Headache Flashcards
Headache red flags
new onset > 55 known/previous malignancy immunosuppressed early morning exacerbated by valsalva
smoking and seasonal variation is assoc with ?? headache
cluster
cluster headache features
unilateral
intense pain around one eye
lacrimation, swelling
typically 1-8 per day, lasting 15 mins - 2 hrs
migrane
risk factors?
more common in which sex?
obesity, patent foramen oval
F > M
what percentage of people with migrane have aura
20
features of migrane
unilateral, throbbing, autonomic feature, photophobia, photophobia
cluster headache tx
high flow O2 - 20 mins
subcut sumatriptan
steroids (no longer than 2 weeks)
verapamil for prophylaxis
migrane acute tx
NSAID +/- anti emetic as soon as possible after onset
or triptans - similar efficacy to NSAIDs
migrane prophylactic tx
when is it given
given if >3 attacks per month or v severe
1st line is propranolol, topiramate
others include valproate, gabapentin
advise to avoid caffeine and hydrate with at least 2L water a day
Trigeminal neuralgia
age group?
triggered by?
elderly
triggered by touch, usually V2/V3
how is the pain described in trigeminal neuralgia and how long does it take to settle
severe stabbing unilateral pain
bouts of pain may last weeks > months before remission
Tx for trigeminal neuralgia
carbamazepine, gabapentin, phenytoin, baclofen …
surgical - ablation, decompression
SUNCT
short lived unilateral neuralgiform conjunctival injections tearing
tx - lamotrigine
Headache in elderly, severe, unilateral, autonomic features, 1-40 per day ..?
paroxysmal hemicrania
Indomethacin is tx for?
paroxysmal hemicrania
