Headache Flashcards
What is the best way to manage chronic daily headache?
- Withdraw regular analgesia to prevent medication-overuse headache
- Manage precipitants (e.g. stress, diet)
- Regular review
What is the definition of chronic daily headache?
Headache on 15 or more days a month for 3 or more months
What are the 2 most common causes of chronic daily headache?
1) Tension-type headache
2) migraine
How would you manage an acute migraine attack in general practice?
- simple analgesia
- triptan
- anti-emetic
- advise to keep a headache diary if appropriate
When must the OCP be stopped in patients with migraine and why?
- Migraine with aura
- Increase risk of stroke
When should you consider prophylaxis for migraines and what is are the options?
- If having >2 a month
- 1st line is propranolol
- 2nd line is topiramate
- Trial for 8 weeks and keep headache diary
Which 5 conditions causing headache require urgent referral to hospital?
1) SAH
2) Brain tumour
3) Raised ICP
4) GCA
5) Meningitis
What 3 features often complicate chronic daily headache?
1) poor sleep
2) stress
3) medication overuse
How should a patient presenting with first cluster headache be managed?
- SC sumitriptan
- 100% oxygen
- Refer to neurology
what investigations should be done by GP for suspected GCA?
- Fundoscopy
- ESR
