Lec 6 Flashcards
“The worst headache of my life”
Aneurysm
Acronym for Intracranial Pain Disorders
SNOOP
Systemic symptoms
Neurologic signs and symptoms
Onset is sudden
Onset after 40 years old
Pattern change
Primary Headache Disorders
1) Migraine
2) Tension-type
3) Trigeminal Autonomic Cephalgia
The simultaneous presence of two diseases or conditions in a patient.
Comorbidity
Comorbidity between these two conditions.
TMD and migraines
Vasoconstriction in the brain reduces blood to the brain, and get a reactionary vasodilation in the rest of the body.
Migraine
These are produced in migraines.
Prostaglandins
Electrophysiological hyperactivity followed by inhibition.
Cortical spreading depression
Occurs in the brain during hypoxic conditions and causes neuronal death.
Cortical spreading depression
Current mechanism of the migraine aura.
Cortical spreading depression
People with migraines have a depletion of this.
Serotonin
Dx:
1) Headaches attacks lasting 4-72 hours.
2) Headaches that are unilateral, pulsating, moderate or severe pain intensity, or aggravated by physical activity.
3) Nausea or vomiting during the headache, or photo/phonophobia.
Migraine without aura
In migraine with aura, visual or sensory changes occur how long before the actual headache?
10-30 minutes
Dx:
1) Aura that’s visual, sensory, speech/language, motor, brainstem, or retinal.
2) At least 1 aura symptom that spreads gradually over 5 minutes, or at least 2 symptoms that occur in succession.
3) At least one aura symptom that’s unilateral.
4) Headache occurs within 60 minutes of the aura.
Migraine with aura
Serotonin levels in people with migraines.
Low
Common medication to treat migraines.
Triptans
Treat migraines by acting like Serotonin.
Triptans
Meds used to treat migraines.
Triptans Beta blockers Antidepressants Ergots Calcium channel blockers.
Treats migraines by reducing trigeminal innervated muscular activity.
Plastic bite block that you put in the incisors.
More than 15 headaches in a month is what?
Migraine
Most common headache.
Tension-type
This headache has tension or pressing around the forehead.
Tension type
Phono and photophobia are associated with this.
Migraines
Exercise can trigger this, but NOT this.
Migraine, but not a tension-type headache.
Lasts 30 minutes to 7 days.
Tension type headache
Location of Tension type headaches
Bilateral temporal or frontal regions
Tension type headaches do NOT have these.
1) Not aggravated by exercise.
2) No nausea or vomiting.
A group of headaches characterized by trigeminal pain and autonomic signs.
Trigeminal Autonomic Cephalgia
Cluster Headache is a type of what?
Trigeminal Autonomic Cephalgia.
These Signs are associated with what?
- Lacrimation/Conjunctival injection
- Nasal congestion/rhinorrhea
- Eyelid edema
- Forehead/Facial sweating and flushing.
- Miosis/Ptosis (pupils get smaller).
Autonomic Trigeminal Cephalgia
Most severe form of a primary headache that is more common in males than females.
Cluster headaches.
Autonomic Trigeminal Cephalgia that occurs in people WITHOUT a headache hx.
Cluster headaches
Usually occur at the same time of the day for several weeks.
Cluster headaches
When do cluster headaches most often occur?
Night
Often get this headache 2-3 AFTER falling asleep.
Cluster
When your eyelid droops, or you have a small pupil on one side.
Horner Syndrome
This headache is most likely autosomal dominant.
Cluster
How to manage cluster headaches.
7 L Oxygen/minute for 15 minutes.
Ergotamines or Sumatriptan
These headaches are NOT caused by another condition.
Primary headaches
Occurs suddenly
Paroxysm
What is paroxysmal hemicrania?
A type of trigeminal autonomic cephalgia.
Cluster headaches have how many attacks?
5
Paroxysmal hemicrania has how many attacks?
20
Difference between cluster headaches and paroxysmal hemicrania.
Number of headaches.
Cluster = 5
Paroxysmal hemicrania = 20
Absolutely prevents Paroxysmal Hemicrania
Indomethacin
These are prevented by Indomethacin.
Paroxysmal Hemicrania
Hemicrania Continua
A continuous chronic headache lasting more than 3 months.
Hemicrania continua
What does SUNCT stand for?
Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival Injection and Tearing
Indomethacin is for the ______.
Hemicranias
These Trigeminal autonomic cephalgias are in the unilateral orbital, supraorbital, and/or temporal regions.
Cluster Headache
Paroxysmal Hemicrania
Unilateral headache lasting more than 3 months.
Hemicrania Continua
Occurs in the orbital or temporal region and can radiate to the jaw or neck.
SUNCT
Used to treat SUNCT.
Anticonvulsants or Gabapentin
No refractory period in this trigeminal autonomic cephalgia.
SUNCT
