headaches Flashcards
headache red flags
new onset headache > 55 years
known/previous malignancy
immuno-suppressed
early morning headache
exacerbation by valsalva
fever, photophobia, neck stiffness
what is a tension headache
produce a mild ache across the forehead in a band like pattern
may be due to muscle ache in the frontalis, temporalis and occipitalis muscles
presentation of tension headache
no visual changes, no N+V and photophobia
associated with stress, depression, alcohol, dehydration and hunger
treatment of tension headache
relaxation physiotherapy
antidpressants: dotheipin or amitriptyline
reassure
sinusitis
headache associated with inflammation of ethmoidal, maxillary, frontal or sphenoidal sinuses
facial pain behind the nose, forehead and eyes
tenderness over affected sinus
cervical spondylosis
caused by degeneration of cervical spine
neck pain- worse on movement, headache, pain back of head and upper neck
exclude anything more serious
trigeminal neuralgia
- Cause is unclear but thought to be caused by compression of the nerve
- Most cases are unilateral
- Can be related to MS
- Elderly patient
- Presents with intense facial pain that comes on spontaneously and can last between seconds to hours
treatment of trigeminal neuralgia
carbamazepine
gabapentin, phenytoin, baclofen
surgical
presentation of idiopathic intracranial hypertension
female
obese
headache: diurnal variation, morning nausea and vomiting
visual loss
investigation for idiopathic intracranial hypertension
MRI with MRV sequence= normal
cerebro spinal fluid= elevated pressure, normal consituents
treatment for idiopathic intracranial hypertension
weight loss
acetazolamide
ventricular atrial/lumbar peritoneal shunt
monitor visual fields
acetazolamide
carbonic anhydrase loop inhibitor and the first-line pharmacological therapy for IIH
presentation of hemicrania
elderly women
paroxysmal
severe unilateral headache, unilateral autonomic features
treatment of hemicrania
absolute response to indomethacin
what is indomethacin
NSAIDs
