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Neurology > Headaches > Flashcards

Headaches Flashcards

1
Q

What is the most common type of headache in the general population?

A

Tension headache

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2
Q

What are some potential causes of a PTs Secondary Headache?

A

Underlying Diseases:
Space-occupying mass or lesion
Infection
Metabolic disturbance or Systemic

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3
Q

What medical Red Flags must you rule out during your exam which may indicate a 2ndary headache?

A

Fixed neurologic deficits
Abrupt onset
Papilledema (Sx of brain hemorrhage or tumor)
New onset headaches (<5 y.o. or >50y.o.)
S/Sx of infection (Kernig Sign –> nuchal rigidity)
Altered level of consciousness
New HA in a cancer or immunocompromised PT

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4
Q

What might the clinical picture of a PT with an aneurysm look like?

A

SUDDEN onset HA
SEVERE “Worst HA of life”
Stiff neck
Fever, Nausea, Vomiting

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5
Q

PT presents with stiff neck, fever, and headache… What condition must you rule out?

What other S/Sx might present with this condition?

A

R/o Meningitis with CT and lumbar puncture

May also be possible:
Papilledema
Seizures

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6
Q

An obese women 25 y/o woman presents to your clinic with CC of a transient HA and decreased vision. What should your work up r/o?

What other factors may increase this woman’s risk profile for the suspected condition?

A

Idiopathic Intracranial HTN
(Pseudotumor cerebri)

Increased risks might include:
Estrogen –> Contraceptives
Tetracyclines
Vitamin A

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7
Q

What is the basic Tx regiment for Idiopathic Intracranial HTN?

A 
Dx:  Made with LP
Tx:
Weight loss
Actezolamide (Diamox) to prevent vision loss
Optic nerve sheath decomp or VP shunt
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8
Q

PT reports to your clinic with a headache that is only improved when lying down… The intense headache and Px come back immediately upon standing up. What kind of headache might this PT have?

What other signs and symptoms might they have?

Dx and Tx for this PT?

A

Low Pressure Headache

VERY INTENSE IN NATURE

Stiff painful neck
Vomiting
Can occur as result of spinal LP, surgery, trauma, or spontaneous

BLOOD PATCH is curative

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9
Q

65 y/o PT presents with a new onset headache with jaw claudication… What condition do you suspect?

A

Temporal Arteritis (inflammation of temporal artery) aka Giant Cell Arteritis

Palpate for tenderness

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10
Q

What is the GOLD STANDARD for diagnosis for a PT you suspect is suffering from Temporal Arteritis?

What other lab could you order?

A

Temporal Artery biopsy

ESR. Sed will be elevated typically

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11
Q

What would the appropriate Tx be for a PT once you receive their Temporal Artery biopsy back and you verify they have Temporal / Giant Cell Arteritis?

A

Steroids (prevent vision loss and reduce Px)

Optic neuropathy

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12
Q

Any PT with Temporal / Giant Cell Arteritis is at greater risk for development of what condition?

What are some of the S/Sx of this complication?

A

Polymyalgia Rheumatica

```
Shoulder and Neck stiffness/Px
may progress to hips
Fatigue
Weight loss
Depression
Anemia
Fever
~~~

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13
Q

What would the appropriate Tx include for a PT who has developed Polymyalgia Rheumatica from a Giant Cell Arteritis?

A

Corticosteroids x 2 to 6 years

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14
Q

What are some common medications that can cause Medication Overuse Headaches?

A 
ACETAMINOPHEN MC
Fiorcet:  (Migraine med:  Acetaminophen/ Butalbital/caffeine)
Butalbital (sedative)
Opioids
Caffeine
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15
Q

What medications are combined in Fiorcet?

What is Fiorcet used to Tx?

A

Acetaminophen / Butalbital / Caffeine

Used to Tx Migraines

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16
Q

How much time (minimum) does it typically take until medication overuse can cause overuse headaches?

A

3 months

17
Q

Which nerve is implicated with migraines?

How does it create the clinical side effects associated with Migraines?

A

Trigeminal Nerve

Afferent components of the nerve trigger release of inflammatory and Px producing substances

18
Q

Medication overuse headaches and migraines are more common in what patient demographic?

A

WOMEN

19
Q

A PT has presented to your clinic and you determine they suffer from Medication Overuse Headaches.

What is the appropriate Tx?

A

Withdrawal of the medication

Bridge therapy –> to avoid total withdrawal

Prophylactic medication (after withdrawal)

20
Q

T/F

Acute and chronic sinusitis is a common cause of RECURRENT headaches.

A

FALSE

Acute and chronic sinusitis (sinus headaches) are an UNCOMMON cause of recurrent HA

21
Q

What is the typical clinical presentation of a “Sinus Headache?”

A

Bilateral pressure-like or dull sensation
HA lasting days
NOT associated; NEG N, V, photophobia, or phonophobia

22
Q

What are some examples of Primary Headaches?

A

Migraines
Tension HA
Cluster HA
Trigeminal Autonomic Cephalgia

Neurology (18 decks)

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