Investigation and Management of Headache Flashcards
What are the commonest causes of headache? (6)
tension migraine sinusitis infection trauma drugs (GNT, mannitol)
What are the most serious causes of migraine? (4)
SAH
Giant Cell arteritis
SOL
Cluster headache
What is the classification of migraine?
Simple (just headache)
Classical (headache + aura)
Acephalic (aura no headache)
What does the aura of a migraine involve?
flashing lights
fortification spectra
numbness
motor disturbance
What are the precipitating factors of headache?
Diet - alcohol, chocolate and cheese
hormonal - OCP
Stress - fatigue, exercise
How would you manage a migraine?
stop precipitating factors
analgesia
prevent using beta blcokers
What are the subtypes of migraine causing focal neurology?
basilar - blurred visual loss, vertigo
Hemiplegic - motor signs one side
opthalmopegic - affecting eye movement
retinal - visual loss
What are the three causes of SAH?
ruptured aneurism
arteriovenous formation
trauma
What are the 5 clinical features of SAH?
thunderclap headache nausea / vomiting photophobia meningism signs of raised ICP
How would you investigate a patient with SAH?
FBC, U+Es
CT scan
Lumpar puncture
What are you looking for in LP in SAH?
Xanthochromia - yellow appearance of CSF
What is the intial management of SAH?
ABC needs definitive airway Analgesia antiemetics calcium channel blocker
What is the management of temporal arteritis?
IV Steroid immediately - prednisilone
