Headaches Flashcards
<p>Cluster Headache</p>
<p>Unilateral. Bouts of frequent attacks, known as cluster periods, may last from weeks to months, usually followed by long periods of relief (remission)<br></br>Pain is severe on one side of the head, accompanied with nasal discharge, or red or tearing eyes.<br></br>Treat with oxygen.<br></br><br></br>"most painful headache of my life"</p>
<p>Migraine</p>
<p>A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Aura. <br></br><br></br>Typically triggered by something: Stress, Allergen etc.</p>
<p><span>Trigeminal neuralgia</span></p>
<p><strong>Malfunction of 5th CN</strong></p>
<p><strong>sudden, severe facial pain</strong><span>. It's often described as a sharp shooting pain or like having an electric shock in the jaw, teeth or gums. Usually happens in short, unpredictable attacks that can last from a few seconds to about 2 minutes. nerve carries sensation from the face to the brain.</span></p>
<p><span>Most common in women over age 50.</span></p>
<p>Bells Palsy</p>
<p><span>This condition results from damage to the 7th CN, facial nerve. </span><strong>Bell's palsy</strong><span> is an episode of facial muscle weakness or paralysis. It begins suddenly and worsens over 48 hours. Pain and discomfort usually occur on one side of the face or head.</span></p>
<p>Headaches</p>
<p>Tension headache - vice like headache. Comes from stress. Most common type.Us</p>
<p>Migraine- usually unilateral, aura, photophobia, phonophobia</p>
<p>Cluster - come in clustered in season or TOD. Periorbital. Tears or runny nose, droopy eye lids. Ipsilateral lacrimation.</p>
<p>Trigeminal neuralgia- Burning stabbing, lightning like pain when brushing teeth, applying makeup or shaving. Treatment is anticonvulsant - carbamazepine.</p>
<p>Worst headache of life or thunderclap - subarachnoid hemorrhage - CT scan w/o contrast (w/o to rule out bleeding. With contrast is for mass).</p>
<p>Meningitis - with fever and neck pain</p>
<p>Epidural Hematoma - lucid interval</p>
<p>Ruprture of Berry aneurysm leads to</p>
<ul><li>subarachnoid homorrhage - bleeding between brain and layer that covers it<ul><li>“worst headache of life”</li><li>“sudden onset"<ul><li>“thunderclap” headache</li></ul></li></ul></li></ul>
Meninges
3 layers of tough elastic connective tissue D- Dura mater A-Arachnoid Mater P-Pia Mater I- Brain
Enclose brain and spinal cord
inflammation is meningitis
Intracrainial hemorrhage
bleeding in these layer
*Epidural hematoma - trauma, lucid interval, biconvex lens shape
Subdural hematoma - Elderly, alcoholics, crescent shaped CT
*Subarachnoid hemorrhage - trauma, berry aneurysm, abrupt onset, intensely painful headache - thunderclap headache
higher than Dura - epidural, below Dura, subdural hematoma, below Arachnoid, subarachnoid hemorrhage
*Epidural hematoma -
Usually result of lateral skull fracture leading to tear of middle meningeal artery MNA
History: Obvious, severe trauma induces an immediate loss of consciousness followed by lucid interval (mins-hrs)
- Uncal herniation - coma with “blown pupil” fixed and dilated ipsilateral
CT shows biconvex lens shape
Treatment: Emergent surgical evaluation (remove), can lead to death
GCS Glasgow Coma Scale (verbal/motorScore >
Subarachnoid hemorrhage
Thunderclap headache - “worst headache of life”, vomiting, nausea, neck stiffness, photophobia. Can be in head or neck. Peaks after second or minutes.
Etiology
- Trauma -
- Berry Aneurysm - usually in circle of willis - important cause of sub. hem.
Diagnosis
- CT with contrast
Subdural Hematom
- Blunt head trauma (falls/assaults) - elderly, alcoholics
Hx: Headache, change in mental status, memory problems - pseudo-dementia
CT Scan - crescent shaped
where is Cerebrospinal Fluid (CSF) located
Occupies the subarachnoid space
-buffer for brain
Lumbar puncture (spinal tap) can diagnoses: meningitis, hydrocephalus (CSF pressure), subarachnoid hemorrhage
Primary vs Secondary headache
Primary - caused by the headache itself (tension, migraine, cluster)
Secondary - Caused by a primary condition like sinusitis (sinus headache)
Pre-eclampsia headache
first Sx: headaches, vision changes accompanies by abdominal pain, rapid weight gain, edema of face and arms
