headaches Flashcards
what is the most common type of headache
migraine
What are the primary types of headaches
tension, migrain and cluster
what are the secondary types of headaches
rebound- medication overuse
What is considered a frequent headache
HA 2-14 days a month
what are chronic headaches
15+ days a month
what usually cause tension headaches
peripheral m tenderness and stress, tension, posture etc
What is the Ddx criteria for tension headaches
bilateral head pain, steady pain, mild to moderate, no aggravation
pain lasts 30 min to 7 days
What are the acute Tx for tension headaches
NSAIDs tylenol, triptans, muscle relaxants
OMT
What are the preventative methods for tension headaches
tricyclic antidepressants SSRIs MAOIs anticonvulsants tizanidine PT OMT accupuncture
what areas of body should be Tx with OMT for tension headaches
upper thoracics, ribs, cervicals, cranial dysfunction like TMJ
lumbar sacrum and pelvis
What are the theories for migrains
vascular dilation or constriction
cortical spreading depression (depolarization)
trigemino-muscular( activation)
sensitization to nociceptive input
What are believed to play a role in development of migrain and increase susceptibility
genetics.
most common from mom
What are precipitating factors for migrains
emotional stress, hormonal changes, not eating, weather change, sleep problems, odors, neck pain, lights ETOH, smoke, computers
What are the prodromal effects of migrains
euphoria, depression, irritabilitym food cravings, constipation and neck stiffness
Which type of headache commonly has auras
migraines
usually visual
What is the HA stage of migrains
throbbing unilateral, intensity increases, nausea/vomiting, photo/phonophobia
chills/sweating
What are the postdromal effects of migraines
movement of head causes pain, exhaustion, mild elation or euphoria
What is the acute Tx for mild migraines
NSAIDs, tylenol, caffeine, OMT
what is the acute Tx for moderate/severe migraines
triptans, sumatriptan-naproxen
ergot alkaloids
opiates
OMT
What are preventative actions for migrains
beta blockers, Ca ch blockers, ACE inhibitors, antidepressants, anticonvulsants
acupuncture, OMT, surgery
riboflavin B2
opoids etc
What are of body is Tx with OMT for migraines
upper thoracic spine, upper ribs, cranial, cervical, abdomen and sacrum
What are episodic cluster headaches
daily attacks with periods of remission. involve pain around one eye
what are chronic cluster headaches
daily attacks with no significant periods of remission
what are the theories of cluster headaches
hypothalamic activation with secondary activation of trigeminal autonomic reflex
neurogenic inflammation at wall of cavernous sinus that prevents venous drainage
what can blocakge of cavernous sinue lead to
injury of SANs fibers in internal carotid a
what are Sx of cluster headaches
ptosis miosis lacrimation, rhinorrhea, conjunctival injection, nasal congestion
what is the Tx for acute cluster headaches
O2, triptans, (not in CV patients) octreotide (somatostatin) lidocaine ergots OMT
What are the preventative methods for cluster headaches
verapamil glucocorticoids lithium methysergide topiromate surgery occipital n procedures deep brain stimulation OMT
What are most common causes of medication abuse leading to HA
opoids aspiring tylenol butalbital triptans ergotamine NSAIDs
If HA presents on waking what could it be
medication overuse HA
What happens when withdraw abused HA medication
get worse then better
what is the bridge theory
used to help people wean off their medication causing HA, give them a different kind
What are indications for imaging for HA complaint
in setting of other disease worst HA ever "thunderclap" waking because of pain rapid increase in frequency frontal HA worse when leaning forward (CHILDREN)
what is included in Patient Ed as DO
self Tx with CV4
