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Y3 Neurology > Headache > Flashcards

Headache Flashcards

1
Q

what age is a red flag for headaches

A

new onset >55

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2
Q

what time of day is a red flag for headaches

A

early morning

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3
Q

give examples of primary headache syndromes

A

migraine
tension headache
TAC

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4
Q

what is the presentation of tension headaches

A

mild episodic tingling headaches

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5
Q

what is the cause of tension headaches

A

stress

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6
Q

are nausea, photophobia or phonophobia present in tension headaches?

A

never

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7
Q

gender more commonly affected by migraine

A

female

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8
Q

how long does migraines last

A

4 to 72 hours

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9
Q

are migraines uni or bilateral

A

unilateral

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10
Q

20% of migraines have what accompanying symptom

A

migraine aura

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11
Q

what is a migraine aura, give examples

A

sensory symptom

example: central scotoma, central fortification, hemianopia, sensory, motor, language

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12
Q

do migraines cause nausea and vomiting

A

can do

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13
Q

abdominal migraines are common in what age range

A

kids

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14
Q

what is an acephalgic migraine

A

only aura present

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15
Q

what additional symptom if present in basilar migraines

A

vertigo, nausea, vomiting

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16
Q

when is prophylaxis indicated in migraines

A

if more than 3 a month

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17
Q

how long should migraine medications be trialed for

A

4 mth

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18
Q

1st choice of migraine prophylaxis

A

propanolol

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19
Q

propanolol contraindications in migraine mx

A

asthma, PVD, HF

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20
Q

acute migraine mx options

A

NSAID or triptan eg. sumatriptan

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21
Q

what does TAC stand for

A

trigeminal autonomic cephalgia

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22
Q

is TAC HA uni or bilateral

A

unilateral

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23
Q

as well as HA, what additional feature is present in TAC

A

autonomic signs

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24
Q

give example of autonomic signs in TAC

A

ptosis, miosis, stuffy nose, N+V, tear, lid edema

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25
Q

give examples of the types of TAC

A

cluster HA, paroxysmal hemicranias, hemicrania continua, SUNCT

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26
Q

age and gender mostly affected by cluster HA

A

M>F 30-40

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27
Q

how long do cluster headaches last

A

45-90min

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28
Q

cluster headaches are mild pain. T or F

A

false, severe

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29
Q

acute management of cluster headaches

A

SC sumatriptan, high flow O2, CCS

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30
Q

prophylaxis of cluster headaches

A

verapamil

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31
Q

age and gender mostly affected by paroxysmal hemicranias

A

F>M 50-60

32
Q

what is the key diagnostic feature in paroxysmal hemicranias

A

always respond to indomethicin

33
Q

how long do paroxysmla hemicranias last

A

10-30min

34
Q

how long do SUNCT HAs last

A

15-120 seconds

35
Q

as well as unilateral HA, what additional symptoms is present in SUNCT

A

conjunctival injection (red eye), tearing

36
Q

when investigating TAC, if a PTx has new unilateral autonomic features, what investigations should you do?

A

MRI brain + MR angio to exclude lesion

37
Q

major risk factors for idiopathic intracranial HTN

A

young obese female

38
Q

describe the headache in idiopathic intracranial HTN

A

morning
throbbing
relief standing

39
Q

basic pathology of IIH

A

raised intracranial pressure

40
Q

what CN palsy can occur as a comp of IIH

A

VI

41
Q

what ENT related symptom can IIH cause

A

pulsatile tinnitus

42
Q

as well as HA (and pulsatile tinnitus), how else does IIH present?

A

N+V
visual field defect
decreased visual acuity

43
Q

what is seen on MRI in IIH

A

normal

44
Q

what test is diagnostic of IIH

A

LP shows CSF pressure >25

45
Q

what is the pharmacological management of IIH

A

acetazolamide or furosemide

46
Q

in IIH, if a PTx has decreased acuity or a visual field defect, how does this affect the management?

A

PTx requires shunt

47
Q

what age and gender are most commonly affected by trigeminal neurlagia

A

female over 60yr

48
Q

what is the distribution of pain in trigeminal neuralgia

A

pain in V2/3 areas

49
Q

what triggers pain in trigeminal neuralgia

A

touch

50
Q

how long does the pain last in trigeminal neuralgia

A

1-90 seconds

51
Q

describe the nature of the pain in trigeminal neuralgia

A

severe stabbing

52
Q

is trigeminal neuralgia bi or unilateral

A

unilateral

53
Q

investigations for trigeminal neuralgia

A

MRI

54
Q

what neurological condition is associated with trigeminal neuralgia

A

MS

55
Q

what is the 1st line pharmacological mx of trigeminal neuralgia

A

carbamazepine

56
Q

“orthostatic HA, diplopia, dizzy, muffled hearing, back of neck/arm pain and galactorrhea” could be the presentation of what condition

A

spontaneous intracranial hypotension

57
Q

what is the pathology of spontaneous intracranial hypotension

A

diverticula in dura, leak CSF

58
Q

what is syringomelia

A

cyst/syrinx in spinal canal or at craniovertebral junction

59
Q

what effect does syringomelia have on upper and lower limb reflexes

A

no upper limb reflexes

lower limb hyperreflexia

60
Q

does syringomelia cause hyperhydrosis or anhydrosis

A

hyperhydrosis

61
Q

does syringomelia cause large or small muscle wasting

A

small muscle wasting

62
Q

a chiari malformation is a malformation of what part of the brain

A

hindbrain

63
Q

basic pathology of chiari malformations

A

impaired csf flow through foramen magnum

64
Q

basic treatment of chiari malformations

A

surgery

65
Q

what is the commonest type of chiari malformation

A

type 1

66
Q

what is the most severe type of chiari malformation

A

type 2

67
Q

what type of chiari malformation is associated with myelomeningoceles

A

type 2

68
Q

what type of chiari malformation is more common in children

A

type 2

69
Q

what type of chiari malformation can cause a downbeat nystagmus

A

type 1

70
Q

synringomelia can present like central cord syndrome. T or F

A

true

71
Q

what is displaced below the foramen magnum in a type 1 chiari malformation

A

cerebellar tonsils

72
Q

what is displaced below the foramen magnum in a type 2 chiari malformation

A

cerebellum + medulla + 4th ventricle

73
Q

what type of chiari malformation can cause a headache when coughing or during neck extension

A

type 1

74
Q

where is the headache located in type 1 chiari malformations?

A

suboccipital

75
Q

what type of gait disturbance can a type 1 chiari malformation cause

A

ataxic gate

76
Q

what type of chiari malformation can cause stridor or a spastic paresis (amongst other symptoms?)

A

type 2

77
Q

what is a type 2 chiari malformation also called

A

arnold chiari malformation

Y3 Neurology (23 decks)

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