Headache Flashcards
1
Q
what important questions should you ask when someone presents with a headache?
A
red flags:
- fever, neck stiffness, photophobia - meningitis
- new neurological symptoms - stroke, malignancy, haemorrhage
- dizziness- stroke
- visual disturbance - giant cell arteritis, glaucoma
- sudden onset occipital headache - SAH
- vomiting- ICP
- history of trauma - intracranial haemorrhage
- pregnancy - PET
- if it gets worse on bending over, coughing or sneezing - raised ICP
- if it’s bad enough to wake you up from sleep - raised ICP
2
Q
what examination should you perform on someone with a headache?
A
fundoscopy - check for papilloedema
3
Q
Tension Headache features
A
- very common
- dull ache
- starts in forehead and band-like distribution around head
- associations w dehydration, skipping meals, stress etc
- rX: reassurance, mild analgesia, hot towels to local area
4
Q
Secondary headache features
A
similar presentation to tension headache, but has a clear cause ie underlying medical condition, alcohol etc
5
Q
Sinusitis
- what is it caused by
- how does it present
- rx
A
- typically a viral illness
Presentation:
- headache with inflammation of sinuses
- facial pain around nose, behind eyes and in forehead
- O/E: tenderness in affected areas
Rx:
- resolves within 2-3 weeks
- nasal irrigation with saline can help, but if not nasal steroid spray given
6
Q
Analgesic headache features
A
- due to analgesic overuse long-term
- features similar to tension headache
- removal of analgesic important in treatment
7
Q
hormonal headache features
A
linked to LOW oestrogen
- around menopause
- couple days before and first few days of menstruation
- pregnancy- in first few weeks, should improve in last 6 months. If headache comes on in 2nd half of pregnancy, investigate for PET
OCP can can improve the headache
8
Q
cervical spondylosis features
A
- degeneration of cervical spine
- presents with neck pain that is worse on movement & headache
