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Neuro phase 3a (little bit) > Headaches: > Flashcards

Headaches: Flashcards

1
Q

List the classification of headaches:

A

Primary:

  • Migraine
  • Cluster headache
  • tension headache

Secondary:

  • Meningitis
  • SAH
  • Giant cell arteritis
  • Medication overuse headache
  • Idiopathic intracranial hypertension

Other:
- Trigeminal neuralgia

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2
Q

What is migraine?

A

Recurrent headache associated with visual and GI disturbance (photophobia and nausea)

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3
Q

What is migraine with aura known as? And what is migraine without aura known as?

A

With - Classic migraine

Without - common migraine

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4
Q

Give some features of migraine:

A
  • Reversible visual symptoms (unilateral blindness, flashes, fortification spectra)
  • Reversible dysphagic speech
  • tingling
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5
Q

What can trigger migraines?

A

Chocolate (oral contraceptives, caffeine, alcohol)

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6
Q

How long to migraine attacks last?

A

4-72 hours

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7
Q

What is the treatment for migraine?

A

Acute - NSAIDs +/- antiemetic (metoclopramide)

2nd line - triptans

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8
Q

What is used as prophylaxis in migraine?

A

Propanolol

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9
Q

What are cluster headaches?

A

Rapid onset, severe short lived headaches (15mins - 3hrs) - more common in men.

Unilateral orbital/supraorbital pain

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10
Q

What does the ‘cluster’ part of cluster headaches represent?

A

The variation in time. Headaches occur in clusters: frequency varies from once every other day to several a day for 1-3 months

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11
Q

What are some associated symptoms in Cluster headache?

A

Ipsilateral autonomic features:

  • Lacrimation
  • Eye redness
  • Nasal blockage
  • Flushing

Restlessness

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12
Q

What is the management for cluster headache?

A

Acute - triptans (sumatriptan)

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13
Q

What is given as prophylaxis in cluster headache?

A

Verapamil (CCB)

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14
Q

Give an example of a triptan?

A

Sumatriptan

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15
Q

What is the most common cause of headache?

A

Tension headache (lasting from 30mins to a week)

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16
Q

What are the features of tension headache?

A
  • Bilateral, of a pressing/tightening quality (not pulsating)
  • Less severe than migraines
  • Stress is usually an etiological factor
17
Q

What is the treatment of tension headache?

A

(largely self-limiting)
Acute:
- NSAIDs/paracetamol

18
Q

Give 4 symptoms of giant cell arteritis (GCA):

A
  • UNILATERAL VISUAL LOSS
  • Scalp tenderness
  • Jaw claudication
  • Headaches
19
Q

What is seen on investigation in GCA?

A
  • ESR raised

- Temporal artery biopsy

20
Q

What is the treatment of GCA?

A

Oral prednisolone

21
Q

What are the features of headache due to raised intracranial pressure?

A
  • Generalised ache
  • Worsened by bending, coughing, straining (^ICP)
  • Worse in morning
  • Vomiting
  • Visual changes
  • Focal neuro signs
  • Papilloedema (blind spot)
22
Q

What can cause raised intracranial pressure?

A
  • SOC

- Idiopathic intracranial hypertension

23
Q

What localising sign can indicate raised ICP?

A

False localising sing such as III/VI CN palsy

24
Q

Give three cardinal presenting symptoms of brain tumours:

A
  • Symptoms of ^ ICP
  • Focal or generalised epilepsy
  • Progressive neurological deficit
25
Q

What are the majority of primary brain tumour ?

A

1) Gliomas (e.g. astrocytoma) (85-90%)

2) Oligodendroblioma (5%)

26
Q

What can be used to treat brain tumours?

A
  • IV dexamethasone (decreases cerebral oedema)
  • IV mannitol
  • Seizures with anticonvulsant
  • Surgical excision (+/- adjuvant chemo-radiotherapy)
27
Q

What medication can be used in Glioblastoma multiforme?

A

Temozolamide

28
Q

What are the features of trigeminal neuralgia?

A
  • Knife-like stabbing pain in CN V distribution
  • Unilateral
  • Last fraction of a second to 2 mins long
29
Q

What can be triggers of trigeminal neuralgia?

A

Washing face, shaving, eating, talking

30
Q

What is the management of trigeminal neuralgia?

A
  • Carbamazepine (anticonvulsant)
31
Q

Give an example of an anti-convulsant:

A

Carbamazepine

Neuro phase 3a (little bit) (6 decks)

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