Headache Flashcards
What is papilloedema associated with?
Raised intracranial pressure
What is peripheral field loss associated with?
Raised ICP
What is 6th nerve palsy associated with?
Giant Cell arteritis
What is oral hairy leukoplakia associated with?
immunodeficiency. Caused by EBV.
What is a purpuric rash associated with?
Meningococcal Sepsis
What is xanthachromic CSF a sign of?
Sub-Arachnoid haemorrhage
What are neutrophils in CSF a sign of?
bacterial infection
What are red flag symptoms in headache?
Sudden onset, maximal immediately
Focal neurological symptoms
Constitutional symptoms
Raised ICP - worse on lying down/wakening + vomiting
New onset aged >60 years
What are the signs and symptoms of temporal arteritis?
Patient over >60, head pain localised to one or both temples, absent temporal pulses, enlarged and tender arteries
What the symptoms of sub-arachnoid haemorrhage?
sudden onset, described as ‘worst-ever’ headache, often occipital, stiff neck, focal signs, decreased consciousness
What are symptoms of meningitis?
fever, photophobia, stiff neck, purpuric rash, coma. May be associated with neck stiffness (meningeal irritation).
What are the symptoms of encephalitis?
fever, odd behaviour, fits or reduced consciousness.
What are the symptoms of sinusitis?
dull, constant ache over frontal or maxillary sinus, with tenderness and postnasal drip. Pain is worse bending over.
What is the commonest cause of sinusitis?
Viral URTI
What are symptoms of raised ICP?
Chronic, progressive headaches. Worse on walking, bending forwards or coughing. Also: vomiting, seizures, false localising signs, or odd behaviour, visual changes, restricted visual fields.
What are the signs of giant cell arteritis?
Jaw claudication tender with thickened, pulseless temporal arteries. ESR >40mm/h. Headache lasted a few weeks. Vision loss (amaurosis fugax).
What is treatment for GCA?
Prednisolone. Anti-platelet to reduce stroke risk. Bisphosphonates as osteoporosis risk.
What are the signs of subdural haemorrhage?
Head trauma, lasts around 2 weeks; often resistant to analgesia. Drowsiness with/without lucid interval, or focal signs.
What cranial imaging is carried suspected space occupying lesion?
CT scan
What can be used to reduce swelling?
Dexamethasone
What are the signs of raised ICP?
Papilloedema, bradycardia, hypertension
What are the signs of a frontal brain tumour?
weakness, dysphasia, personality changes, dementia
What are the signs of a parietal brain tumour?
sensory symptoms, dressing apraxia, visual field defects
What are the signs of a temporal tumour?
dysphasia, visual field defects
What are the signs of an occipital tumour?
visual field defect
What is a sign of a posterior fossa lesion?
dysmetria, in-coordination, gait ataxia, cranial nerve palsies, tremors, nystagmus
What is the most common type of brain tumour?
glioblastoma multiforme (Grade IV Glioma)
Where does a meningioma rise from?
arachnoid cap cells
what is normal ICP?
<15 mmHg in adults. Lower in children.
How is raised ICP managed?
Patient position, sedation, ABG (normal PCO20, Temp, Mannitol (osmotic diuretic), hyperventilation, barbiturates,
What are the surgical treatments for raised ICP?
removal of space occupying lesion
Decompressive craniotomy
What is the best imaging for soft tissue lesions?
MRI
