Headache Flashcards
What are important parts of headache history? and Examination? And tests?
Onset, frequency, duration, quality, intensity, location, triggers/easers, does it change? is it episodic
associated symptoms
System review important-can be what causes headache
also ask PMH (can be cause), and drugs (can be cause), drinking etc
EXAMINATION-minimum-neuro exam, fundoscopy (raised intracranial pressure (papillodema) check meningism (stiff neck), Temp, BP
Then can get to test if all the rest has been discussed-CT, MRI, ESR, bloods, LP
what are types of primary headache
primary (no causative)-Migraines, tension, cluster, other
things that sound like that can still be secondary (not because it sounds like)
What are causes of secondary headache
something is causing it-
head trauma, occular trauma, teeth issues, vascular disorders (stroke, VTE, subdural), CNS infections (menigitis), raised intracranial pressure (space occupying lesion), metabolic disorders (hyperglycemia, hyperuremia, hypercalceamia), Drug withdrawal (can be medical/prescribed/recreational), teeth, eyes (glaucoma), psychiatry
What are the red flags for headache?
Any NEW headache after 50-secondary-scary
Onset-very abrupt and severe (thunderclap)
Temporal-progressive severe or increasing severity
Pattern-change in headache pattern/type
Neuro signs-stiff neck, focal sign, confusion, altered LOC
Systemic-abnormal exam, fever, weight loss
Triggers-posture (WORSE IN THE MORNING/lying down)(-raised intracranial pressure, valsalvar manoeuvre, coughing, exertion
(all these for raised IC HTN
secondary risk factors-systemic disease, cancer (prothrombotic),, HIB, 3rd trimester of pregnant (prothrombotic), recent head injury
When do you do a CT for a thunderclap?
CT only very early after start-or else blood leaves in about 1 day
What are the causes of thunderclap headaches?
Subarachnoid heamorghaes (often present as only)
What kind of condition show normal CTs?
Tons-Subarachnoid, meningitis, some raised pressure, more
