Headaches Flashcards

1
Q

what are primary headaches?

what are secondary headahces

A

Primary headaches- 90%- headache is the main issue, episodic and benign

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2
Q

types or primary headahces?

A
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3
Q

types of less worrying secondary headaches

A
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4
Q

Immediately more worrying headaches

A
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5
Q

describe Tension type headache

A
  • Primary
  • most commong
  • young adults
  • stress and depression
  • epsiodic (<15 days month) chronic
  • Featureless headahce (no other symptoms, normal neuro exam)
  • mild- moderate bilateral pain
  • tight band squeezing (may also have neck pain)
  • duration 30 mins - 7 hours
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6
Q

Describe migraine generally

A
  • affecst 1 in 7
  • disabling0 large efect on QoL
  • childhood/ young adulthood onset
  • more common in females
  • not fully understood- though to have triggers
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7
Q

describe the pahses of migraines

A
  • prodrome
  • aura (focal neurological symptoms)
  • headache
  • prodrome
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8
Q

describe clinical presentation of migraine

A
  • Featureful headache
  • lasts 4 hours- 3 days
  • seevre unilateral- throbbing/pulsating
  • patient want to lie ind ark rooma dn go to slee
  • for diagnosis need headache +
    • nausa/vommiting or Photophobia/phonophobia
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9
Q

what are the 3 main types of migraine

A
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10
Q

treatment for migraines

A

simpel analgesia

anti-inflammatories

anti-sickness drugs

triptans

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11
Q

triggers for mirgaine

A
  • lack of sleep/too much
  • premenstrual
  • chocolate
  • cheese
  • dehydration
  • missed meals
  • stress
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12
Q

desrribe cluster headache generall- occurence ?

A
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13
Q

triggers for cluster headaches

A
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14
Q

Clinical features of cluster headaches?

A
  • severe, unilateral pain around the eye
  • ipsilateral autonomic symptoms (same side as headache,m eye watering, nasal congestion, facial sweating)
  • excrutiating sharp pain (not pulsatile)- behind the eye
  • alos knowna s suicide headahce
  • last 15 mins to 3 hours
  • typically occurs at night and wakes the patient
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15
Q

Treatment for cliuster headaches

A

simple analgesia NOT recommended by nice

oxygen- administered at start of attack can lesses

triptans

preventer therpoay ( verapamil tablkets)

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16
Q

Describe the causes of a Vascular headahce?

A

subarchnoid haemorrhage- SAH- bleeding increases intracnial pressure- irirtant effect opn brain by the blood

commest cause of non-trauamric SAH- rupture berry aneurysm (tends to grwon in circle or willis (associated with polycystic kidney disease)

  • causes
    • genetic
    • arteriovenous malformation
    • trauam
    • infections (cuase weakness
    • smoking, hypertension, alcohol excess
17
Q

Clinical presentation of Vascular headache

A
  • Explosive or thundercalp headache
  • wrost ever
  • peak intensity within 3 seconds
  • may have signs of meningism
    • jheadache, neck stiffness, photophobia
  • nausa vomiting
  • high mortality and mobdidiyt
18
Q

What is Giant cell arteritis (GCA)

19
Q

symptoms of GCA

A
  • headache- usually oveer the site of arteries affeceted
  • scalp tenderness (coimbing hair)
  • jaw claudication
  • amaurosis fugax ( temporary visual loss)
  • generally unwell, stiff joints ( polymylagia rheumatica)- association -n shoudler or pelvic girdle
20
Q

Treatment of GCA

A

urgent assessment by rheumatolgoists

visual loss needs same day assessment by opthalmost

once suspected need immeidate high dose oral steriod (prednisolone)

21
Q

Causes of Raised intracranila pressure

22
Q

Clinical presentation of Raised intracranial pressure

A

triad of

headache

vomiting

papilledema (sweleling ot the optic disc on fundoscopy

23
Q

describe late stage raised intrcranial pressure

A

Raised BP, wide pulse pressure, bradycardia

cushing triad

caused by compression of the medulla

24
Q

what is a space occupying lesion
?

25
what are the mechanism behind which space occupying lesions cause signs and symptoms
26
what are red flags that indicat a high risk SOL
New headache in a patient with PHO cancer and immunosuppression Headache and focal neurology Worsening headache- growing Headaches associated with seizures
27
types of intracranial infections? and cause (which is more severe bacterial or viral)
Meningitis encephaltiis meningoencephaltiis bacterial is more severe
28
what are Meningism a tirad of
headache, stiffness of neck, photphobia. also fevr, altered mental state, focal neurology, petechial rash (non blanching)
29
Causes of Encephaltiis and triad of symtpoms seen
usually viral- HSV common at extreems of age presnetation - triad of- hgih fever, headahce, personality chnage (noticed by friend/family) range from mild to serious
30
what is Medication overuse headache
obverurse headache medication using medication 10-15 per month for period of 3 months
31
describe the use of antimigraine therpay
32
describe acute management of migraine
oral triptan+ NSAID ( most effective) OR oral triptan + paracetmol Or monotherpay if patient prefers Consider antiemetic
33
Descirbe prophylaxis of migraine
if significant impact, treatment resistant or at risk of MOH ## Footnote **topiramate or propranolol**
34
Describe thow Triptains work- give examples
35
give examples of Anti-emetics used in combination with analgesics for migraine management
36
contraindictaes for Topiramate (anti-epileptic medication)- used in prophyalxis for migraines?
37
treatment if the migraine fails to respond to pahramcological prophylaxis?
botulinum toxin Type A (specialist teatment)