morning headache
Exacerbation by valsalva (coughing/sneezing which raise ICP)
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3
Q

What is released in response to stress?

A

Serotonin

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4
Q

What chemical irritates nerves and blood vessels resulting in pain?

A

Substance P

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5
Q

What are 3 types of visual aura?

A 
Central scotomata (blurred portion)
Central fortification (weird lines)
Hemianopic loss (half is lost)
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6
Q

What are triggers?

A 
Sleep
Dietary
Stress
Hormonal
Physical exertion
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7
Q

What drugs are good treatment for headaches?

A

NSAIDs

+/- anti-emetic

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8
Q

What are triptans?

A

5HT agonist

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9
Q

When would you consider Prophylaxis?

A

3+ attacks a month or very severe

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10
Q

How long must each dose of prophylaxis be trialed at?

A

minimum of 4 months

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11
Q

What drug reduces the frequency of migraines by 60-80%?

A

Propranolol

Avoid in asthma, PVD heart failure.

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12
Q

What are side effects for Topiramate (Carbonic anhydrase inhibitor)

A

Weight loss
Paraesthesia
Impaired concentration
Enzyme inducer

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13
Q

What other drugs can help treat migraines?

A

Amitriptyline
Gabapentin
Pizotifen
Sodium valporate

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14
Q

What are the Ipsilateral Cranial Autonomic features?

A 
Ptosis
Miosis
Nasal stuffiness
Nausea/Vomiting
Tearing
Eye lid oedema
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15
Q

What are the 4 main types of TCA?

A

Cluster
Paroxysmal hemicrania
Hemicrania continua
SUNCT

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16
Q

What are treatments for a cluster headache?

A

High flow O2
Sub cut Sumatriptan 6mg
Steroids
Verapamil for prophylaxis

17
Q

What’s the treatment for Paroxysmal hemicrania?

A

Indomethicin

18
Q

What is a paroxysmal hemicrania?

A

Severe unilateral headache, unilateral autonomic features
10-30 mins
1 to 40 per day

19
Q

What is a cluster headache?

A

Severe unilateral headache
1 to 8 per day
45-90 mins a time

20
Q

What does SUNCT stand for?

A 
S = short duration (15-120 secs)
U = unilateral
N = Neuralgiaform headache
C = Conjunctival injections
T = Tearing
21
Q

What is the treatment for SUNCT?

A

Lamotringe

Gabapentin

22
Q

What two imaging techniques should be used with new onset unilateral cranial autonomic features?

A

MRI brain

MR angiogram

23
Q

What is trigeminal neuralgia?

A

Severe stabbing unilateral pain
1 sec to 90 secs
10-100 times per day

24
Q

What are treatments for trigeminal neuralgia?

A

Carbamazepine
Gabapentin
Phenytoin
Baclofen

25
Q

What are surgical options for trigeminal neuralgia?

A

Ablation v Decompression

26
Q

What should you also consider with a headache?

A 
Eyes
Ears
Sinuses
Teeth
TMJ

Neuro (19 decks)

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