Headaches Flashcards
What are the symptoms of tension headaches?
Bilateral feeling of heaviness, pressure or tightness that “extends like a band around the head” which can also affect the upper part of the neck.
Do tension headaches require a counselling room?
No
What are 12 red flags for referral with tension headaches?
- Children < 12 and adults with new symptoms > 50
- Associated with injury/trauma
- Severe and last > 4hrs
- Severe occipital headache (across back of head)
- Worse in morning then improves
- Associated drowsiness, visual disturbance or vomiting
- Neck stiffness
- Frequent migraines
- OTC treatment resistant
- Medication induced (for example, pill)
- Starts after exercise, sex, straining or coughing
- Cluster headache.
What are the symptoms of cluster headache?
Orbital pain often worse at night and associated with conjunctivitis and nasal congestion on the same side of the head as the headache
Do tension headaches have a PSA self-care card?
Yes (headache)
What is the preferred treatment option for tension headaches?
Paracetamol
What are the directions for paracetamol in tension headaches?
15mg/kg (to a maximum of 1g) every 4 to 6 hours when required. Maximum of FOUR doses (up to 4g) in 24 hours.
What are 2 non-preferred options for tension headaches and why?
- Ibuprofen (greater risk of side effects)
- Diclofenac (greater risk of side effects)
Is paracetamol safe in pregnancy?
Yes
Is paracetamol safe in breastfeeding?
Yes
What is the age range for paracetamol?
Safe in children over 1 month
What are 8 pieces of non-pharmacological advice for tension headaches?
- Keep a headache diary detailing time of headache/migraine, drugs and dosages used, response to treatment and what may have triggered attack.
- Practice relaxation exercise.
- Exercise regularly.
- Eat a well-balanced, regular diet.
- Drink plenty of water.
- Get adequate sleep.
- Avoid triggers
- Physical therapy such as massage or stretching, heat and postural correction can help with symptoms.
How should you always follow up with a patient with a headache?
Advise patient to talk to their doctor if:
1. Warning signs or additional symptoms develop.
2. Migraine persists for > 3 days.
3. Analgesics fail or have been tried before unsuccessfully.
What are the symptoms of migraines?
Recurrent episodes of throbbing head pain, often unilateral (but often swaps sides between attacks). Pain is severe and limits or stops activity and is usually associated with nausea, vomiting and/or photophobia. Migraines may be preceded by aura (usually visual disturbances such as flickering lights, zigzag lines, loss of part or all vision).
Do migraines require a counselling room?
No