Headaches Flashcards
Describe primary headaches
Not caused by an underlying medical dietitian
Not a symptom of another cause
Tension type headaches are mc. Dull persistent pain in temporal and frontal and occipital lobes.
Causes: stress, poor posture, fatigue, muscle strain
Migraines
4 hours- several days, can have visual disturbances and tingling sensations
Accompanied by nausea, vomiting, sensitivity to Light, sound, smells
thought to involve abnormal brain activity and changes in blood flow to the brain, exact cause is still being researched. Triggers include certain foods, hormonal changes, stress, and environmental factors.
Cluster headaches are rare but extremely painful. Several headaches per day or over a period f weeks or months followed by a period f remission. Intense burning or piercing pain around one eye, redness or watering of eye, nasal congestion, facial sweating.
Causes: alocogol, strong smells, change in sleep
Chronic daily headache: daily or near adult bases for at least 3 months.
Chronic tension headaches or migraines
Describe secondary headaches
Occur as a result of an underlying medical condition
Head injury: post. Traumatic headaches can occur after a concussion, whiplash and feel tension-type or migraines
Sinusitis: inflammation of sinus to due infection (bacterial, viral,m fungal).
Deep aching around frontal, cheek, eyes. Worsen with sudden head movement when bending forward,
Accompanied with sinus infection infections like facial swelling, running nose and nasal congestion
High bp (hypertension)
Lead to headache. Throbbing or pulsating pain in occipital or temporal. Dizziness, nausea, blurry vision. Signals of hypertensive crisis which is a medical emergency
Infections:
Meningitis inflammation of the membranes around the brain and spinal cord) or encephalitis (inflammation of the brain) can cause severe headaches, often accompanied by fever, neck stiffness, nausea, and altered mental status. These types of infections are serious and require immediate medical attention.
Brain Tumors:
can vary depending on the tumor’s location, size, and rate of growth. The pain is often dull and persistent but can be more intense upon waking up in the morning or when coughing or sneezing. It may be associated with other neurological symptoms, such as vision problems, balance issues, or personality changes.
Medication Overuse (Rebound Headaches):
Overusing pain medication, particularly for primary headaches, can lead to rebound headaches. This happens when the medications themselves start to cause more frequent headaches. It often occurs with the overuse of over-the-counter painkillers (like acetaminophen or ibuprofen) or prescription migraine medications.
Dehydration:
Not drinking enough fluids can lead to dehydration, which can cause headaches. The pain is usually dull and can be relieved with hydration. Dehydration-related headaches can also be accompanied by symptoms like dry mouth, dark urine, and fatigue.
Cervical Spine Disorders (Neck Problems):
Issues like herniated discs, spinal stenosis, or other neck problems can refer pain to the head. This is sometimes called a cervicogenic headache. The pain usually originates in the neck and radiates to the head, often on one side. It may worsen with certain neck movements or posture changes.
Giant Cell Arteritis (Temporal Arteritis):
This condition involves inflammation of the arteries that supply blood to the head, particularly those around the temples. It can cause severe, throbbing headaches that are often accompanied by scalp tenderness, jaw pain when chewing, and vision problems. If left untreated, giant cell arteritis can lead to vision loss or other complications, so it’s important to seek prompt medical attention.
Intracranial Pressure Changes:
Any condition that affects the pressure inside the skull, such as a brain hemorrhage (bleeding in the brain) or hydrocephalus (excess cerebrospinal fluid in the brain), can lead to secondary headaches. These headaches are often accompanied by other neurological symptoms like confusion, vision problems, or loss of coordination.
Temporomandibular Joint (TMJ) Disorders:
Problems with the TMJ, which connects the jaw to the skull, can cause tension in the head and neck muscles, leading to headaches. These are often described as dull or aching and may be associated with jaw pain, difficulty chewing, or teeth grinding.
Compare and contrast primary and secondary headaches
Primary occur without an underlying medical condition whereas secondary are due to a medical isssue
Causes:
1 intrinsic factors like genetic, brain chemistry, stress, food, sleep changes
2 SI it’s, head injuries, hypertension, brain tumours, infections, medication overuse
Duration:
Both can vary from days to weeks/ months
Symptoms:
(List them)
1=pain is primary symptom
2=pain is symptoms of a larger issue]
Severity:
Migrants can be sever, headaches moderate and cluster can be considered the most intense type of pain with extreme severity
2severe headaches however underlying issue can be worse and cause an emergency
Treatment:
1= varies. TTH ibruphen, stress management
Migraine= beta blockers, NSAIDS
Cluster= oxygen therapy and Tristan’s
2 Treating the under;lying cause
Sinusitis: Antibiotics (if bacterial), decongestants, or nasal sprays.
