headache and CNS infections Flashcards
what are headache “red flags”
-severity of pain
-sudden onset
-increase in intracranial pressure
-visual changes
-confusion
-loss of consciousness
-meningism (stiff neck), fever, rash
associated history e.g cancer HIV- at risk of cns infections
what are primary headaches?
-unpleasant but not lasting damage
list the examples of primary headaches
-tension headaches
-migraine
-cluster headache
-trigeminal neuralgia
-medication overuse headache
describe a tension headache
-gradual onset
-symmetrical
-stress related
-worse at end of the day
what is the treatment for tension headaches
conventional analgesia
describe a migraine
-pre headache aura- visual problems/focal symptoms
-migraine within 1 hr- throbbing on one side, nausea/vomitting, photophobia
what is the treatment for migraines?
-conventional analgesia
-metoclopramide
-serotonin antagonists
describe a cluster headache
-common in males/smokers
-episodic
-sever pain around eye
what is the treatment for cluster headaches
-“triptans”
-oxygen
describe trigeminal neuralgia
-severe stabbing pain
-affects 2 branches of nerve
- evoked by light touch
what is the treatment for trigeminal neuralgia?
-carbamazepine
-surgery
describe medication overdose headache
-chronic headaches
-common in those taking opiates, triptans and paracetamol
what is the treatment for medication overdose headache?
medication withdrawal
what are secondary headaches?
headaches associated with mortality and permanent disability
what is giant cell arteritis?
inflammation of the arteries in the temple
-affects branches of external carotid artery
what are the symptoms of giant cell arteritis?
-headache
-scalp tenderness
-loss of temporal pulse
-jaw claudication- not enough blood supply to jaws of mastication
-can lead to blindness as it affects retinal artery
what is the risk of giant cell arteritis?
risk of blindness- refer to gp
what is glaucoma?
causes an increase in pressure of the eye
what are the symptoms of glaucoma?
-reduced vision
-constant eye ache
-red cloudy eye
this requires an urgent referral
what are two CNS infections?
meningitis and encephalitis
what is meningitis an infection of?
infection of inner lining of the brain
what are symptoms of bacterial meningitis
-headache
-photophobia
-meningism - neck stiffness
-fever
-rash
-nausea
-impaired consciousness
what is the treatment for bacterial meningitis?
-hospitalisation
-antibiotics
-prophylaxis for contacts
how is meningitis investigated?
-lumbar puncture
-brain imaging
-blood cultures
viral meningitis is less serious than bacterial meningitis- what are the symptoms of viral meningitis?
-headache
-meningism- neck stiffness
-photophobia
what is encephalitis?
a viral infection causing inflammation of the parenchyma (whole brain)
what are the symptoms of encephalitis?
-headache
-viral infection
-change in personality
-seizures
how is encephalitis investigated?
EEG, MRI
how is encephalitis treated?
-hospitalisation
-prolonged antiviral therapy
how is a cerebral abscess investigated?
CT
MRI
Biopsy
how is a cerebral abscess treated?
-neurosurgically treated- drained to relieve pressure
-antibiotics
