headaches

Question 1

what is a primary headache?

Answer 1

no serious underlying cause, migraine or tension headache.

Question 2

what is a secondary headache?

Answer 2

caused by underlying injury or disease or medication. always needs to be referred.

Question 3

referral criteria

Answer 3

very sudden and severe onset. increasing severity which could indicate infection. lasts longer than two weeks,drowsiness, confusion,loss of consciousness,rash and or fever,nausea and or vomiting without migraine symptoms. recent trauma to the head,first headache, 15+ days a month, under 12, stiff neck, over 50, non responding to painkillers and other medication use.

Question 4

what is a tension headache?

Answer 4

most common. triggered by stress and chemical imbalance. fall of serotonin causing blood vessels to widen and cause pain.can last from 30 minutes to 7 days.

Question 5

trigger factors of a tension headache

Answer 5

stress, poor posture, anxiety or depression, working or holding awkward positions.

Question 6

symptoms of a tension headache?

Answer 6

tightness or pressure around the head which tends to gradually worsen but remains mild to moderate.

Question 7

treatment for a tension headache

Answer 7

painkillers, levomenthol ( headache sticks)

Question 8

what is a migraine?

Answer 8

involves recurrent episodes of moderate to severe headaches which can last from a few hours up to three days. can involve nausea and vomiting and visual disturbances.

Question 9

what are the five stages of a migraine?

Answer 9

prodome,aura,headache,resolution and recovery.

Question 10

what is the prodome stage of a migraine?

Answer 10

occurs in 50%-80% of patients. usually lasts for three hours but can last up to 24 hours. it can cause cravings,mood swings and poor concentration.

Question 11

what is the aura stage of a migraine?

Answer 11

can last up to an hour. symptoms include blindness, slurred speech,pins and needles,flashing lights and zig zags. occurs in less than 25% of sufferers.

Question 12

what is the headache stage of a migraine?

Answer 12

can last from 4 to 72 hours. includes nausea and vomiting in 70% of sufferers. physical movement tends to worsen pain.

Question 13

what is the resolution stage of a migraine?

Answer 13

as headache subsides, patients can feel lethargic and drained so sleep is best. medication may not work as drug absorption is hindered.

Question 14

what is the recovery stage of a migraine?

Answer 14

a washed out feeling or elation.

Question 15

referral criteria for a migraine

Answer 15

never experienced a migraine or where otc medicine has failed to resolve.

Question 16

dietary triggers for a migraine

Answer 16

6 hours within ingestion. red wine,mature cheese,chocolate, citrus fuits, caffeine and preservatives such as monosodium glucomate (msg)

Question 17

hormonal triggers for a migraine

Answer 17

fluctuation in levels of oestrogen. menstruation, hrt,oral contraceptives, menopause and stress at work or home

Question 18

environmental triggers for a migraine

Answer 18

extreme hot or cold, bright flashing lights, poor air quality, perfumes and a computer screen.

Question 19

treatment for a migraine

Answer 19

exercise regularly, regular balanced meals, regular sleep pattern, relaxation techniques and painkillers. anti-emetics ( prochloperazine 18+), ( buclizane 10+),sumatriptan (18-65)

Question 20

symptoms of a medication overuse headache

Answer 20

daily occurence, improves with painkillers but returns when they wear off, persists throughout the day, worsens with physical or mental exertion, depression, nausea, anxiety,restlessness, irritability.

Question 21

what is a cluster headache?

Answer 21

severe, lasting for 15 minutes. can occur up to 8 times a day. pain is always round the same eye. male to female ratio is 6:1. can cause eyelid drooping, nasal congestion and runny eyes. always refer.

Question 22

what is sinusitis?

Answer 22

blocked sinuses, causing pain and infection. pain is felt under the eyes and in the head especially when bending down, usually occurs after the flu.

Question 23

symptoms of sinusitis

Answer 23

pain/ pressure under eyes, pain/ pressure across cheeks and nose, sore eyes and tenderness and nasal congestion.

Question 24

treatment options for sinusitis

Answer 24

painkillers with a decongestant ( pseudoephedrine). refer to pharmacist if pain is severe, prolonged or unwell.