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Neurology > Headache > Flashcards

Headache Flashcards

1
Q

What is a primary and secondary headache?

A

Primary (90%): headache is the pathology e.g. migraine, tension, cluster

Secondary (10%): headache is due to something else e.g. brain tumour, meningitis, SAH

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2
Q

What are red flags in a headache history?

A

Systemic symptoms
Neurological signs
Older age
Onset is acute
Previous headache history is different/absent
Triggered headache e.g. Valsalva, posture

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3
Q

What headaches occur at different sites?

A

Unilateral or ocular : cluster or migaine

Bilateral: tension, migraine

Temporal: temporal arteritis

Occipital: SAH

Paranasal: sinusitis

Dermatomal: post-herpetic neuralgia

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4
Q

What headaches are diffuse?

A

Raised ICP and mass lesions

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5
Q

What headaches can radiate?

A

Tension
Migraine
Cluster
Trigeminal neuralgia

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6
Q

What symptoms are associated with migraine?

A

N/V
Photo/phonophobia
Visual and sensory aura

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7
Q

What symptoms are associated with meningitis?

A

N/V
Photo/phonophobia
Neck pain
Rash

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8
Q

What symptoms are associated with cluster headache?

A

Ipsilateral rhinorrhoea or lacrimation

Diplopia or ptsosis

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9
Q

What are triggers for migrane?

A 
Cheese, chocolate
bright lights
COCP
Tiredness and stres
alcohol 
dehydration 
menstrutiaon
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10
Q

How do you treat a cluster headache?

A

Acute: 100% O2 and SC triptan

Prophylaxis: verapamil

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11
Q

What are causes of a raised ICP headache?

A
  • idiopathic intracranial hypertension
    • traumatic head injuries
    • infection
    • meningitis
    • tumours
    • hydrocephalus
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12
Q

What symptoms are associated with raised ICP headache?

A

worse on bending, coughing, sneezing

vomiting
	• reduced levels of consciousness
	• papilloedema
	• Cushing's triad
	• widening pulse pressure
	• bradycardia
	• irregular breathing

impaired visual acuity and third nerve palsy

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13
Q

What invesitgations for raised ICP headache?

A

CT or MRI

Invasive ICP monitoring

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14
Q

What treatment for ICP headache?

A

IV mannitol
Controlled hyperventilation
Removal of CSF e..g repeated LP

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15
Q

What drugs are associated with headache?

A

Alcohol
cocaine (ICH)
paracematol overuse

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16
Q

What investigations should you do for headache?

A

CT/MRI if suspected pathology

Fundoscopy for papilloedoema in raised ICP

17
Q

What is management of migraine?

A

Avoid triggers
Analgesia (high dose aspirin is abortive)
Triptans

Prophlaxis with beta-blockers e.g. propranolol

18
Q

What are causes of thunderclap headache?

A

SAH
ICH
Arterial dissection
Central venous sinus thrombosis

19
Q

What are causes of raised ICP headache?

A

Tumour, haematoma
Venous sinus thrombosis
Hydrocephalus
Idiopathic

Neurology (11 decks)

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