headache Flashcards
what are characteristics of tension headache?
- type of pain
- where it is located
- time course
- Constant pressure
- Usually bilateral, moderate pain
- usually occipital ( tight band around head)
- 4-6 hours
What is the treatment of tension headache?
NSAIDS or other analgesics
Anything abnormal on physical exam or testing for tension headache.
- Nope none
Most common characteristic of migraine?
Visual disturbance such as photophobia.
First time pt has headache with photophobia what do you do?
- Scan the brain because your first time you should be thinking subarachnoid hemorrhage
Abortive therapy for migraine headache
- Triptans or ergotamine = they work by being a vasoconstrictor.
What and when do you give prophalaxis meds for headache
- give if patient has more than 3 headache a month
- propranalol
- Ca channel blockers (Verapamil)
- Tricycle antidepressants ( Amitriptyline)
- Valproic acid
What are contraindications for ergot alkaloids and Triptans for migrains
- Uncontrolled hypertension or coronary artery disease becasuse they cause vasoconstriction.
What are characteristics of cluster headache
- 6x more common in med
- occur cyclically for a period of time then go into remission
- Usually occur at end of night or right after falling asleep
- Red eye, tearing, rhinorrhea, possible horners syndrome.
Preventive medication for cluster headache
Verapamil
lithium
prednisone
Abortive medication for cluster headache
oxygen
sumotriptan
dihydroergotamine
What are symptoms of temporal (giant cell) arteritis
- Mostly occurs in older people
- Visual distrurbances
- Jaw claudication
- Headache ( scalp tenderness)
- muscle pain
- weakness
- fatigue
Test that will be abnormal in temporal arteritis.
- elevated ESR
- temporal artery biopsy
Treatment for Temporal arteritis
Prednisone
What are common physical exam findings on Pseudotumor cerebri
- papilledema
- possible 6th CN pulsy (pt is unable to look out)
- loss of visual acuity
