headache Flashcards
tension type headache is the most common type of what?
primary headache
tension type headache treatment
paracetamol/ asprin
NSAIDs
tension headache description:
mild, bilateral headache
NOT disabling
no associated features
Migraine is the most common what?
DISABLING primary headache
during migraine attacks
migraine is known for episodic attacks
headache
nausea/photophobia
functional disability
migraines are usually male or female?
100% male
22% female
migraine triggers
sleep disturbance
stress
hunger
environmental stimuli
diet
dehydration
changes in oestrogen in women
What is aura?
transient neurological symptoms resulting from cortical or brainstem dysfunction
(can involve visual/sensory/motor/speech symptoms)
how long does aura usually last?
15 to 20 mins
medication overuse headache is what kind of headache?
primary
migraine treatment
NSAIDs or aspirin
triptans
propanolol
gabapentin
depressant medication
(limit to 10 days to make sure of no medication overuse headache)
the combined oral contraceptive pill is involved in active
migraine with aura
trigeminal autonomic cephalgias are a group of headaches. 4 types:
cluster headache
paroxysmal hemicrania
SUNCT (short-lasting unilateral neuralgiform headache with conjunctival tearing)
SUNA (short-lasting unilateral neuralgiform headache with autonomic
pain of a cluster headache attack is usually
orbital and temporal
cluster headache attacks are bilateral or unilateral?
unilateral
cluster headaches are episodic in
80-90% of patients
some conditions of cluster headache attacks
rapid onset
unilateral
last 15mins to 3 hours
suicide headache
migraine symptoms are often present
treatment of a cluster headache
100% oxygen
subcutaenous sumatriptan
oral predisnolone
verapamil
paroxysmal hemicrania
attacks are strictly unilateral
last 2-30 minutes
excruciatingly severe
in 10% attacks are precipitated by bending or rotating the head
SUNCT pain
stabbing/ pulsatile
triggers for SUNCT pain
cuteanous triggers like:
wind/ cold
touch
chewing
Treatment of SUNCT/ SUNA
lemotrigine
gabapentin
carbamezepine
cuteanous triggers of trigeminal neuralgia
cold/wind
touch
chewing
treatment of trigeminal neuralgia
surgical decompression
prophylaxis
red flags for a secondary headache
new onset
new or change in headache
neck stiffness or fever
abnormal focal examination
abnormal neuro examination
high pressure (worse when lying down etc)
low pressure (worse when standing up)
thunderclap headache
a high intensity headache reaching maximum intensity in less than 1 minute
thunderclap headache - primary or secondary?
can be both
thunderclap headache differential diagnosis
subarachnoid haemorrhage
primary headache
intracerebral haemorrhage
TIA/stroke
meningitis/ encephalitis
people with thunderclap headaches often present with
subarachnoid haemorrhage
space occupying features/ raised ICP RED FLAGS
focal symptoms or signs
worsens when lying down or brought on by valsalva
seizures
headaches worse in the morning or wakening from a sleep
intracranial hypotension is usually caused by
CSF leak
what is arteritis?
inflammation of the walls of an artery
giant cell arteritis should be considered in patients that are:
over 50 with a sudden on set headache
Giant cell arteritis presents with
scalp tenderness
jaw claudication
visual disturbance
