Headache types

Question 1

What are the two categories for headaches?

Answer 1

Primary and Secondary

Primary

• No structural abnormalities can be identified
• including migraines, tension-type headaches, cluster type headaches

Secondary
- are associated with various underlying primary aetiologies such as head and neck trauma, infections, substance abuse or it’s withdrawals

Question 2

Red Flags for headaches

Answer 2

• Sudden onset
• Severe and debilitating pain
• Progressive
• Fever
• Personality change

Question 3

what is a cervicogenic headache

Answer 3

is a headache caused by neck disorders

Question 4

What can cause it?

Answer 4

abnormalities in any structure innervated by the upper two cervical cutaneous nerve.

Question 5

Clinical features

Answer 5

• usually in the occipital region unilaterally, with pain starting in the neck spreading to the head.
• Can radiate to the eye socket or temporal area.
• Moderate pain that is non-throbbing
• usually present on waking and lessens during the day

Question 6

What is a Tension Headache

Answer 6

is considered the most common headache, 75% are female.

patients describe having a band of pain around the head superior to the eyes

Question 7

what can cause a tension-type headache

Answer 7

often associated with cervical dysfunction, musculoskeletal problems, street and mental tension,. typically bilateral tightness

Question 8

Clinical Features

Answer 8

• Frontal, over forehead and temples
• dull ache, “tight pressure feeling” “ tight band across head”
• Almost daily, can last for hours even days
• pain on waking and can get worse during the day
• alcohol can help relieve symptoms

Question 9

What is frontal sinus headaches

Answer 9

Symptomatic inflammation of paranasal sinuses usually associated with concurrent inflammation of the nasal mucosa

Question 10

what can cause a frontal sinus headache?

Answer 10

cause by viral infections (rhinovirus, influenza)

Risk factors - smoking, older age, air travel exposure

Question 11

Clinical features

Answer 11

• Facial pain or discomfort, the pressure that worsens/localised to sinus when bending forward
• Developing in the morning, worse at midday
• Can last for weeks
• Pain/ Tenderness to sinuses

Question 12

What is a migraine headache?

Answer 12

There are two types, classic migraines with aura (visual - lights/bright spots before a migraine) or common migraines (without aura). Pain involving half the head 10-15% of adults ( more common in females, peaks between 20-50 yrs old)

Question 13

What can cause a migraine

Answer 13

Stress, hormonal changes, lights, sound. Migraine triggers are not fully understood.
- was thought to be caused by vascular but recent studies have suggested abnormalities of brain function leading to a chain of events.

Question 14

Clinical Features

Answer 14

Temporofrontal region unilaterally, can be bilaterally

• intense throbbing pain
• 1 or 2 times a month, can last for a few hrs to days
• sleeping or vomiting can relieve symptoms

Question 15

Meningitis

Answer 15

Inflammation usually caused by an infection

• in AUS most common being viral or bacterial
• Access route through the bloodstream or systemic infection

Question 16

What causes it?

Answer 16

Bacterial

• Meningococcus is the most common
• the bacterial inhabitants the nasopharynx

Viral

• caused due to herpes, chicken pox
• more common than bacterial
• usually begins in the respiratory or gastrointestinal tract

Question 17

Clinical Features

Answer 17

• Headaches are usually generalised and radiates to the neck
• headache is constant and severe, may begin abruptly
• Fever and neck stiffness

Headaches and Fever refer straight to hospital

Question 18

Cervical Artery Dissection (CAD)

Answer 18

Can mimic a musculoskeletal complaint, is a tear in the carotid or vertebral arteries
- Spontaneous (60%), trauma (30%) cervical soin manipulation (9%)

Question 19

What can cause it

Answer 19

Cervical spine trauma, cardiovascular disease, cervical manipulation

Question 20

Clinical features

Answer 20

• Sudden onset (thunder clap headache)
• Unilaterally
• Constant aching/ throbbing pain
• Horner syndrome ( dropping of an eyelid, un even pupil size)

Question 21

what is a raised intracranial pressure headache?

Answer 21

when in there is an increase in cranial pressure, putting a strain on the brain

Question 22

what can cause it

Answer 22

causes of the space-occupying lesion including tumours and subdural hematoma

Question 23

Clinical features

Answer 23

• generalised headache, usually worse in the morning and aggravated by abrupt changes in intracranial pressure
• usually in occipital and can radiate to orbital
• dull, deep steady ache
• happens daily
• sneezing, coughing and staining can aggravate

Question 24

Medication headaches

Answer 24

can be caused by tritans, opiods, ergots

or

Paracetamol, asprin or NSAID

Question 25

TMJ related headaches

Answer 25

• Recurrent pain in one or more regions of the head/face
• pain is precipitated by jaw movement (chewing)
• Reduced ROM or irregular jaw opening
• Noise from one/both TMJ during jaw movement
• Tenderness at one/both TMJ joint capsule