Headache Flashcards
Aetiologies of tension type headache?
Triggers include stress, noise, prolonged concentration, anxiety, depression, refractive errors, analgesic overuse, hypertension
Aetiologies of migraine?
Hypersensitivity to triggers: stress, hormones, hunger, food cravings, sleep disturbance, dehydration, environmental stimuli
Aetiologies of Cluster headache?
Sporadic
Aetiologies of SUNCT?
Sporadic
Triggers: wind, touch, cold
Aetiologies of thunderclap headache?
Primary headaches SAH TIA/stroke ICH Vertebral artery dissection Meningitis
Aetiologies of Giant cell arteritis?
Unknown cause
Pathology of tension type headache?
Generated by neuromuscular irritation with pain referred to scalp
Pathology of migraine?
Complex changes in brain which hypersensitive the trigeminal ganglion
Pathology of cluster headache?
Hyperactivity of the trigeminal autonomic systems due to usually unsinister stimuli
Pathology of giant cell arteritis?
Inflammation of the large arteries in the brain resulting in granulomatous deposits
Signs and symptoms of tension type headache?
Tight band sensation
Pressure behind the eyes
Throbbing sensation
Signs and symptoms of migraine?
Prodrome - mood change, yawning
Aura - Visual cascade, motor dysarthria
Headache - very severe, photophobia, phonophobia, nausea and vomiting
Signs and symptoms of cluster headache?
Excruciating, unilateral pain in bouts lasting months but then remitting for months
Associated with orbital/temporal pain, lacrimation, ptosis
Pain ceases rapidly
Signs and symptoms of SUNCT?
As cluster headache but with 10s-4min duration up to 200 times a day
Associated symptoms include - conjunctival injection and lacrimation
Signs and symptoms of thunderclap headache?
Highly intense headache with sudden onset which reaches maximum within 1 min
Settles instantaneously
Signs and symptoms of giant cell arteritis?
Diffuse headache Systemic unwell Jaw claudication Visual disturbance Beaded temporal artery
Investigation and findings of headaches?
If suspicious presentation admit for an MRI/CT brain
Investigation and findings of giant cell arteritis?
FBC - CRP and ESR elevated, high platelets
Biochem
U+Es
Management of migraine?
Triptans
NSAIDs
Prophylaxis
Management of cluster headache
100% O2
Triptans
Short course steroids
Management of SUNCT?
Symptomatic relief
Analgesics
Anti epileptics
Management of thunderclap headache?
Treat cause
Management of giant cell arteritis?
High dose prednisolone
