Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology and Neuroscience > Headache > Flashcards

Headache Flashcards

1
Q

List patterns of headache.

A 
acute single headache
dull headache, increasing in severity
dull headache, unchanged over months
recurrent headache
triggered headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Possible explanations for dull headache increasing in severity?

A

usually benign, medication overuse, HRT/contraceptive pill, neck disease, temporal arteritis, benign intracranial hypertension, cerebral tumour, cerebral venous sinus thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Possible explanations for acute single headache?

A

febrile illness, sinusitis, 1st attack of migraine, after head injury, subarachnoid haemorrhage, meningitis, tumour, drugs, toxins, stroke, thunderclap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Possible explanations for dull headache unchanged over months?

A

chronic tension headache

depressive, atypical facial pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Possible explanations for recurrent headaches?

A

migraine
cluster headache
episodic tension headache
trigeminal or post herpetic neuralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Possible explanations for triggered headaches?

A

coughing, straining, exertion
coitus
food and drink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are red flags for headaches?

A

onset: thunderclap, acute, subacute
meningism: photophobia, phonophobia , stiff neck, vomiting
systemic symptoms, neurological symptoms, orthostatic, strictly unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List examples of focal signs.

A 
double vision
Horner syndrome
3rd nerve (oculomotor) palsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list vascular and circulatory causes of headache

A

subarachnoid haemorrhage, coiling an aneurysm, acute intracerebral bleed, raised intracranial pressure, papilloedema, carotid and vertebral arteries, chronic subdural haemorrhage, temporal arteritis, cerebral venous thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

list infective causes of headache

A

herpes simplex encephalitis
meningitis
sinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

list causes of headaches involving intracranial pressure

A

brain tumour
idiopathic
chiari malformation
obstructive sleep apnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

list facial pain causes of headache

A

trigeminal neuralgia

atypical facial pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

list traumatic causes of headache

A

post traumatic headache

management of post traumatic headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

list cervicogenic pain causes of headache

A

cervical spondylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

symptoms of subarachnoid haemorrhage

A

sudden generalised headache, meningism - stiff neck and photophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most subarachnoid haemorrhages are caused by?

A

ruptured aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

some subarachnoid haemorrhages are caused by?

A

arteriovenous malformations

unexplained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what % of subarachnoid haemorrhages are instantly fatal?

A

50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what physiological action may stop the leak in a subarachnoid haemorrhage?

A

vasospasm (sudden constriction of a blood vessel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

list medication used to treat subarachnoid haemorrhage

A

diazepam (manage mental conditions)
amlodipine (reduce BP)
clonazepam (seizure prevention)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

list surgical procedures used to treat subarachnoid haemorrhage

A

craniotomy

endovascular coiling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why is nimodipine used in subarachnoid follow up treatment?

A

prevention of problems after a subarachnoid haemorrhage > high risk of further bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

imaging used in assessment of subarachnoid haemorrhage

A

CT brain
lumbar puncture (RBC and xanthochromia) and MRA
angiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is aneurysm coiling?

A

instead of clipping ro wrapping, fill the aneurysm with platinum coils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cause of acute intracerebral bleed?

A

coning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

coning refers to?

A

the herniation of the brain through the foramen magnum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

mechanism of coning

A

raised intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is papilloedema?

A

optic disc swelling due to raised intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

headache can arise due to pathology of what large neck arteries?

A

vertebral

carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

mean age for carotid/vertebral artery dissection

A

40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

which is more common: carotid or vertebral artery dissection?

A

carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

carotid and vertebral artery dissection can be divided into what causative categories?

A

traumatic

spontaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

imaging for carotid + vertebral artery dissection

A

MRI/MRA
Doppler
angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

treatment for carotid and vertebral artery dissection

A

aspirin or anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

epidemiology of temporal arteritis

A

> 55

3x commoner in females

36
Q

temporal arteritis presents as?

A

constant unilateral headache, scalp tenderness, jaw claudication
25% present with polymyalgia rheumatica - proximal muscle tenderness

37
Q

involvement of the posterior ciliary arteries in temporal arteritis causes?

A

blindness

38
Q

what is notable in lab results of temporal arteritis?

A

elevated ESR and CRP

39
Q

describe the temporal artery in temporal arteritis

A

inflamed

tortuous

40
Q

is the state of the temporal artery visible on ultrasound?

A

yes

41
Q

biopsy shows what in temporal arteritis?

A

inflammation and Giant cells

42
Q

treatment for temporal arteritis

A

high dose steroids

aspirin

43
Q

cerebral venous thrombosis

A

thrombosis in dural venous sinus or cerebral vein

44
Q

risk factors for cerebral venous thrombosis

A

thrombophilia
pregnancy
dehydration
Behcet’s

45
Q

causes of meningitis

A

viral, bacterial, tuberculous, fungal, granulomatous, syphilis, carcinomatous

46
Q

how does meningitis present?

