Headaches - Dr. Thomas Flashcards
The most common type of primary headache is: A. Sinus B. Cluster C. Tension D. Migraine
C. Tension
Sinus headache is secondary, not primary!
True or False: Tension headache is the least studied of the primary headache disorders, despite the fact that it has the highest socio-economic impact.
True (bc there isn’t a lot of money to be made on them since they can be treated effectively with OTC meds)
\_\_\_\_\_ headache is characterized by bilateral location, pressing/tightening (non-pulsating) quality, mild to moderate intensity, not aggravated by routine physical activity/exertion, and there is no nausea, vomiting, photophobia or phonophobia. A. Sinus B. Cluster C. Tension D. Migraine
C. Tension
True or False: Migraine headache is considered a neurological syndrome and has a genetic component.
True
Migraine headaches are more common in ____.
Women
What is the difference between common migraine and classic migraine?
Common migraine = without aura
Class migraine = with aura
_____ headache is characterized by unilateral location, pulsating quality, moderate to severe pain intensity, aggravation by or causing avoidance of routine physical activity, and includes at least one of the following: nausea, vomiting, photophobia/phonophobia.
Migraine headache
Which is more common: Migraine with aura (classic migraine) OR migraine without aura (common migraine)?
Migraine without aura (common migraine)
Which of the following is a secondary type of headache? A. Sinus B. Cluster C. Tension D. Migraine
A. Sinus
List the phases/stages of migraine headaches.
- Prodrome
- Aura (only in about 15-20% of patients)
- Headache
- Postdrome
Put the 3 primary types of headaches in order from most severe to least severe.
- Cluster headache
- Migraine headache
- Tension headache
_____ headache is considered one of the (if not THE) most painful syndromes to afflict humans, is characterized by severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting up to 3 hours if untreated, ipsilateral nasal congestion and/or rhinorrhea, eyelid edema, forehead and facial sweating mitosis and/or ptosis, and a sense of restlessness or agitation.
Cluster headache
A patient is experiencing watery left eye, drooping eyelid, and runny nose. What type of headache is this likely to be? A. Sinus B. Cluster C. Tension D. Migraine
B. Cluster
What is the acute treatment of cluster headache?
Sumatriptan SC
The main prophylactic treatment for cluster headache is _____.
Verapamil
The older theory of migraines states that migraines are due to:
A. Spasming of cranial vasculature
B. Inflammatory mediators inducing pain (“cortical depression” model)
A. Spasming of cranial vasculature
True or False: Migraines are likely due to spasming of cranial vasculature and inflammatory mediators as part of the “cortical depression” model.
True
With the “cortical depression” model of migraines, you first get hyper excitation that starts in the ___ lobe, which can describe why some experience a visual aura, followed by a period of cortical depression.
Occipital
The ___ nerve is believed to involved in the pain seen with migraines as well as cluster headaches.
Trigeminal
Migraine has been described as “low ____ syndrome” because the platelet levels of it drop rapidly during the onset of a migraine and there is increased 5-HIAA excretion, which is a breakdown product of it, during attacks.
Serotonin
The gold standard pharmacological treatment of migraines is _____.
Triptans
Can NSAIDs be used for migraines?
Yes, they are somewhat effective, but not like ergotamine or triptans
Ergotamine is an agonist at NE and serotonin subtypes 5HT1B and 5HT1D, which results in ______, thus stabilizing the spasming vasculature.
vasoconstriction
Can caffeine be used to treat migraines?
Yes