Head injury: Pain relievers, rest, and monitoring for symptoms of concussion or more serious injury.
Hypertension: Blood pressure medications and lifestyle changes.
Brain tumors or infections: Surgery, chemotherapy, or antibiotics, depending on the cause.
Diagnosis:
1 clinical based on symptoms and pt history.
2a full medical work up like blood tests, neurological exam and imaging like CT or MRI
What is the Glasgow coma scale
Neurological scale to assess persons level no consciousness following a head injury or neurological impriarment
- Eye opening :
4 = Eyes open spontaneously
3 = Eyes open to speech (i.e., when spoken to or called)
2 = Eyes open to pain (i.e., a painful stimulus)
1 = No eye opening
2.verbal response
5 = Oriented (person can respond appropriately and is aware of their surroundings, time, and place)
4 = Confused conversation (the person responds but is disoriented and confused)
3 = Inappropriate words (speech is incoherent, inappropriate, or random words)
2 = Incomprehensible sounds (moaning or groaning without clear speech)
1 = No verbal response
3motor response
6 = Obeys commands (the person can carry out simple requests, like moving a hand)
5 = Localizes pain (the person responds purposefully to painful stimulus by trying to remove it)
4 = Normal flexion (withdraws from pain in a purposeful way, but not localized)
3 = Abnormal flexion (decorticate posturing, flexing arms inward toward the body) cortex issue
Decorticate
2 = Abnormal extension (decerebrate posturing, arms and legs extend outwards, typically a worse sign) cerebrum issue
Decerebrate
1 = No motor response
3 = Deep coma or brain death (the lowest possible score, with no eye, verbal, or motor response)
15 = Fully alert and oriented (the highest possible score)
8 or less is considered a sever Brian injury
9-12 moderate impairment
This is used for post-injury monitoring
Trauma and emergency medicine and neurological disorders
There are limitations like cultural and language barriers abd sedation, intoxication which could cause a low score even if their neurological condition is not severe
Describe rapid stroke assessment
Fave. Has it fallen on one side
Arms. Can they raise them?
Speech. Is it slurred?
Time. 999
Describe the SCAT 5 assessment
Confusion assessment
Sports concussion assessment tool
Player info
Assessment of symptoms (0-6 severity)
Cognitive screening
Physical assessment
Glasgow coma scale
Concussion severity score
What is intercranial hypertension
Increased pressure in the brain
Can result from many different neurological diseases
Secondary to many CNS issues
Pressure in different areas can cause different symptoms:
Papilledmea (optic disc odema)
Nausea and vomiting
Coma
Headaches
Herniation through foremen magnum (down) focal weakness, posturing, cardiac arrest, pupil change
What is large artery occlusive disease
Stenosis of larger extracranial and intercranial arteries
Atherosclerosis mc for cerebral ischameic events
Base of brain/ stem
Main risk factors: HEDS due to weak ct tissue of vessel walls, hypertension, hypercholesterolemaii , smoking
What Cardiac disease can lead to a cardiac embolism
Post MI
Rheumatic valvular disease
Mechanical heart valve
Infective endocarditis
Mitral valve proplapse, calcification,
Patient foramen oval
Atria;l septal aneurysm
What is small vessel disease (lacunes)
Penetrating arteries deep brain not prone to atherosclerosis. They degenate in response to endothelial damage
Focal enlargement of vessel wall and a haemorhagic rupture.
1-20mm lesions called lacunes
What is arterial dissection
Main vulnerability is several cm distal to skull base
Vertabral artery tends to occur when engaged c6-c2and in skul through form and
• Dissection between the intima and media usually causes stenosis / occlusion.
• Dissection between the media and adventitia is often associated with aneurysmal dilatation.
• Congenital abnormalities can predispose.
• Stroke from two causes:
• Clot at site of intimal tear and embolize to the distal cerebral circulation.
• Expanding thrombus within the media may progress to severe stenosis and cerebral hypoperfusion
List the triad for meningitis
Fever
Stiff neck
Altered mental state
Infection of spinal cord and brain that can be life threatening
Can come with a rash too
