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Diff Dx > Headaches > Flashcards

Headaches Flashcards

1
Q

Primary headaches

A

migraine
tension
cluster

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2
Q

secondary headaches

A

caused by underlying organic disease

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3
Q

cervicogenic headaches

A

secondary although some classify as primary

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4
Q

abnormal findings with headaches warrant what?

A

neuroimaging to rule out intracranial pathology

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5
Q

what is the preferred method to rule out hemorrhage?

A

CT

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6
Q

MRI is necessary for imaging what?

A

posterior fossa

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7
Q

what are CSF analyses for?

A

hemorrhage
infection
tumor
CSF disorders

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8
Q

headache onset after 50 years is?

A

a red flag

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9
Q

ddx for headaches beginning after 50 years

A

temporal arteritis

mass lesion

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10
Q

possible work ups for headaches beginning after 50

A

ESR/CRP, neural imaging

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11
Q

ddx for sudden onset headache

A

subarachnoid hemorrhage
mass lesion
vascular malformation

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12
Q

possible workup for sudden onset headache

A

neuroimaging

lumbar puncture if neuroimaging is negative

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13
Q

ddx for increased frequency and severity of headache

A

mass lesion
subdural hematoma
medication overuse

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14
Q

possible workup for increasing frequency and severity of headache

A

neuroimaging

drug screening

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15
Q

red flags considering headaches

A 
>50 years
sudden onset
increase in frequency and severity
HIV/cancer
systemic illness (fever, stiff neck, rash)
focal neurological S&S
papilledema
subsequent to head trauma
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16
Q

ddx for headache from HIV/cancer

A

meningitis
abcess
metastasis

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17
Q

possible workup for headache from HIV/cancer?

A

neuroimaging

lumbar puncture if neuroimaging is negative

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18
Q

ddx for headaches from systemic illness

A 
meningitis
encephalitis
lyme disease
systemic infection
collagen vascular disease
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19
Q

possible workup for headaches from systemic illness

A

neuroimaging
lumbar puncture
serology

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20
Q

ddx for focal neurological S&S

A

mass lesion
vascular malformation
stroke
collagen vascular disease

21
Q

possible workup for headaches from focal neurological S&S

A

neuroimaging

collagen vascular evaluation

22
Q

ddx for a headache with papilledema

A

mass lesion

meningitis

23
Q

possible workup for headache with papilledema

A

neuroimaging

lumbar puncture

24
Q

ddx for headache from subsequent trauma

A

intracranial hemorrhage
subdural/epidural hematoma
posttraumatic headache

25
Q

possible workups for headaches from subsequent trauma

A

neuroimaging of the brain, skull and possibly cervical spine

26
Q

migrain pain location

A

unilateral

27
Q

tension headache pain location

A

band like and bilateral

28
Q

cluster headache location

A

strictly unilateral

29
Q

temproal arteritis headache location

A

distribution of temporal artery

30
Q

trigeminal neuralgia pain location

A

distribution of trigeminal nerve

31
Q

acute glaucoma pain location

A

eye pain

32
Q

what is one of the most common cause of headaches?

A

whiplash

33
Q

4 primary headache patterns

A

migrain
tension type
cluster headache
cervicogenic

34
Q

when must acute headache be evaluated?

A

if associated with neurologic S&S

35
Q

describe a migraine

A

associated with nausea, vomiting, or sleepliness and separated by pain free intervals

36
Q

what is a chronic progressive headache? What may be suspected?

A

severity and frequency increase over time

structural disorder of CNS

37
Q

what is a chronic nonprogressive headache?

A

most typical type, usually related to stress

38
Q

most patients presenting to physician’s office for evaluation of headache have what?

A

either a tension headache or migraine

39
Q

S&S of a migraine

A 
nausea
photophobia
phonophobia
exacerbation by physical activity
aura
40
Q

intracranial organic pathologies are from what?

A 
infection
intracranial mass lesion
hemorrhage
hypertensive parenchymal hemorrhage, subdural hematoma
ischemic conditions
traumatic brain injury
41
Q

other organic syndromes

A 
cluster headache
cranial bone pain
scalp pain
vascular involvement
eye pain
ear pain
acute sinusitis
dental pain
facial nerve pain
neck pain
acute febrile illness
metabolic disorders
42
Q

red flags for headaches

A 
sudden, severe headache
new headache, older patient
headache due to head trauma
associated residual neurologic S&S
cognitive changes
vomiting w/o nausea
persistent or progressive headache
nuchal rigidity with or without fever
suspicion of drug or alcohol dependance
headache associated w' 15-mm Hg
persistent/severe headache in child
43
Q

headaches associated with exertion may mean

A

underlying tumor or vascular weakness

44
Q

when do you do a CT/MRI for post traumatic headaches?

A

signs of neurological dysfunction and loss of consciousness

45
Q

most primary headaches occur when?

A

at an early age and are recurring

46
Q

when should a new headache be a concern?

A

if they are middle aged or older complaining of a new headache

47
Q

older patients with a temporal headache need to be considered to have..

A

temporal arteritis

48
Q

headaches that are constant and more severe without reprieve likely indicate

A

intracranial process and should necessitate a referral for evaluation

49
Q

how to manage a headache without red flags

A

modify patient behavior (sleep, diet, exercise)
manage with CMT
supplements or herbal alternates
nonpharmacological treatments,
if chiro is unsuccessful (acupuncture/biofeedback)
refer for medical management if still unsuccessful

Diff Dx (17 decks)

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