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Neuro. CM3 > Headaches > Flashcards

Headaches Flashcards

1
Q

Most common type of HA:

A

Tension (W > M)

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2
Q

SNOOP 4 flags for headache:

A 
Systemic disease 
Neurologic signs
Onset that is sudden
Onset that is over 40
Previous HA with new features
Progressive 
Postural
Precipitation by valsalva/exertion
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3
Q

Migraines will hit their max pain usually in:

A

1-2 hours

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4
Q

What is a defining feature of migraines vs. SAH:

A

Transient with ipsilateral tearing and rhinorrhea

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5
Q

Imaging needed for HA:

A

MRI without contrast

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6
Q

Frequencies of HA:

A

Infrequent: <1 d/month
Frequent: 1-14
Chronic: >15/month

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7
Q

Tension headache does NOT

A

Throb - it is a headband of pressure

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8
Q

TTH has at least two of the following (4):

A
  • Bilateral head or neck pain
  • steady pressing or tightening and non-throbbing pain
  • Mild to moderate pain
  • not aggravated by normal physical activity
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9
Q

Best treatment for tension

A

Rest

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10
Q

Do not want to treat a HA for more than how many days a month (risk of developing MOH)?

A

More than 9

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11
Q

Treatment for Tension headaches (4):

A
  • Ibuprofen (600 I; 800 I)
  • APAP 1000 x1
  • Ketorolac injection IM
  • Excedrin with caffeine (APAP)
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12
Q

Cannot use what in pregnancy?

A

NSAIDS

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13
Q

A menstrual migraine (starting 2-3 days) from too low estrogen does not have:

A

An aura

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14
Q

Cluster headaches are more common:

A

In men and at night

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15
Q

Cluster headaches have:

A

Throbbing

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16
Q

Two most common types of aura:

A
  1. visual

2. Sensory

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17
Q

What is cutaneous allodynia?

A

Perception of pain produced by the innocuous stimulation of normal skin

18
Q

What type of headache affects young women and children?

A

Basilar - Vertigo + dysarthria

19
Q

Retinal ocular migrants result in:

A

Monoocular stomata that lasts an hour that is followed by a HA

20
Q

If you have someone with migrainous vertigo make sure they do not have:

A

Meniere’s

21
Q

Migraine without aura (more common) has more than two of the following 4:

A
  • Unilateral location
  • Pulsating quality
  • Moderate-serve intensity
  • aggravation by routing physical activity
22
Q

Food triggers are more likely to tip off a:

A

Migraine

23
Q

Why do oral agents not work as well when someone has a migraine?

A

Because there is secondary gastric stasis

24
Q

Options for acute treatment of a migraine:

A
  • NSAID +/- APAP
  • Triptan (inhaled)
  • Ergots
25
Q

You can use what medications for nausea AS MONOTHERAPY?

A

IV Metoclopramine or IV/IM chlorpromazine and prochlorperazine or IV ondansetron (zofran)

26
Q

Do not use this for a headache!!!

A

Opioids

27
Q

If you have more than 4 HA a month, take prophylactic treatment (2):

A

1st line options: Beta-blockers (propranolol) and AEDS (topiramate) - need 4-6 weeks to work

28
Q

Menstrual HA treatment?

A

Long extended release OC and triptans

29
Q

What triggers an attack in a cluster HA most common in men?

A

Alcohol - will be sensitive during the episode

30
Q

Cluster HA happen at:

A

Night

31
Q

What are symptoms of cluster HA?

A

Unilateral throbbing, corners, rhinorrhea and conjunctiva injection

32
Q

What are two treatments for cluster HA?

A

Oxygen and triptans

*prednisone can be a bridge

33
Q

SUNCT syndrome is what?

A

Short-lasting unilateral neualgiform HA with conjunctival injection and tearing - more common in men

34
Q

If you have SUNCT, you need to do a:

A

MRI

35
Q

SUNCT is how short:

A

30-120 seconds

36
Q

What is chronic paroxysmal hemicranial?

A

More common in women, CONTINUOUS head pain

37
Q

Treatment for CPH

A

Indomethacin

38
Q

What is a sign of pseudotumor cerebri?

A

Papilledema

39
Q

Diagnosis for Pseudoturmor cerebri?

A

20-30 mL of CSF - will reduce pressure

40
Q

Treatment for pseudo tumor cerebri:

A

Acetazolimide - next best is topiramte

41
Q

What is the difference between hemicranial continua and CPH?

A

HEMICRANIA continua never really goes away

Neuro. CM3 (11 decks)

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