Headaches Flashcards
(22 cards)
Migraine with aura can be a risk factor for…
stroke
What is Migraine equivalent?
Don’t have the headache pain. Just have neuro and somatic manifestations (can still be just as debilitating)
Types of atypical migraine headaches
Basilar artery migraine, familial hemiplegic migraine, opthalmoplegic migraine
If patient with headache and diplopia…
first r/o internal carotid artery aneurysm an diabetes. Otherwise could be opthalmoplegic migraine.
Blindness or bilateral visual disrurbances, followed by dysarthria, dysequilibrium. Can have loss of consciousness, confusion, and throbbing occipital HA
Basilar artery migraine
autosomal dominant condition. Has lateralized throbbing headache associated with aura
familial hemiplegic migraine
When would you initiate preventative tx for migraines
if headaches occur more than 2-3 times a month or if very severe
Do not confuse cluster headaches with..
hemicrania continua. Both are unilateral, but cluster HA’s are episodic, hemicrania continua are non-episodic
Patient presents with unilateral head pain that is non-episodic, and tearing, stuff nose as well as other autonomic sx. what is tx?
Suspicious of hemicrania continua- tx is indomethacin
Which headache should you not treat with triptans?
tension headache
Most common type of HA
tension HA
“Vise-like” feeling, occurs daily, no neurological symptoms, begins in occipital region and radiates to forehead
tension HA
Cough headaches associated with…
chiari malformation in 10% of people.
Patient presents with severe headache everytime he sneezes or strains. It lasts 5-6 minutes then goes away. Has been going on for the last 2 years. How would you handle this?
Do CT or MRI to r/o brain tumor. Prescribe Indomethacin. If doesn’t help, consider LP for relief.
What happens if temporal arteritis is left untreated?
Monocular blindness
Elderly patient with headache. Feels tired, anorexic, has tenderness over temporal arteries, jaw claudication. Increased ESR. Dx?
Temporal arteritis
Half of all chronic daily headaches d/t..
medication overuse headache
Patient presents with headache that gets worse with straining and has visual disturbances, including papilledema, abducens nerve palsy- causing horizontal diplopia.
Peudotumor cerebri
What headache disorders if left untreated, can cause some type of visual deficit?
Temporal arteritis- monocular blindness. Pseudotumor cerebri- optic atrophy and blindness
If see young patient with trigeminal neuralgia…suspect…
MS. Must check CSF and evoked potentials
Trigeminal Neuralgia…but in the THROAT!
Glossopharyngeal Neuralgia- r/o MS
Post shingles infection may occur in elderly or immunocompromised patient. Outbreak of virus on that part of face.
Postherpetic neuralgia
