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J Neuro > Headache > Flashcards

Headache Flashcards

1
Q

headache red flags

A 
new onset >55
early morning/wakes you up 
exacerbated by sneezing/coughing 
neck stiffness
seizures 
change in vision, photophobia
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2
Q

classic type of person with migraine (gender, age)

A

female

teenager-40yo

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3
Q

migraine triggers (4)

A

stress
hormonal (periods)
sleep
diet - cheese, red wine, caffeine

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4
Q

what chemical does triggers (eg stress) release

what does this do to blood vessels (in brain)

what does this result in

A

serotonin

vasodilation of cranial blood vessels

pain = migraine

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5
Q

how long can migraines last for (each time)

how often do people get migraines

A

4-72 hours

once per month (avg)

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6
Q

what GI symptoms may migraine present with

A

nausea and vomiting

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7
Q

what ophtho symptoms may migraine present with

A

photophobia

aura

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8
Q

how does the headache feel in a migraine

A

unilateral throbbing headache

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9
Q

acute management for migraine (2)

A

NSAIDs

triptans - costly

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10
Q

prophylaxis for migraines

A

lifestyle modification - avoid triggers (use diary)
first line - propanolol (not asthmatics), topiramate (carbonic anhydrase inhibitor)
second line - gabapentin, sodium valproate

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11
Q

what is contraindicated in people with migraines with aura

A

oral contraceptives

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12
Q

presentation of tension headache

A 
no nausea/vomiting
no photphobia/aura 
bilateral
mild/moderate 
'monday morning'
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13
Q

management of tension headache (3)

A

relaxation
beta blockers
antidepressants

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14
Q

pathophysiology of tension headache

A

nothing, theyre fine

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15
Q

what are the 3 types of trigmeninal autonomic cephalgias

A

cluster headache
paroxysal hemicrania
SUNCT

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16
Q

how do trigeminal autonomic cephalgias present (2 categories of symptoms)

A

unilateral trigeminal distribution (headache)

ipsilateral cranial autonomic features - eg ptosis, miosis, nasal stuffiness, tearing, eye lid oedema

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17
Q

who get cluster headache s(gender and age)

A

young men

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18
Q

who get paroxysmal hemicrania (gender and age)

A

50-60yo women

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19
Q

what are the autonomic features in trigeminal cranial cephlagia (5)

A 
ptosis
miosis
nasal stuffiness
tearing
eye lid oedema
20
Q

how often do men get ‘clusters’ of cluster headaches

A

every couple months

21
Q

how long do the headaches last in cluster headaches

ow many do you get in a day

A

45-90mins

1-8 in a day

22
Q

how long to paroxysmal hemicrania headaches last

how many do you get in a day

A

10-30 mins

1-40 in a day

23
Q

acute treatment of cluster headaches

A

oxygen and sumatriptan SC

24
Q

prophylactic treatment of cluster headaches

A

verapamil

25
Q

treatment of paroxysmal headaches (in older women)

A

indomethicin (diagnostic if it works)

26
Q

what is SUNCT

how does it differ from other types of trigeminal autonomic cephalgia

A

stands for;

short lived
unilateral headache
neuralgia headache
conjunctival injections tearing

it lasts longer than other trigeminal autonomic cephalgia

27
Q

investigations for trigeminal autonomic cephalgia

A

MRI/CT

28
Q

who get idiopathic intracranial hypertension

A

obese females

29
Q

when is headache worse in idiopathic intracranial hypertension

A

morning

30
Q

idiopathic intracranial hypertension causes increased … and hence … (eye symptom)

A

increased ICP = papilloedema = vision loss

31
Q

investigations for idiopathic intracranial hypertension

A

fundoscopy - for papilloedema

brain MRI - for other causes of papilloedema

32
Q

management of idiopathic intracranial hypertension

A

LOSE WEIGHT! though no one does lol

acetazolamide

33
Q

how does acetazolamide work in relieve idiopathic intrancranial hypertension
what is another common drug that would do this same job

A

decreases ICP

diuretics

34
Q

who gets trigeminal neuralgia

A

elderly women

35
Q

what is the pathophysiology of tirgeminal neuralgia

A

blood vessel touches trigeminal nerve = extreme pain when nerve is triggered (eg by touch to face, chewing etc)

36
Q

presentation of pain in trigeminal neuralgia

how long does pain last for
how many times per day do they get pain

A

sharp stabbing unilateral pain
lasts <90 seconds
happens 1-100 times per day

37
Q

investigations for trigeminal neuralgia

A

MRI

38
Q

treatment for trigeminal neuralgia

A

carbamazepine
gabapentin
phenytoin
ablation decompression (big surgery)

39
Q

20yo female
headache with nausea, aura and photophobia
once per month
lasts 4-72 hours

A

migraine

40
Q

feels like a band squeezing round head

A

tension headache

41
Q

bilateral headache
no nausea/vomiting/visual loss/photophobia
mild/moderate
feels like a band squeezing round head

A

tension headache

42
Q 
young male
unilateral headache
eye lid oedema
ptosis 
lasts 45-90mins, 1-8 times per day
A

cluster headache

43
Q

general headache treatment (a good guess in exam)

A

triptan

44
Q 
60yo women 
unilateral headache 
miosis 
tearing
nasal stuffiness 
lasts 10-30mins, 1-40 times per day
A

paroxysmal hemicrania

45
Q

obese female
vision loss
headache worse in morning
nausea and vomiting

A

idiopathic intracranial hypertension

46
Q

elderly women
severe unilateral stabbing pain in face
<90secs, 1-100 times per day
triggers - chewing, touch face

A

trigeminal neuralgia

J Neuro (32 decks)

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