Headaches Flashcards
Components of evaluation of headaches
Chronology Location, duration, quality Associated activity Timing of menstrual cycle Presence of associated symptoms Presence of “triggers”
What is the single most common type of headache
Tension headache
Tension headache signs and symptoms
Vise like
Usually generalized
May be most intense about the neck or back of head
No associated focal neurological deficits
Usually las for several hours
Tension headache management
Over the counter analgesics
Relaxation
What are the two categories of migraines
Classic migraine with aura
Common migraine without aura
Migraine patho
Related to dilation and excessive pulsation of branches of the external carotid artery
How long do migraines typically last
2 to 72 hours following the trigeminal nerve pathway
Causes of migraines
Onset usually adolescence or early adults Family history Female “Triggers” Nitrates in food Change in weather
What are some migraine triggers
Emotions or physical stress Lack or excess sleep Missed meals Specific foods Alcoholic beverages Menstruation Oral contraceptives
Migraine symptoms
Unilateral, lateralized throbbing episodically Gradual, lasts for several hours Focal neurological deficits Visual disturbance Aphasia, numbness, tingling N/V Photophobia and photophobia
Physical exam findings of migraine
Often normal
Appears I’ll
Careful Neuro exam for focal deficits or findings supportive of tumor
Labs done to rule out causes of migraine
BMP CBC VDRL - syphillis ESR - inflammation CT Scan - stroke, TIA
Management of migraine
Avoidance of triggers
Relax
Prophylactic daily therapy if attacks occur more than. 2-3 time La per month
Amitryptyline Depakote Inderal Topamax Gabapentin Magnesium
Management of acute migraine attack
Rest, dark quiet room
Simple analgesics
Imitrex
Cluster headaches
Very painful syndromes, mostly affecting middle aged men
