HEADACHES AND MIGRAINES Flashcards
1
Q
TEMPORAL ARTERITIS - DEFINITION
A
- Temporal arteritis is a form of vasculitis
- Also known as giant cell arteritis or Horton’s arteritis
- In TA, the temporal arteries (the blood vessels near the temples), which supply blood from the heart to the scalp are inflamed and constricted
2
Q
TEMPORAL ARTERITIS - CAUSE
A
- The causes are poorly understood
- There is no well-established trigger or risk factors
- Once cause may be a faulty immune response
- TA often occurs in people who have polymyalgia rheumatica
3
Q
TEMPORAL ARTERITIS - POPULATION AFFECTED
A
Women aged between 70 and 80
4
Q
TEMPORAL ARTERITIS - RISK FACTORS
A
- Age – most cases occur between 70 and 80
- Gender – women are 2 times more likely than men
- People of northern European or Scandinavian descent
- Having polymyalgia rheumatica
- Family history
5
Q
TEMPORAL ARTERITIS - CLINICAL PRESENTATION
A
- Most common symptom is a throbbing, continuous headache on one or both sides of the forehead
- Fatigue
- Fever
- Jaw pain that may become worse after chewing
- Tenderness at the scalp or temples
- Vision problems
o Double vision
o Blurry vision
o Transient vision loss
o If this is not treated, it could be followed by permeant, irreversible vision loss - Muscles aches in the upper arms or shoulders, hips, upper thighs, lower back and buttocks
- Loss of appetite or weight loss
6
Q
TEMPORAL ARTERITIS - DIAGNOSIS
A
- Blood tests
o Erythrocyte sedimentation rate
o C-reactive protein
o Haemoglobin level - Biopsy
- MRI scan
- PET scan
- Ultrasound
7
Q
TEMPORAL ARTERITIS - TREATMENT
A
- No cure
- Can be treated with medications
- Treatment is steroids
- Glucocorticoids such as oral prednisone
- Patient should not smoke, and alcohol should be kept to a minimum
8
Q
TEMPORAL ARTERITIS - PREVENTION
A
- Eat a healthy diet
- Exercise regularly
- Get check ups
- Talk to your doctor about taking aspirin daily
9
Q
TEMPORAL ARTERITIS - PROGNOSIS
A
- Outlook is very good, unless the person has had vision loss
- If vision loss occurs it generally cannot be reversed
- Most complications associated with temporal arteritis are from the use of steroid drugs, not from the disease itself
10
Q
STROKE - DEFINITION
A
- A stroke is a life-threatening condition that happens when a part of the brain doesn’t have enough blood flow
- This most commonly happens because of a blocked artery or bleeding in the brain
11
Q
STROKE - TYPES
A
- 2 main ways strokes can happen – ischemia and haemorrhage
- Ischemia
o When cells don’t get enough blood flow to supply them with oxygen.
o This usually happens because something blocks blood vessels in the brain, cutting off blood flow.
o This type is most common and account for about 80% of all strokes
o Usually happens due to thrombosis, an embolism, lacunar stroke (small vessel blockage) or cryptogenic stroke (an unknown reason) - Haemorrhagic
o Cause bleeding in and around the brain
o Usually happens due to bleeding inside the brain (intracerebral) or because of bleeding into the subarachnoid space (the space between the brain and its outer covering
12
Q
STROKE - CAUSE
A
- Ischemic
o Atherosclerosis
o Clotting disorders
o Atrial fibrillation
o Heart defects
o Microvascular ischemic disease - Haemorrhagic
o High blood pressure
o Brain aneurysms
o Brain tumours
o Diseases that weaken or cause unusual changes in blood vessels in the brain, such as moyamoya disease
13
Q
STROKE - POPULATION AFFECTED
A
- Anyone can have a stroke
- Most common in people over 65
14
Q
STROKE - RISK FACTORS
A
- Alcohol use disorder
- High blood pressure
- Hyperlipidaemia
- Migraine headaches
- Type 2 diabetes
- Smoking
- Drug misuse
15
Q
STROKE - CLINICAL PRESENTATION
A
- Stroke symptoms often depend on the area of the brain that is affected
- Symptoms of stroke can lead to one or more of the following:
o One-sided weakness or paralysis
o Difficulty with or loss of speaking ability (aphasia)
o Slurred or garbled speaking (dysarthria)
o Loss of muscle control on one side of the face
o Sudden loss – partial or total – of one or more senses (vision, hearing, taste, smell and touch)
o Diplopia
o Ataxia
o Dizziness or vertigo
o Nausea and vomiting
o Neck stiffness
o Emotional instability and personality changes
o Confusion or agitation
o Seizures
o Memory loss (amnesia)
o Headaches (usually sudden and severe)
o Passing out or fainting
o Coma
16
Q
STROKE - DIAGNOSIS
A
- Diagnosis involves a combo of neurological examination, diagnostic imaging and other tests
- CT scan
- Lab blood tests
- ECG
- MRI scan
- EEG
17
Q
STROKE - TREATMENT
A
- Treatment depends on many factors, the most important factor in determining treatment is what kind of stroke a person has
- Ischemic
o Top priority is restoring circulation to affected brain areas
o Restoring circulation usually involves a certain medication type called thrombolytics but may also involve a catheterization procedure
o Thrombolytic drugs (within 3 to 4.5 hours)
o Thrombectomy (within 24 hours if there is no significant brain damage)
o Blood pressure management - Haemorrhagic
o Treatment depends on the location and severity of the bleeding
o Reducing blood pressure is often the top priority because this will reduce the amount of bleeding and keep it from getting worse
o Another treatment option is to improve clotting so the bleeding will stop
o Surgery is sometimes necessary to relieve pressure on the brain from accumulated blood - Rehabilitation
o Speech therapy
o Physical therapy
o Occupational therapy
o Cognitive therapy
18
Q
STROKE - PREVENTION
A
- Improve your lifestyle
- Avoid risky lifestyle choices or make changes to your behaviours
- Manage health conditions and risk factors
- Reduce caffeine, alcohol, fried foods and recreational drugs
19
Q
STROKE - PROGNOSIS
A
- Ischemic
o The more severe an ischemic stroke is, the worse the damage
o You are more likely to lose certain abilities, at least temporarily
o The faster you get medical attention the effects or more likely to be temporary or less severe - Haemorrhagic
o These usually cause much worse symptoms, especially when bleeding is more severe
o Symptoms tend to get worse quickly - Strokes have the potential to cause death when they are severe or if they go too long without treatment
- Outlook does depend a lot on how severe the initial stroke is
20
Q
TRANSIENT ISCHEMIC ATTACK (TIA) - DEFINITION
A
- A TIA starts like a stroke but only lasts from several minutes up to 24 hours
- A TIA does not kill the brain cells so there is no lasting damage to the brain
- Also called a mini-stroke
21
Q
TRANSIENT ISCHEMIC ATTACK (TIA) - CAUSE
A
- Happens when one of the blood vessels that supply the brain with oxygen-rich blood becomes blocked
- In TIAs the blockage quickly resolves and the brain’s blood supply returns to normal before there is any significant damage
- The blockage in the blood vessels responsible for most TIAs is usually caused by a blood clot that’s formed elsewhere in the body and travelled to the blood vessels supplying the brain
- It can also be caused by pieces of fatty material or air bubbles
22
Q
TRANSIENT ISCHEMIC ATTACK (TIA) - POPULATION AFFECTED
A
Adults over 55
