headaches Flashcards

1
Q

what is the most common type of headache

A

migraine

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2
Q

What are the primary types of headaches

A

tension, migrain and cluster

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3
Q

what are the secondary types of headaches

A

rebound- medication overuse

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4
Q

What is considered a frequent headache

A

HA 2-14 days a month

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5
Q

what are chronic headaches

A

15+ days a month

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6
Q

what usually cause tension headaches

A

peripheral m tenderness and stress, tension, posture etc

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7
Q

What is the Ddx criteria for tension headaches

A

bilateral head pain, steady pain, mild to moderate, no aggravation
pain lasts 30 min to 7 days

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8
Q

What are the acute Tx for tension headaches

A

NSAIDs tylenol, triptans, muscle relaxants

OMT

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9
Q

What are the preventative methods for tension headaches

A
tricyclic antidepressants
SSRIs MAOIs
anticonvulsants
tizanidine
PT OMT
accupuncture
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10
Q

what areas of body should be Tx with OMT for tension headaches

A

upper thoracics, ribs, cervicals, cranial dysfunction like TMJ
lumbar sacrum and pelvis

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11
Q

What are the theories for migrains

A

vascular dilation or constriction
cortical spreading depression (depolarization)
trigemino-muscular( activation)
sensitization to nociceptive input

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12
Q

What are believed to play a role in development of migrain and increase susceptibility

A

genetics.

most common from mom

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13
Q

What are precipitating factors for migrains

A

emotional stress, hormonal changes, not eating, weather change, sleep problems, odors, neck pain, lights ETOH, smoke, computers

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14
Q

What are the prodromal effects of migrains

A

euphoria, depression, irritabilitym food cravings, constipation and neck stiffness

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15
Q

Which type of headache commonly has auras

A

migraines

usually visual

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16
Q

What is the HA stage of migrains

A

throbbing unilateral, intensity increases, nausea/vomiting, photo/phonophobia
chills/sweating

17
Q

What are the postdromal effects of migraines

A

movement of head causes pain, exhaustion, mild elation or euphoria

18
Q

What is the acute Tx for mild migraines

A

NSAIDs, tylenol, caffeine, OMT

19
Q

what is the acute Tx for moderate/severe migraines

A

triptans, sumatriptan-naproxen
ergot alkaloids
opiates
OMT

20
Q

What are preventative actions for migrains

A

beta blockers, Ca ch blockers, ACE inhibitors, antidepressants, anticonvulsants
acupuncture, OMT, surgery
riboflavin B2
opoids etc

21
Q

What are of body is Tx with OMT for migraines

A

upper thoracic spine, upper ribs, cranial, cervical, abdomen and sacrum

22
Q

What are episodic cluster headaches

A

daily attacks with periods of remission. involve pain around one eye

23
Q

what are chronic cluster headaches

A

daily attacks with no significant periods of remission

24
Q

what are the theories of cluster headaches

A

hypothalamic activation with secondary activation of trigeminal autonomic reflex
neurogenic inflammation at wall of cavernous sinus that prevents venous drainage

25
Q

what can blocakge of cavernous sinue lead to

A

injury of SANs fibers in internal carotid a

26
Q

what are Sx of cluster headaches

A

ptosis miosis lacrimation, rhinorrhea, conjunctival injection, nasal congestion

27
Q

what is the Tx for acute cluster headaches

A
O2, triptans, (not in CV patients)
octreotide (somatostatin)
lidocaine
ergots
OMT
28
Q

What are the preventative methods for cluster headaches

A
verapamil
glucocorticoids
lithium
methysergide
topiromate
surgery
occipital n procedures
deep brain stimulation
OMT
29
Q

What are most common causes of medication abuse leading to HA

A
opoids
aspiring
tylenol
butalbital
triptans
ergotamine
NSAIDs
30
Q

If HA presents on waking what could it be

A

medication overuse HA

31
Q

What happens when withdraw abused HA medication

A

get worse then better

32
Q

what is the bridge theory

A

used to help people wean off their medication causing HA, give them a different kind

33
Q

What are indications for imaging for HA complaint

A
in setting of other disease
worst HA ever "thunderclap"
waking because of pain
rapid increase in frequency
frontal HA worse when leaning forward (CHILDREN)
34
Q

what is included in Patient Ed as DO

A

self Tx with CV4