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Year 3 Conditions > Headache > Flashcards

Headache Flashcards

1
Q

Mnemonic for remeering sinister causes of headache

A

Vascular
Infective
Visual threatening- GCA, apoplexy, cavernous sinous thrombosis, acute glaucoma
Intracranial pressure- SOL, HTN, cerebral oedema from trauma, hydrocephalus
Dissection- carotid

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2
Q

What needs to be considered with headache and LOC

A

SAH must be ruled out
If trauma could be haematoma
Infective causes can lead to this

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3
Q

What is implied by LOC following lucid interval

A

Extradural haematoma

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4
Q

What is implied by fluctuating LOC

A

Subdural haematoma

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5
Q

How would felt like hit in back of head indicate

A

SAH

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6
Q

What do seizures or focal neurology suggest about a headache

A

Intracranial or could be migraine aura

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7
Q

What does recurrent headaches suggest about overall pathology

A

Not that sinister

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8
Q

What is most common cause of amaurosis fugax

A

TIA

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9
Q

What to think when amaurosis fugax alongside headache

A

Any under VIVID

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10
Q

What to ask about if suspect GCA

A

Scalp tenderness
Jaw pain
Shoulder pain

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11
Q

If suspect carotid dissection what should ask about

A

Yoga

Neck chiropractic manipulation

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12
Q

What does headache worse when lying or bending over suggest

A

Raised ICP as no support on head

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13
Q

What does headache with morning nausea suggest

A

Raised ICP

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14
Q

What does headache worse when standing up suggest

A

Low ICP- very common after LP and will resolve after analgesia and time

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15
Q

What do constitutional Sx with headache suggest

A

TB
Malignancy
Chronic inflammation like temporal arteritis

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16
Q

What would be considered if PMH of immunosuppression such as HIV or recent transplant in headache Px

A

Increased risk of infection

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17
Q

What would history of TB in headache presentation suggest

A

Potential tuberculoma, abcess and toxoplasmosis

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18
Q

What would history of cancer and headache suggest

A

Metastases

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19
Q

What does tongue deviation suggest

A

12th nerve palsy

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20
Q

What can cause 12th nerve palsy

A

Carotid dissection

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21
Q

What is most likely cranial nerve palsy

A

6th as has longest route

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22
Q

What appears as convergent squint inwards or failure to abduct eye

A

6th nerve palsy

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23
Q

Common cause of 6th nerve palsy

A

Something compressing eye, can be from ICP

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24
Q

What does exopthalmos with headache suggest

A

Cavernous sinus thrombosis

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25
Q

What does a cloudy cornea suggest

A

Acute glaucoma

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26
Q

What does reduced visual acuity and headache indicate

A

Acute glaucoma and GCA

27
Q

Non sinister headaches

A 
Tension
Migraine
Sinusitis
Medication overuse
TMJ syndrome
Trigeminal neuralgia
Cluster headache
28
Q

What are 2 types of headache

A

Primary and secondary

In primary if removed headache then would be no harmful pathology

29
Q

Questions for non-sinister headaches

A

Suffer any headaches usually- migraine users susceptible to medication overuse
Triggers- migraines and tension types
How disabling?
Aura?

30
Q

What does stress fatigue dehydration and hunger trigger

A

Tension headaches

31
Q

How do tension headaches present

A 
Feel like tight band around head
Bilateral
Can radiate to shoulders and neck
No more than few hours
Only disabling if for regular basis
32
Q

What are migraine aura differentials

A

TIAs

33
Q

Which sex are medication overuse headaches particularly prevalent in

A

Females

34
Q

Presentation of sinusitis

A

Facial pain that worsens with movement

Associated with coryzal symptoms

35
Q

Who does TMJ syndrome most commonly occur in

A

20-40

36
Q

How does TMJ syndrome present

A

Get headache and dull ache in muscles of mastication that radiates to ears and jaw

37
Q

What headache can lead to hearing click when move neck

A

TMJ

38
Q

How does trigeminal neuralgia present

A

Stabbing pain that only comes about when patient touches or does anything involving face

39
Q

What can separate trigeminal neuralgia from cluster and migraines

A

Trigeminal rarely wakes people up at night

40
Q

Pain over eye differentials

A

Cluster
Migraine
GCA

41
Q

When is only time you give preventative medication for migraines

A

If occur on a fortnightly basis

42
Q

Examinations ordered for non-sinister headaches

A

Obs- rule out malignant HTN
Head and neck examination- muscle tenderness and stiffness
Focal neurology signs suggest something more sinister
Fundoscopy- ICP and HTN

43
Q

What looking for SAH on CT

A

Blood in fissures and in CSF

44
Q

Management of SAH if CT positive

A

Give Nimpodipine a CCB that reduces spasm of arteries preventing a stroke
Angio to find location of bleed and platinum coil to clot the bleed

45
Q

How are visual problems described in migraines

A

Slow march where gradual worsening of visions and resolves in similar way

46
Q

Other than TIA what else can cause positive signs sporadically

A

Epilepsy

47
Q

Common epilepsy signs

A

Feeling sensation in her skin
Convulsions
Flashing lights seen

48
Q

Most common brain tumour in children

A

Medulloblastoma of cerebellum- ataxia symptoms

49
Q

IF brain tumour is strongly suggested what are steps to management

A

Do urgent MRI

Will treat with dexamethasone to reduce swelling and ease headache in mean time then will have surgery

50
Q

What are examples of primary headache

A

Migraine
Cluster
Tension

51
Q

RFs tension headache

A

Stress

Disturbed sleep

52
Q

Management of tension headaches

A

Avoid triggers and make a headache diary
Simple analgesia
Beware of medication overuse headaches

53
Q

First line management of migraines

A

Avoid triggers and make a headache diary

Simple analgesia

54
Q

If simple analgesia doesnt work with migraines what is given

A

Triptans

55
Q

If want to prevent migraines what is first line

A

Propanolol or topiramate

56
Q

If Propanolol or topiramate dont work in preventing migraines what is given

A

Amitryptiline

57
Q

What is topiramate

A

An anti-epileptic

58
Q

What is amitriptyline

A

An antidepressant

59
Q

When do cluster headaches normally happen

A

At night

60
Q

Where is pain in cluster headache

A

Behind the eye

61
Q

What can trigger cluster headaches

A

Alcohol or strong smells

62
Q

Assocaited symptoms of cluster headache

A

Watery, red eye
Facial flushing
Nasal congestion

63
Q

Signs on examination of cluster headache

A

Partial horners with ptosis and miosis

Year 3 Conditions (33 decks)

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