headachee

Question 1

what are the signs of meningism seen in examination ?

Answer 1

nuchal rigidity
kernigs sign
brudzinski neck sign

Question 2

what are the diagnostic criteria for migrane ?

Answer 2

episodic attacks of headache lasting 4-72 hours

two of :
unilateral pain
throbbing pain
aggravated by movement
moderate/severe pain severity

one of :
nausea and or vomiting
photophobia and phonophobia

Question 3

what are the phases of a migrane ?

Answer 3

premonitory
aura
headache
resolution

Question 4

most common type of aura associated with migranes ?

Answer 4

visual aura

Question 5

what is the management for migranes ?

Answer 5

aborrtivve treatment
specific - triptans
non specific - NSAIDS
TCA - amitriptylline

Question 6

what is the definition of chronic daily headaches ?

Answer 6

headaches on 15 or more days per month
descriptivvee not diagnosis

Question 7

what is medication overuse headache ?

Answer 7

1) headache present on more than 15 days a month
2) pain killers for more than 15 days a month for the past 3 months
3) worsened during pain killer overuse
4) headache resolves after. 2 months of detoxification

Question 8

what is the difference between a migrane and tension type headache ?

Answer 8

tension type headache - lasts 30 mins to 7 days
its bilateral
not throbbing
mildd or moderate
not aggravated by movement (( opposite of a migrane )
has photophobia or phono phobia

Question 9

tension type headache ?

Answer 9

featureless headache

Question 10

recurrent moderate to severe headache is ….. until proven otherwise ?

Answer 10

migraine

Question 11

what is the criteria for a cluster headache ?

Answer 11

severe unilateral
orbital, supraorbital or temporal pain
associated with ;
-Conjunctival injection
-Lacrimation
-Ptosis
-Miosis
-Eyelid oedema
-Nasal congestion
-Rhinorrhea
-Forehead and facial sweating

Question 12

what are the peak time periods of cluster headaches ?

Answer 12

2 am
9 pm
3 pm

Question 13

what abortive treatment is associated with good efficacy in cluster headaches ?

Answer 13

subcutaneous sumatriptan

Question 14

what is trigeminal neuralgia ?

Answer 14

paroxysmal attacks of pain lasting from a fraction of a second to 2 minutes, affecting 2 or more divisions of thee trigeminal nerve

Question 15

what are the features of the pain associated with trigeminal neuralgia ?

Answer 15

intense sharp, superficial or stabbing pain
precipitated by trigger factors

Question 16

what are the causes of trigeminal neuralgia ?

Answer 16

Vascular compression of the trigeminal nerve
Multiple sclerosis
Intracranial aneurysms
Intracranial tumour

Question 17

what is thee investigation and management of trigeminal neuralgia ?

Answer 17

inv - MRI
management - carbamazepine

Question 18

what is the description of subarachnoid hge ?

Answer 18

thunderclap
worst headache of their life
sudden onset

Question 19

what are the signs of carotid dissection vs vertebral dissection ?

Answer 19

carotid dissection - ipsilateral horny syndrome
vertebral dissection - brainstem or cerebellar ischemia

Question 20

what is the effect of positions and the intensity of headaches ?

Answer 20

1- standing up worsens low pressure headaches
2- lying down raises ICP so worsens high pressure headaches and improves low pressure headaches
3- valsalva manoeuvre elevates ICP

Question 21

what is IIH ?

Answer 21

idiopathic intracranial hypertension
more common in young obese women

Question 22

what is the differential diagnosis of IIH ?

Answer 22

obstructive sleep apnea

Question 23

what must be exclude before making a diagnosis of IIH ?

Answer 23

exclude sinus thrombosis

Question 24

what is the treatment of IIH ?

Answer 24

weight loss
acetazolamide
repeated LP
CSF shunting may be necessary if vision threatened

Question 25

what is the presentation of intracranial hypotension ?

Answer 25

orthostatic headache

Question 26

what is the best investigation to demonstrate the site of leak in intracranial hypotension ?

Answer 26

CT myelography

Question 27

what is the management of intracranial hypotension ?

Answer 27

post LP headache - usually resolves
caffeine corticosteroids
epidural blood patching
surgery - repair of the leak

Question 28

what disease is commonly associated with GCA ?

Answer 28

polymyalgia rheumatica