Headaches Flashcards
How is the head able to “hurt”? Where are the receptors that are being activated in such cases?
Scalp, meninges, blood vessels, and muscles.
What nerve innervates the cerebrum above the tentorium?
The first divisions of the trigeminal nerve (V1)
What nerves innervate the meninges and cerebral vessels below the tectorium?
C1-C3 (cranial nerves 1-3).
What are the three major classifications of headache disorders?
- Migraines.
- Tension type headaches.
- Trigeminal autonomic cephalalgias.
What are secondary headaches?
Headaches caused by a physical implication (organic disorder, such as intracranial hemorrhage), as well as a tumor (neoplasm).
What are primary headaches?
Headaches that have no organic cause.
What are the most common forms of primary headaches?
Tension-type headaches, migraines, cluster headaches.
What are tension-type headaches?
Possibly related to muscle contraction, often milder and bilateral in nature. May be episodic or chronic.
What is the diagnostic criteria for migraine disorder?
At least five attacks lasting 4-72 hours that present with:
-Unilateral location
-Pulsating quality
-Moderate to severe pain
And is aggravated by physical activity.
As well, feelings of nausea or vomiting occur.
What is the typical timeline of a migraine?
- Premonitary stage: mood and appetite changes, neck stiffness.
- Aura.
- Headache.
- Resolution.
What are the presumed triggers of the premonitary stage?
Hunger, sleep deprivation, bright light.
What would a clinician expect to see of a patient’s PET scan during premonitary stage?
Increased blood flow to hypothalamus, regions in the cerebrum.
Wat are the two types of visual auras? What do they present as/
- Positive: fortification spectra
2. Negatve: scotoma.
What is the theoretical cause of auras in migraines?
Cortical spreading of depolarizing wave that first activates neurons in an area to induce positive symptoms. The proceeding wave represents hyper-polarized neurons that are recovering and briefly inactivated and therefore present negative symptoms.
What is the neurophysiology of a headache?
- Stimulus causes the trigeminal nerve to secrete Substance P and CGRP, which cause vasodilation and sterile inflammation in cerebral blood vessels. Swelling and irritation stimulates the trigeminal vessel which induces nociception in the TCC synpase.
