Headaches

Question 1

primary

Answer 1

migrane
tension
trigeminal
cluster

Question 2

Secondary

Answer 2

tumor
bleed
increased ICP
injury
other condition

Question 3

Migraine

Answer 3

unilateral and throbbing pulsatile, N & V
2- 72 hours, PIN acronym

Triptans and NSAIDS
antiemetics
Sumatriptan
Naproxin

Question 4

Tension type

Answer 4

bilateral nonthrobing
30min to 7 days mild to moderate pressure

NSAID
Caffeine
acetaminophen and aspirin
Fioricet is not first line

Question 5

cluster

Answer 5

Unilateral, orbital, temporal, severe attacks
ipsilateral autonomic symptoms 15-180minutes

Oxygen
Triptans
Verapamil for prophalxis

Question 6

secondary

Answer 6

diagnose the problem and treat underlying cause

Question 7

Hemiplegic

Answer 7

hallmark sign
unilateral weakness after migraine impaired vision, speech and sensation
two or more experienced

neuro
CT or MRI
no RCT for therapy
avoid triptans
and betablockers

Question 8

thunderclap

Answer 8

severe and sudden onset
peaks in 60 seconds
can be leakage of CSF HTN, meningitis SAH
urgent eval for
CT and LP urgent
nonurgent MRI