Headaches

Question 1

4 types of headaches

Answer 1

Sinus, cluster, tension, migraine

Question 2

90% of all headaches

Answer 2

primary headaches

Question 3

75% of headaches

Answer 3

tension headaches

Question 4

HIT-6

Answer 4

Measures how severe headaches affect a lifestyle

Question 5

What is the biggest factor for converting from episodic migraines to chronic migraines?

Answer 5

Opioid use

Question 6

> 15 headaches a month for >3 months

Answer 6

Chronic migraine

Question 7

What are the 5 phases of a complete migraine attack?

Answer 7

Prodrome, aura, headache, resolution, recovery

Question 8

What is the most common element of migraine aura?

Answer 8

Visual disturbances

Question 9

What is the vascular theory of a migraine?

Answer 9

Serotonin release, which leads to vasoconstriction. This can increase prostaglandin release

Question 10

What is the neurogenic theory of migraine?

Answer 10

Changes in activity of locus coeruleus, which leads to excitation of efferent neurons in trigeminal nuclei. This causes vasoactive substances to be released from trigeminal nerve and leads to activation of PGE and degranulation of mast cells.

Question 11

Is there usually an aura in menstrual migraines?

Answer 11

No.

Question 12

What do they believe is the main factor in menstrual migraine?

Answer 12

Decrease in premenstrual estradiol.

Question 13

What is the 3-step approach to Migraine Treatment?

Answer 13

1. Non-specific treatment for mild migraine (NSAIDS, ASA, APAP, etc.)
2. Specific treatment for moderate-severe pain. Combinations of analgesics, triptains, ergots, anti-emetics
3. Prophylaxis in a migrainer

Question 14

When do you use opioids in treating acute migraine attacks?

Answer 14

As a last resort