Headaches Flashcards
1
Q
Types of headaches
A
- Primary: not caused by other diseases
- secondary: results from assoicated disease or trauma
2
Q
secondary causes of headaches
A
- head and neck trauma (cervicogenic)
- infection
- vascularr
- medications
- disorder homeostasis
- psychiatric disorders
3
Q
Mirgraines
3 key features
A
- inherited tendency: tend to run in the family
- sensitive to endogenous and exogenous tiggers
- stereotypical attack phenotype
4
Q
Migraines
A
- recurrent episodic neuromuscular disorders of the brain
- impact structures in the brain stem and diecenphalan
5
Q
Mirgraines: abnormal perception of the normal stimulus
A
- pain/allodynia
- sensitivity to light, sound,
- cognitive symptoms: brain fog, visual and hearing changes
- autonomic symptoms: HR, BP, RR, nausea, vomitting
6
Q
Migraines
Variations
A
- with or without aura;
- familial hemiplegic,
- basilar,
- childhood;
- abdominal
- retinal
- opthalmoplegic
- retinal chronic
- aura: depression, irritability, loss of appetite, visual aura
7
Q
Mirgraines
Pathogenesis
A
- Central sensitization
- peripheral sensitization: occurs within the trigeminal ganglion (opthalmic division) and upper cervical dorsal roots
- Neurotransmitter substance: regulate tone in cranial blood vessels;
- serotonin activate pain receptors
- endocrine connections: menstrual migraines, estrogen drops, prostaglandins
8
Q
Trigeminal vascular theory of migraines
A
- Thalamic neurons prolong the effects of the pain stimulus that come from the trigeminal vascular systems
- Stimulation of the trigeminal nerve causes vascular dilatation, and neurogenic inflammation also contributes to migraine symptoms
- retinothalamic pain pathway
- olfactory input stimulates limbic structures and pons
9
Q
Mirgraines
Diagnosis
A
- History
- normal neuro exam
- often undiagnosed
- differentiate with tension or sinue headaches
- MIDAS: migraine disability assessment questionaire measures the impact of headaches
10
Q
mirgraines
treatment
A
- if you can figure out where they are starting then you can get specific
- direct at implicated system
- avoid triggers
- quiet, dark place
- medication
11
Q
Mirgraines
Medications
A
- triptans: gold standard
- calcitonin Generelated peptide receptor antagonist
- antiepileptics - gabapentin, valproate and topiramate
- botox
- beta blockers
- vasoconstrictors
- NSAIDs
12
Q
Tension type headaches
A
- Most common type of headache
- episodic or chronic
- pericranial myofascial nocicpetion
- neck musculature becomes firm without increased firing
13
Q
Tension type headaches
Episodic or chronic
A
- chronic: genetic and environmental effect
- episodic: more environmental
14
Q
tension-type head
Pericranial myofascial nociception
A
- Peripheral sensory afferent neurons become hypersensitized possibly by serotonin and bradykinin
- once central afferents get involved transitions to chronic
15
Q
tension-type headaches
Diagnosis
A
- Requires exclusion of other causes
- palpation of temporal, lateral pterygoid, masseter, SCM, and trapezius muscles specifically
