Headache Flashcards
Secondary headaches are a sign of?
Organic disease
What are the 10 worrisome signs which may indicate headache of pathologic origin (secondary HA)?
- “Worst HA”
- Onset of HA after age 50
- Atypical HA for patient
- HA w/ fever
- Abrupt onset (max. intensity in sec. to min.)
- Subacute HA w/ progressive worsening over time
- Drowsiness, confusion, memory impairment
- Weakness, ataxia, loss of coordination
- Paresthesias/Sensory loss/ Paralysis
- Abnormal medical or neurological exam
Any patient presenting with a headache who has a “worrisome history” or abnormal examination needs what?
- Urgent imaging study
- Perhaps even a L.P. and possibly arteriogram
Differentiate a common migraine from a classic migraine.
- Common migrarine = without aura
- Classic migraine = with aura
What is the intensity, age of peak prevalence, and gender ratio for common migraines?
- Intensity: moderate to severe
- Prevalence peaks between 35-40 years
- Gender ratio: F:M = 3:1
What is the location, patient description of pain, and patient behavior with a common migraine?
- Location: unilateral or bilateral
- Description: throbbing/sharp/pressure
- Behavior: retreat to dark, quiet room
What are the 4 most common associated symptoms with a common migraine?
- Nausea
- Vomiting
- Photophobia
- Phonophobia
How long does the aura associated with Classic Migraines usually last?
Usually 15-30 mins, but sometimes longer
What are the common visual symptoms associated with Classic Migraines?
- Scintillations: flashes of light
- Scotoma: an interruption or break in the visual field (blind spots)
*Often hemianopic
The most widely discussed theory about the cause of migraines says that they are caused by?
Neurogenic inflammation
To be defined as a chronic migraine which criteria must be met?
Headache for 15 or more days/month, lasting 4 hours or longer, for a period of at least 3 months
What is the intensity and disability caused by Tension-Type HA’s?
- Intensity: Mild to Moderate
- Disability: May inhibit, but does NOT prohibit daily activities
What is the common location, patient description of pain, and is there an associated aura/prodrome with a Tension-Type HA?
- Location: bifrontal, bioccipital
- Description: dull, aching, squeezing, pressure
- No prodrome or aura
Which type of headache has an association with sleep apnea as a comorbidity?
Cluster HA
*This will be on the exam!
What is the intensity and gender ratio for Cluster HA?
- Intensity: severe, excruciating
- Gender ratio: F:M = 1:6