A

malaise, headache, fever, neck stiffness, photophobia, confusion, alteration of consciousness

47
Q

herpes simplex encephalitis causes what changes in the brain?

A

haemorrhagic changes in the temporal lobes

48
Q

what is the approach for meningitis?

A

treat then diagnose

49
Q

treatment for meningitis

A

antibiotics

50
Q

investigations for meningitis

A

blood and urine culture
lumbar puncture: antigens, cytology, bacterial culture
CT or MRI

51
Q

lab findings for meningitis

A

increased white cell count

decreased glucose

52
Q

classic findings on imaging of bacterial meningitis

A

cerebral oedema with effacement of ventricles and sulci and inflamed meninges

53
Q

how does sinusitis present?

A

malaise, headache, fever, blocked nasal passages, loss of vocal resonance, anosmia, nasal or postnasal catarrh, local pain and tenderness

54
Q

describe the pattern of pain in sinusitis

A

frontal pain characteristically starts 1-2 hours after rising and clears up during the afternoon

55
Q

imaging findings in sinusitis

A

opacification of the paranasal sinus

56
Q

what is pseudotumor cerebri?

A

increased pressure inside the skull for an unknown reason

57
Q

pseudomotor cerebri is also known as?

A

idiopathic intracranial hypertension

58
Q

pseudotumor cerebri often presents in what population?

A

young obese women

59
Q

pseudotumor cerebri presents as?

A

Headache, visual obscurations, diplopia, tinnitus

Papilloedema, +/- visual field loss

60
Q

treatment of pseudotumor cerebri

A

weight loss, diuretics, optic nerve sheath decompression, lumboperitoneal shunt, stenting of stenosed venous sinuses

61
Q

what is the cause of low pressure headache?

A

CSF leak due to tear in dura

62
Q

low pressure headache occurs in response to?

A

spontaneous or traumatic post lumbar puncture

63
Q

treatment for low pressure headache

A

rehydration
caffeine
blood patch

64
Q

imaging findings for low pressure headache

A

meningeal enhancement

65
Q

what is the chiari malformation?

A

cerebellar tonsils descend through foramen magnum

66
Q

when a patient with chiari malformation coughs, what happens?

A

brain tissue descends further and tugs on the meninges causing cough headache

67
Q

imaging findings with chiari malformation

A

normal brain that just sits very low within the skull

68
Q

risk factors for obstructive sleep apnoea

A

often characteristic body habitus, history of loud snoring and apnoeic spells

69
Q

consequences of obstructive sleep apnoea

A

hypoxia, CO2 retention, non-refreshing sleep, depression, impotence, poor performance at work

70
Q

diagnosis + treatment of obstructive sleep apnoea

A

require sleep study

nocturnal NIV, surgery

71
Q

describe the pain in trigeminal neuralgia

A

Electric shock like pain in the distribution of a sensory nerve

72
Q

trigeminal neuralgia is often triggered by?

A

innocuous stimuli

73
Q

which divisions of the trigeminal can be affected by neuralgia?

A

any division

74
Q

where is the neurovascular conflict in trigeminal neuralgia?

A

at the point of entry of the nerve into the pons

75
Q

trigeminal neuralgia can be a symptom

A

multiple sclerosis

76
Q

treatment of trigeminal neuralgia

A

carbamazepine, lamotrigine, gabapentin

posterior fossa decompression

77
Q

atypical facial pain presents most commonly in what population?

A

middle aged women

78
Q

how does atypical facial pain present?

A

Daily, constant, poorly localised deep aching or burning. Facial or jaw bones, but may extend to the neck, ear or throat. Not lancinating. Not conforming to the strict anatomical distribution of any nerve. No sensory loss

79
Q

for a diagnosis of atypical facial pain, pathology in what must be excluded?

A

in teeth, temporomandibular joints, eye, nasopharynx and sinuses

80
Q

atypical facial pain is unresponsive to?

A

conventional analgesics, opiates and nerve blocks

81
Q

atypical facial pain is managed by?

A

tricyclics

82
Q

post traumatic headache can occur after?

A

car accidents

sports injuries

83
Q

treatment of post traumatic headache

A

NSAIDs - ibuprofen, naproxen

Tricyclic antidepressants - amitriptyline

84
Q

what is the commonest cause of new headache in older patients?

A

cervical spondylosis

85
Q

how does cervical spondylosis present?

A

usually bilateral, occipital pain can radiate > frontal region, steady pain, no nausea or vomiting, worsened by moving the neck

86
Q

imaging findings of cervical spondylosis

A

narrowing of joint space due to worn disc

87
Q

management of cervical spondylosis

A

Rest, deep heat, massage.
Anti-inflammatory analgesics.
Over-manipulation may be harmful.

Neurology and Neuroscience (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions