Headaches Flashcards
the most common neurological disorder
headache
what is a structural headache
brain tumor, IICP, aneurysm, infarct, stroke
what is functional headache
no identifiable cause for the headache
what is an organic headache
headache from a secondary issue (carbon monoxide poison, high BP)
causes and triggers for headaches
stress, fatigue, alcohol
3 headache classifications
cluster
migraine
tension
are ct/mri helpful in determining cause/type of functional headache
no
best determination in treatment for functional headache
pt hx and assessment
most common type of headache
tension
pain level w/tension headaches
mild to moderate pain
with tension headaches pt. complains of what
rubber-band/vice-like pressure radiating to neck, shoulder, upper back muscles
location of tension headache
bilateral
how often could you get a tension headaches
infrequent
frequent
chronic
what triggers tension headaches
vasospasm similar to migraines
are tension headaches r/t time
no
fxrs making tension headaches worse
sensitivity to light/sound
duration of tension headaches
minutes-week
does pt experience n/v w/tension headache
not usually
dx study for tension headache
pt. hx and physical exam
what type of things would we ask to do for pt w/tension headache
shrug shoulders, turn head side-to-side
2 types of migraine headaches
migraine w/aura (prior to getting migraine)
migraine w/o aura
s/s of migraine
n/v
sweat/pale
sensitive to light/sound (photophobia/phonophobia)
pain level w/migraine
moderate to severe - highly debilitating
location of migraine headache
uni or bi-lateral
duration of migraine headaches
4-72 hrs
pt coping w/migraines
hibernate (turn everything off/shut shade)
pt describes migraine pain as
throbbing that matches their pulse
cause for migraines
vascular (vasoconstriction to vasodilation)
deficit of serotonin
auto-immune disorders (MS)
family hx
trt for migraines
imitrex
SSRI for serotonin levels
migraine triggers
foods high in sugar/nitrates/MSG/aged-cheeses
red wine
fatigue/stress
dx studies for migraines
pt. hx neuro exam (cranial nerves)
pain level w/cluster headache
severe pain
duration of cluster headache
a few minutes
where is the pain located during a cluster headache
pain around eye radiating to temple, forehead, cheeks, gums, nose
what causes cluster headaches
unknown theory (hypothalamus) infection r/t the trigeminal nerve? genetic smoking/alcohol association
are cluster headaches r/t time
yes, cyclical
almost always occur in the middle of the night
are cluster headaches common
no - rare - more in females
questions to ask pt when coming to ED for headache
is there a specific time you get these headaches
s/s of cluster headache
UNILATERAL pupil constriction swelling around the eye rhinitis pallor ***pain along trigeminal nerve
dx of cluster headache
ct or MRI to rule out aneurysm, pt hx/assess
what do headache diaries help with
tracking (triggers, when headache occurs)
