Headaches Flashcards
Give 3 examples of primary headache?
- Migraine
- Cluster
- Tension headache
What is a secondary headache?
A headache where there is an underlying cause
What are the red flags for a headache?
- HIV or immunosuppressed
- Fever
- Thunderclap headache (link to subarachnoid haemorrhage)
- Seizure and new headache
- Suspected meningitis
- Suspected encephalitis
- Red eye? Acute glaucoma
- Headache + new focal neurology eg papilloedema
What are the features of a migraine?
- Recurrent
- Throbbing
- Often preceded by an aura
- Associated with nausea, vomiting and visual changes
Give some examples of secondary headaches?
- Meningitis
- Subarachnoid haemorrhage
- GCA
- Idiopathic Intracranial Hypertension
- Medication Overuse Headache
What is another cause of headache that doesn’t fit into the primary or secondary catergory?
Trigeminal neuralgia which is a facial pain
What would be some red flags for a brain tumour in someone who presents with a headache?
- New headache with Hx of cancer
- Cluster headache
- Seizure
- Significantly altered consciousness, memory, confusion, coordination
- Papilloedema
- Other abnormal neuro exam or symptom
What are the two types of migraine?
- Episodic (with or without aura)
- Chronic
How can you classify a headache as a migraine?
Two of the following:
- Unilateral
- Pulsing
- Moderate, severe pain
- Aggravated by routine physical activity
What other symptoms would be associated with a migraine?
- Nausea and vomiting
- Photophobia and phonophobia
What is aura with a migraine?
Disturbances that can include flashes of light, blind spots and other vision changes or tingling in your hand or face
How long do migraine attacks typically last for?
4 - 72 hours
What are some features of a tension headache?
- Episodic (<15 days / month) or chronic ( >15 days a month for at least 3 months)
- Usually has one of the following
- Bilateral
- Pressing / tight non-pulsatile
- Mild/moderate intensity
+/- scalp muscle tenderness - Not aggravated by physical activity
- Pressure behind eyes, - Mild moderate pain
How long do tension headaches usually last?
30 minutes - 7 days
What are the features of a cluster headache?
- Abrupt onset
- Rapid onset of excruciating pain around one eye, temple or forehand
- Ipsilateral cranial autonomic features
- Eye may become watery and bloodshot with lid swelling, lacrimation
- Facial flushing
- Rhinorrhea (blocked nose)
- Miosis (excessive pupil constriction) +/-ptosis drooping or falling of upper eyelid) 20%
- Pain is strictly unilateral and almost always affects the same side
