Headache

Question 1

Physical exam findings of Pseudotumor cerebri

Answer 1

1. Papilledema
2. Visual field loss
3. Abducens (CN VI) palsy

Question 2

Pseudotumor Cerebri treatment

Answer 2

1. Carbonic anhydrase inhibitors (acetazolamide)

2. Furosemide

Question 3

What are the three most common causes of drug rebound headache

Answer 3

1. Opioids
2. Butalbital/analgesic
3. Aspirin/acetaminophen/caffeine

Question 4

Treatment for Cluster headache

Answer 4

1. 100% oxygen
2. Sumatriptan or zolmitriptan
3. Prednisone 100mg QD for 5 days
4. Intranasal lidocaine

Question 5

Prophylaxis for cluster headache

Answer 5

Verapamil (CCB)

Question 6

Prophylaxis for migraine

Answer 6

• Valproic acid
• Amitriptyline
• Propanolol

Question 7

Who gets migraine prophylaxis

Answer 7

• 3 or more migraines a month, with disabling symptoms

- Symptoms lasting more than 48 hours

Question 8

Red flags for headache

Answer 8

1. Abrupt onset of severe headache
2. Focal neurologic symptoms
3. Change in headache
4. Systemic symptoms
5. New onset >50 years
6. New onset HIV or cancer
7. Waking from sleep
8. Jaw claudication/temporal tenderness
9. Posture/exercise/valsalva provoked

Question 9

Migraine prodrome

Answer 9

• Yawning
• Irritable
• Depression
• Food cravings
• constipation
• neck stiffness

Question 10

Cluster headache symptoms

Answer 10

• pain around one eye
• ptosis
• tearing
• eyelid edema
• nasal congestion or rhinorrhea

Question 11

What is the most significant risk factor for cluster headache

Answer 11

family history (14x more likely!!)