Headaches Flashcards
Why can assessment of headaches be difficult?
Difficulties in quantifying symptoms as well as co-existence of several types in some cases
What are some specific symptoms to consider with headaches?
Aura Autonomic features Systemic/neurological features Contacts with similar symptoms Effect on daily activities Drug History
What is an Aura?
Visual, auditory or gustatory disturbances that preceed/accompany a headache
Why is the effect on daily activities important with headaches?
Some are debilitating, others are not
What are some features suggestive of a new-onset severe headache?
Fever Papilloedema New-onset neurological deficit Change in behaviour Atypical aura Dizziness Visual disturbances Vomiting Recent severe head trauma Current or recent pregnancy
Why is a current/recent pregnancy concerning with a new-onset headache?
Possibly Pre-eclampsia
What features suggest a headache being a Migraine without Aura?
5 attacks of: Headache lasting 4-72h Unilateral, pulsing, moderate/severe pain Aggrevated by exercise N+V Photophobia Phonophobia
What features suggest a headache being a Migraine with Aura?
2 attacks of: Aura 2/more in succession Aura lasts 5-60 mins Aura accompanied by headache
What are some examples of Auras?
Visual symptoms
Sensory symptoms
Speech and language symptoms
Motor weakness
What features suggest a headache being a Tension-Type?
Recurrent episodes lasting from 30mins-7 days not associated with N+V with at least two of:
Bilateral
Pressing/Tightening quality
Mild/moderate intensity
Not aggrevated by routine physical activity
What features suggest a Cluster headache?
At least 5 attacks of unilateral orbital, supraorbital or temporal pain lasting 15-180 minutes
What associated symptoms can there be with Cluster headaches?
Nasal congestion
Facial Sweating
Miosis
How often do Cluster headaches occur while active?
At least every other day
What features suggest a Medication overuse headache?
Headache at least 15 days of the month after regularly overusing medication for more than 3 months to treat a primary headache
Which medications can lead to a medication overuse headache?
Ergotamines
Analgesics
Triptans
Opioids