Headaches and Migraine Flashcards
When is headache most likely to effect someone
- in the reproductive years
name the 3 questions which can predict If you have migraines or not
- does Light bothers you
- Your headaches limit your ability to work study or do what you need to do
- Nausea or sick
Positive predictive value for migraine diagnosis
- 2 positive answers 93%
- 3 positive answers 98%
how do you diagnose primary headaches
- Diagnosis is made on the history in the absence of physical signs (all based on history as any tests or investigations are not relevant to the headache)
How do you diagnose secondary headaches
- Diagnosis is made on the history in the presence of physical signs (think that someone has a headache you do specific physical tests on them to work it out)
What are the 3 main headaches
- Diagnosis is made on the history in the absence of physical signs (all based on history as any tests or investigations are not relevant to the headache)
Name some causes of headaches
- Insufficient sleep
- Mentral stress
- Alcohol
- Excess heat
- Reading
- Excess noise
- Excess light
- Excess sleep
- Travel
- Hunger
- Shopping
when do normal headaches disappear
- Disappear soon after the noxious or potentially noxious stimulus has ceased
describe the characteristics of a tension headache
- Band-like, bilateral
- Tightness/pressure/dull ache
- Radiate to neck and shoulders
- Mild to moderate
- Not aggravated by movement
- 30 minutes to several day
what can cause a cluster headache
- Within a cluster anything that can cause vasodilation such as alcohol, caffeine, smoking and exercise can trigger it
How do you treat a cluster headache
- Oxygen in high doses works as a vasoconstrictor so can be used, or sumatriptan can be used as an injection as a treatment for a cluster headache
- these are both vasoconstrictors
describe what a cluster headache is like
- Occurs in clusters
- Linked to circadian rhythm
- Experience severe headaches
- Start a few hours after they go to sleep with excruciating headache that effects one side of the head – centres on the eye, can get several attacks in one day
How does the international headache society criteria define a migraine without aura
A. At least five attacks in a lifetime fulfilling criteria B-D
B. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)
C. Headache has at least two of the following four characteristics:
- Unilateral location
- Pulsating quality
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity (e.g. walking or climbing stairs)
D. During headache, occurrence of at least one of following symptoms:
- Nausea and/or vomiting
- Photophobia and phonophobia
How common are the 3 main types of headaches
- Tension type headache= 80% = female more likely
- Migraine = 15% = female more likely
- Cluster headache = 0.2-0.3 = male more likely
what in genetics may cause a migraine
- Over-responsive brains
- Heightened senses – smell, light, sounds, touch – doesn’t filter out stuff that is not important
what can be used to treat headaches if genetics leading to heighten senses cause migraines
- Help desensitise the brain – antiepileptic, some of the anti-hypertensives, Botox
what are the triggers of a migraine
- Triggers include lack of food, dehydration, lack of sleep, and an extra trigger of hormonal triggers – once these cross the threshold this sets of a change in brain chemistry – you cannot abort an attack even if you can alleviate symptoms
- It is not what triggers it is how many triggers that you have had
describe the migraine threshold
- this is the idea that once you have had a certain number of triggers you can develop a migraine
- people who’ve migraines a lot might have a lower threshold than other people
