Headaches - J Prunuske Flashcards
Cluster headaches are more common in men or women?
men
How do cluster headaches present?
Individuals tend to have a cluster of headaches over a periods of days weeks or months
The pain is severe, unilateral, orbital eyes pain, usually lasting 15 minutes to 3 hours. every other day or up to 8 per day
Why do oral pills not help those with cluster heacaches
You need to use injectible or nasal from because it has to be fast-acting in order to help when they last for such a short amount of time.
Oxygen is also a good way to treat them (because lack of oxygen is probably part of the presentation)
Prevalence of headaches in males and females?
Female:Male 3:1
18% Women - 6% of men have migraine
One of the hallmarks of migraines that will usually help you differentiate it from tension headaches?
The nausea
Common presentation of tension headache?
Muscle contraction Greater occipital nerve compression Exacerbated by emotional stress Bilateral Not aggravated by physical activity No nausea Can use analgesics or various other techniques to treat
How does a migraine present?
Typical symptoms – intermittent, unilateral, throbbing, crescendo-decrescendo headache lasting hours to days, gradual onset, associated with nausea
Can have aura
Why would you worry about someone who has a sudden onset of headache with exercise?
Could be a subarachnoid hemorrage!
Not involved in any migraine/headache category if comes on with exercise
What if an older patient has a headache and confusion a couple weeks after a fall while shoveling snow? What could that be?
Subdural hematoma!
What if every single person in the dorm has been getting headaches all of the sudden? What could be the problem?
Carbon monoxide poisoning? Some other funky environment exposure?
What if your good buddy Ed has a headache along with a fever and stiff neck?
Mengitis! Maybe encephalitis even?
If your neighbor is 65 and begins having headaches for the first time, do you tell her that is just old age?
NO!
New onset after 50 is probs important to know. Maybe its temporal arteritis or an intercranial mass!
How do triptans help migraines?
They constrict vessels of the brain and cause vasospasm. This is good because the pain is caused by swelling in these vessels and you want to shrink them back down!
Watch out for nausea with these, you may want an anti-emetic like dexamethasone! or ondansetron
