Headache/Temporal Arteritis Flashcards
Headache with nuchal rigidity, photophobia and prostration? Further workup?
Suspect meningitis. Lumbar puncture
Red flags for headaches?
- Fundamental change in pattern
- First severe and/or worst headache
- Abrupt onset attacks especially those that awaken from sleep
- Neurologic symptoms lasting >1 hour
- You headache in the patient’s 50 years old
- You headache in patients with cancer, immunosuppression, pregnancy
- Headache triggered by exertion, sexual activity, or valsalva
Patient with nuchal rigidity and headache with clouded consciousness? Work up?
Intracranial hemorrhage.
1) CT scan
2) lumbar puncture’s shows bloody tap and xanthochromic (if older)
Patient with severe new pounding headaches associated with nausea and vomiting localized to one side. Work up?
Brain tumor. CT or MRI
Patient > 50 with Unilateral pounding headache and vision changes? Work up?
Temporel arteritis. ESR >50, arterial biopsy
Patient with severe eye pain and nausea and vomiting. Pupil partially dilated? Measure?
Glaucoma, elevated intraocular pressure.
Headache precipitated by alcohol and occurs with rhinorrhea and lacrimation?
Cluster headache
Xanthochromia indicates?
Presence of Bilirubin, differentiating subarachnoid hemorrhage from traumatic tap
Criteria for giant cell arteritis?
Three or more of the following:
- Age >50 years
- New onset/type of headache
- Tenderness or decreased pulsation of the Temporal artery
- Elevated ESR
- Abnormal findings on temporal artery biopsy
GCA closely related to? Symptoms?
Polymyalgia rheumatic. Stiffness of the neck, torso, shoulders, proximal muscles
Drug/Dose to treat GCA? For polymyalgia rheumatica?
Prednisone 40 to 60 mg
Prednisone 10 to 20 mg
Cranial autonomic features of migraines?
Tearing or nasal congestion
Treatment of migraines?
Preventative: Tricyclic antidepressants, beta blockers
Acute episode: NSAIDs, sumatriptan, dihydroergotamine
