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Neurology > Headache and Migraine > Flashcards

Headache and Migraine Flashcards

1
Q

What investigation should you do if the headache is due to head trauma?

A

CT

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2
Q

What can be triggers in trigeminal neuralgia?

A

Washing affected area, shaving, eating, talking

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3
Q

What can cause trigeminal neuralgia?

A

Compression of trigeminal root

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4
Q

What does CHOCOLATE stand for? (Migraine partial triggers)

A

Chocolate, Hangover, Orgasm, Cheese/caffeine, Oral contraceptives, Lie-ins, Alcohol, Travel, Exercise

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5
Q

What presentations suggest sinusitis?

A

Dull, constant ache over frontal/maxillary sinuses, worse on bending over

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6
Q

What presentation suggests intracranial hypotension?

A

Worse on standing

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7
Q

Describe a tension headache

A

Bilateral, non-pulsatile +/- scalp muscle tenderness

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8
Q

What are some types of headache that tend to recur?

A

Migraine, cluster headache, trigeminal neuralgia

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9
Q

What features can suggest raised ICP?

A

Chronic, progressive headaches that are typically worse on waking, lying, bending forward, coughing

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10
Q

What features can suggest acute glaucoma?

A

Eye pain +/- reduced vision

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11
Q

What feature can suggest giant cell arteritis?

A

Jaw claudication, tender with thickened, pulseless temporal arteries

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12
Q

Describe a cluster headache

A

Rapid onset excruciating unilateral pain around one eye that may become watery and bloodshot

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13
Q

Describe the timing pattern of cluster headaches?

A

Pain lasts 15-180 mins once or twice a day for 4-12 weeks and then months-years pain free

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14
Q

Describe pain from trigeminal neuralgia

A

Intense unilateral stabbing pain lasting seconds in trigeminal nerve distribution

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15
Q

What other symptoms can accompany a migraine?

A

Nausea and vomiting, all stimuli can produce pain

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16
Q

What can type of auras are there?

A

Visual, somatosensory, motor, speech

17
Q

What can cause an medication overuse headache?

A

Mixed analgesics

18
Q

What should you ask about their life?

A

Stress and recent life events

19
Q

What investigation should you do in trigeminal neuralgia?

A

MRI to exclude secondary causes

20
Q

How can you help manage cluster headaches?

A

100% oxygen for 15 minutes, sumatriptan at onset

21
Q

How can you manage trigeminal neuralgia?

A

Some AEDs

22
Q

What migraine prophylaxis can you start?

A

Propranolol, amitryptyline

23
Q

How can you help migraines during an attack?

A

Triptan, NSAIDs, anti-emetic

24
Q

What non-pharmacological management can help migraines?

A

Acupunture

25
Q

What contraception should people with migraines use?

A

Progesterone-only or non-hormonal contraception

26
Q

What red flags can indicate SAH?

A

First and worst headache, thunderclap

27
Q

What red flag can indicate acute glaucoma?

A

Unilateral eye pain

28
Q

What red flag can indicate a tumour or vascular cause?

A

Unilateral pain and ipsilateral symptoms

29
Q

What red flags can indicated increased ICP or venous thrombosis?

A

Cough-initiated headache, worse in the morning or bending forward

30
Q

What red flag can indicate giant cell arteritis?

A

Persisting headache +/- scalp tenderness in over 50s

31
Q

What red flag can indicate meningitis?

A

Headache with fever or stiff neck

32
Q

What other red flags could be present?

A

Change in pattern of a usual headache, decreased level of consciousness

33
Q

What’s are migraines?

A

Recurrent throbbing headache often preceded by an aura and associated with nausea, vomiting, visual changes

34
Q

Describe a migraine

A

Unilateral pain, throbbing-type pain, moderate to severe intensity, motion sensitivity

35
Q

Give an example of a triptan

A

Sumatriptan

36
Q

Give an example of an anti-emetic

A

Prochlorperazine

37
Q

What prevention for cluster headaches is there?

A

Verapamil is first line, then prednisolone, reduce alcohol and stop smoking

38
Q

What is the first line prophylactic treatment of migraines?

A

Topiramate

39
Q

What can cause tension headaches?

A

Depression, lack of sleep, missed meals, stress

Neurology (22 decks)

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