Headaches Flashcards
Tension HA
Usually starts in back of head
Steady, vice-like, non-throbbing, pain in neck
No aura, no GI sx, exacerbated by stress
Lasts for a long period of time
Meds for tension HA
NSAIDS
Midol?
Robaxin (muscle relaxant)
Tension HA prophylaxis
Amitriptyline
Topirimate
Migraine HA
Characterized by neuro, GI, autonomic changes
Migraine w/ or w/o aura
Caused by spasm of vertebral vessels
Pain caused by dilation of extracranial arteries
What causes the aura?
Diminished cerebral perfusion
Common Migraine
Migraine w/o aura
Classic migraine
Migraine with aura, scintillating scotoma
onset within 60 minutes of aura
Opthalmoplegic Migraine
Lateralized pain, N/V, diploplia
INvolves CN III, VI
Headache lasting more than a couple of days
Basilar Migraine
Bilateral visual disturbance
Ataxia
Dysarthrias
Triptans
First-line for moderate to severe migraine
Rizatriptan
Zolmitriptan
Sumatriptan
Triptan CI
Coronary vasospasm
Ischemic heart dz
CVD
age >65
Tx for Migraine HA
Propranolol TCA's SSRI's CCB's Topirimate
Cluster HA
Less common, more severe Come in clusters More common in men 50-60 Smoking is big risk factor (but quitting doesnt help) ETOH provokes attacks
Cluster HA S/S
Pain around one eye, drooping of the lid
Tearing and congestion on same side as pain
Steady, stabbing deep eye pain
Attacks often occur within 2-3 hrs of falling asleep
Injected eye, unilateral
Horner’s syndrome
Miosis
Ptosis
Associated with cluster HA