Headaches (secondary HAs)- MJ Flashcards
The following are possible etiologies of what group of headaches?
- Trauma/injury to head/neck
- Cranial or cervical vascular disorder
- Non-vascular intracranial disorder
- A substance or its withdrawal
- Infection
- Disorder of homeostasis
- Disorder of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or cervical structure
- Psychiatric disorder
Secondary headaches
Who does pseudotumor cerebri (AKA idiopathic intracranial HTN) primarily affect?
women of childbearing age who are overweight
What is the eitiology of pseudotumor cerebri?
chronically elevated intracranial pressure (ICP)
What are the 3 possible causative medications of Pseudotumor Cerebri?
- Growth hormone
- Tetracyclines
- Hypervitaminosis A
What are the 9 conditions that are possibly related to Pseudotumor Cerebri?
- Addison Disease
- Hypoparathyroidism
- Anemia
4. Sleep apnea
- SLE (Lupus)
- Behcet’s syndrome
7. PCOS
- Coagulation disorders
- Uremia
What is the MC presentign symptom of a patient with Pseudotumor Cerebri?
Headache (sxs vary)
What can cause headache with vision loss?
Pseudotumor Cerebri
The following are associated sxs of what condition?
- Transient visual obscurations
- Intracranial noises (pulsatile tinnitus)
- Photopsia
- Back pain
- Retrobulbar pain
- Diplopia
- Sustained visual loss
Pseudotumor Cerebri
What are the 4 physical exam findings of someone w/ Pseudotumor Cerebri?
- Obesity
- Papilledema
- Visual field loss
- Abducens (CN VI) palsy
How do you diagnose Pseudotumor Cerebri?
- Clinical presentation suggesting increased ICP
- LP- Opening pressure showing elevated ICP w/ normal CSF
- MRI w/ MR venography to r/o secondary causes
What are the 6 treament options for a patient w/ Pseudotumor Cerebri?
- Weight loss for obese patients
- Decrease sodium intake
- Acetazolamide (Carbonic anhydrase inhibitors)-> reduce rate of CSF production
- Furosemide (Loop diuretics)–> adjunct to Acetazolamide
- Serial LPs (can be bridge to sx)
- Surgery (optic nerve fenestration, CSF shunting)
What medication is no longer recommended for tx of Pseudotumor Cerebri?
Corticosteroids
What 2 pharmacologic medications can be used to tx Pseudotumor Cerebri?
- Acetazolamide (carbonic anhydrase inhibitor)–> reduce rate of CSF production
- Furosemide (adjunct to acetazolamide)
Which 3 acute symptomatic headache medications are most commonly realted to medication overuse headache?
- Opioids
- Butalbital / analgesic combinations
- Aspirin / acetaminophen / caffeine combinations
What 3 underlying behavioral disorders should you consider when diagnosing a headache as a medication overuse headache?
- Addictive personalities
- Depression
- Anxiety