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Neurology > Headaches > Flashcards

Headaches Flashcards

1
Q

Classic: lateralized throbbing headache

Diagnosis based on symptom patterns when there is NO evidence of
intracranial pathology

A

Migraine Headache

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2
Q

When is the typical onset for migraine headaches?

A

Usually starts in adolescence or early childhood

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3
Q

A “classic” migraine has what distinguishing feature?

A

Headache with aura

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4
Q

What can the aura of a migraine be?

A

Aura can be anything: smell, scotomas, geographic lights, etc

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5
Q

List some associated symptoms with a migraine

A

Anorexia
Nausea/vomiting
Photophobia
Phonophobia
Blurred vision
Visual disturbances
Numbness/tingling
Clumsiness
Dysarthria
Disequilibrium
Osmophobia
Cognitive impairment

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6
Q

List some triggers for migraine headaches

A

Emotional stress
Physical stress
Lack of sleep
Excess of sleep
Missed meals
Alcohol
Menstruation
OCPs
Barometric pressure change
Specific Foods

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7
Q

What is the first line treatment for migraine headaches?

A

Simple analgesics

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8
Q

What line of medication is last line and why?

A

Opioid analgesics - Last line as they can cause rebound headaches

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9
Q

What Migraine Variant is described below:

Blindness or visual disturbances
Dysarthria, disequilibrium, tinnitus and perioral/distal paresthesia’s
Transient loss of consciousness
Throbbing headache, usually occipital region with N/V

A

Basilar artery migraines

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10
Q

Most common primary headache type is what?

A

Tension Headache

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11
Q

Generalized headache

Described as “band-like” or “vise-like” pain

A

Tension Headache

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12
Q

The following is associated with which type of headache?

Poor concentration
Neck and posterior head pain
No focal neurological deficits

A

Tension Headache

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13
Q

What factors can exacerbate a tension headache?

A

Emotional stress

Fatigue

Noise

glare

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14
Q

What are the characteristics of a tension headache?

A

Poor concentration
Constant daily headache – vise like or tight sensation
Usually generalized, most intense in neck or back of head (base of skull)
Without neurologic symptoms
Often develops during the course of the day

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15
Q

What is the first line treatment for tension headaches?

A

Simple analgesics

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16
Q

What is the first line treatment for migraine headaches?

A
17
Q

Severe, unilateral periorbital headache
Middle-aged men most commonly
No family history
Episodes often occur at night, however can occur at any time, can occur several times in one day

A

Cluster Headache

18
Q

There are times that remission of cluster headache does not occur, this is called

A

Hemicrania continua

19
Q

List some triggers of a cluster headache

A

Alcohol
Stress
Glare
Specific foods

20
Q

List some associated symptoms you can see with a cluster headache

A

Severe unilateral periorbital pain with one or more:
Ipsilateral nasal congestion
Rhinorrhea
Lacrimation
Redness of eye
Horner’s syndrome

21
Q

How is the diagnosis of cluster headaches made?

A

Diagnosed by symptomology
Exclude intracranial pathology

22
Q

What route of medication is typically ineffective in cluster headaches

A

Oral medications are usually ineffective

23
Q

Disturbance in brain function caused by direct or indirect force to the head (Functional rather than structural injury)

Rapid onset of short-lived impairment of neurologic function that resolves
spontaneously

A

Concussion

24
Q

Most common symptom in a concussion

A

Headache

25
Q

When should you obtain imaging studies in a concussion?

A

LOC,
evidence of skull fracture
focal neurological deficits
cervical spine injury

26
Q

What is the imaging of choice in a concussion?

A

CT brain without contrast is modality of choice

27
Q

List some associated symptoms with a patient who has a concussion

A

Emotion instability
Nausea
Vomiting
Scintillating scotomas
Disequilibrium
Impaired memory
Poor concentration

28
Q

What is the key initial management of a concussion?

A

Complete cognitive and physical rest are key in initial management

29
Q

Type of headache caused by coughing, laughing, sneezing, straining

Usually on lasts for a few minutes or less

A

Primary Cough Headache

30
Q

Describe the cause of a lumbar puncture headache?

A

Caused by the leakage of CSF through the dural puncture site

31
Q

What are the most common causes of a lumbar puncture headache?

A

Most common cause is large needle or non-compliance (not lying down for 3 hours post-stick)

32
Q

What are the characteristic features of a lumbar puncture headache?

A

Dull, throbbing headache
May last for several days
Worse with standing, better with lying down

33
Q

What is the treatment for a lumbar puncture headache?

A

IV fluids/caffeine
Blood patch

34
Q

What are two methods to help prevent a lumbar puncture headache?

A

Using a small needle
Lies prone post procedure

Neurology (15 decks)

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