Headache uwu Flashcards
Note parenchyma have no pain receptors
- bone yes
- cranial nerves yes
okie
Name signs and principles of sinister headaches [4]
- RICP but can be normal
- but all RICP is sinister
- Neurological deficits mostly
- Tempo
- Sudden Onset like SAH vs Tumors, gradual
- – tumor will have constitutional features of cachexia
- Meningitis Features
- Neck Stiffness
- Photophobia
- Headache
- Age - Elderly - Temporal Arteritis
Gimme the 2 types of Hydrocephalus leading to RICP
Non-Communicating hence Obstruction
- SOL, tumor, abscess
- Meningitis, Scarring
- Arnold Chiari Malformation
- venous thrombosis
Communicating
- SAH; due to arachnoid granulations, villi affected
- meningitis
What are some features of RICP
- gimme 2 eye features one RICP and one glaucoma
WORSEN on bending, lead to visual obscuration
- since ICP is aLREADY raised
- Perfusion Pressure drops even more as ICP increases
- occipital lobe, vision goes first
- Headache at night cos ICP increase
- Vomitting when wake up;
- pulsatile titinus
RICP - optic disc swelling, oedema, bluured margins
– this is cos of venous pressure increased
Glaucoma
- optic disc CUPPING cos of pressure in eye increase
RICP CN first nerves affected
C6 (because of long course)
C3, C4
- may lead to blindness careful pls
Just name the headaches in question when thinking of rapid onsets!
2 artery related 1 venous related [3]
SAH
Venous sinus thrombus
Carotid Dissection
- Primary headaches like migraines
Note that epidural and subdural hemorrhages are not associated w headaches
- their convex and convace shape is linked to whether the bleed is under pressure or not;
SAH w that thunderclap headache
okie
What is the location of SAH
Circle of Willis - Berry Aneurysms
- juncture of arteries is weak;
How does SAH headache lead to neurological deficit
Blood itself can irritate CN, damage it; clot is also inflammatory
- CN is also present in the SAS
Note blood can leak into parenchyma also
So how to exclude SAH? other than CT
Lumbar Puncture CSF
- check Xanthochromia after 8hrs for Bilirubin
- not RBC check cos needle
Venous sinus thrombus
- which px group and why
Pregnant
- hypercoagulable
- dehydrated;
Carotid Artery Dissection
- Describe, Presenting
- Cx
Carotid artery intima wall tears open
- exposing tunica media
- which is pro inflammatory and prothrombotic
- can clot in the torn artery wall
- neck PAIN not stiffness;
Cx:
- SHOCK - most common cause of shock
- Hypoglossal N CN 12
- Horner’s Syndrome
caused by head manipulation lmao
Neck stiffness what to worry about
Cervicogenic headache
- neck strain/ neuro problem in neck presenting as head pain
- can be referred pain from cervical nerve
- MENINGISM - meningeal irritation
- meningitis from infection
- meningitis from blood (SAH), tumor
Triad of meningism
- + 2 specific signs 1 bacteria and 1 viral
Headache
Neck stiffness
Photophobia
- non blanching rash (think n. meningitis)
- Cos NM lead to DIC lead to depletion of coagulation factors
- altered mental state (think encephalitis)
How to diff between infective meningitis or tumor or SAH
Fever - infection
Sudden Onset - SAH
