Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

brain and behavior > Lecture 67-69: Headaches > Flashcards

Lecture 67-69: Headaches Flashcards

You may prefer our related Brainscape-certified flashcards:
The Brain flashcards
1
Q

Two kinds of migraine

A

With and without aura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Migraine without aura criteria

A

5 attacks at least 4 - 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Migraine with aura criteria

A

Migraine w/out aura symptoms + aura (visual, sensory, dysphasic…)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Migraine w/ aura symptom progression

A

Prodrome (cold hands/feet, odd feeling, food craving) –> aura –> headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cortical spreading depression theory of migraine; related to what brain state?

A

Wave of neuronal depolarization followed by a suppression of neuronal activity with corresponding blood flow changes moved across cerebral cortex at about 3 mm/minute; “hyperexcitable brain”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe meningeal involvement in migraine

A

Meninges innervated by V1; activation causes neural-related inflammation in meninges, which may be related to incredible pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What brainstem centers are activated in migraine? Describe.

A

PAG and TNC (trigeminal nucleus caudalis); PAG connecs to the TNC and is known to exert inhibitory influences on that structure. This region of the midbrain is activated during a migraine attack and this activity persists even after the pain has been relieved.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathway of head pain

A
  1. Cortical spreading depression; 2. Inflammatory release in blood vessels of meninges; 3. Pain information travels through trigeminal nerve into brainstem nuclei
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the numbness pattern of migraine and the formal name

A

Cheiro oral numbness: face/hand numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Glial cells and migraine. Why and relation to vulnerable cortex?

A

Glial cells may propagate cortical depression wave; glial cells redistribute ions, etc and primary occipital cortex has lowest glial-neronal ratio, so if there is an ion imbalance, this region would be extra vulnerable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe astrocyte waves in more detail (ion, and what is released)

A

Astrocyte calcium waves could mediate propagated cortical phenomena of migraine via release of neuroactive and vasoactive messengers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vascular issues with migraine might not be due to blood flow, but due to…

A

Intercellular communication with astrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common headache? Describe

A

Tension headache; pressing, bilateral, steady mild-moderate pain, not aggravated by activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does a tension headache not have?

A

Nausea, photophobia, phonophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ANS migraine involvement

A

TNC can irritate superior salvitory nucleus –> ANS symptoms (sinus symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Childhood migraine: 7 unique symptoms

A

Benign paroxysmal vertigo, alternating hemiplegia, cyclic vomiting, recurring ab pain, benign torticollis (head turns to one direction), confusion, car sickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Four associations with migraines being bad…

A
  1. Progression (get worse over time, so you should TREAT early); 2. Migrainous stroke (risk factor for stroke, especially for women); 3. Persistant aura without infarction (aura that never goes away); 4. Epilepsy (more miraines, increased risk for epilepsy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Two neurological changes associated with migraine

A
  1. Iron deposition in PAG; 2. White matter changes on MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3 Primary head aches

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Red flags (6)

A

New/different headache; abrupt onset; cancer/HIV/preg; abnormal physical; neuro symptoms; headache onset with syncope/exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Comfort signs (5)

A

Stable; family/personal hx; normal physical; triggers; variable locations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is it common for brain tumors to present with just headaches?

A

No: N/V, abnormal neurological exam, etc…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Idiopathic intracranial hypertension common in…What’s happening? Presents like…

A

Obese women w/ menstrual abnormalities; brain swelling; brain tumor w/out local symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Idiopathic increased intracranial pressure most commonly effects which nerve? What is this like?

A

VI nerve; causes VI nerve palsy = double vision in distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe headaches with idiopathic intracranial hypertension

A

“Brain tumor headache,” visual complaints (double vision), cranial bruits, N/V, radiculopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does increased idiopathic intracranial pressure look like in a lab? (MRI and spinal tap)

A

Flattened post globes and normal CSF w/ increased pressure

27
Q

Treatment…watch for?

A

Correct predisposing factors, diuretics, shunt; watch eyes (blindness can occur)

28
Q

Headache and stroke: which circulation most frequently presents with headache?

A

Most frequent in posterior circulation

29
Q

Is headache severity related to stroke severity (infarct size)?

A

No

30
Q

% headache w/ intra parenchymal hematoma

A

50%

31
Q

Sudden onset sever headache, think…

A

Aneurysm (subarachnoid)

32
Q

How to diagnose SAH and how to diagnose aneurysm…

A

CT scan; catheter angiography

33
Q

Cluster headaches

A

Intense, boring, unilateral pain with ANS effects (Horner’s syndrome; eye watering); male predominance

34
Q

Cluster headaches can be either…(2)

A

Episodic (bouts of headaches lasting 1-4 months w/ circadian patterns); chronic (no circadian patterns)

35
Q

T/F: Cluster headaches can wake people out of sleep?

A

True

36
Q

What is Giant Cell Artertis? Describe headache and location. Lab tests and what can it lead to?

A

Inflammation of arterial lining; generalized, throbbing, temporal; sedimentation rate; blindness due to ischemic optic neuropathy (stroke)

37
Q

Did ya know, angina pain can refer to…

A

The head!

38
Q

Describe headaches associated with sexual activity

A

Come on with orgasm, explosive onset

39
Q

Describe headaches associated with carotid artery dissection

A

Headache w/ neck pain, facial pain, Horner’s syndrome

40
Q

Meningeal enhancement is typical with a…What else is associated with these?

A

Low pressure headache; positional (worse upon standing)

41
Q

What procedure can bring about a LP-headache? Treatment?

A

An LP! caffeine, epidural blood patch if it persists

42
Q

Describe trigeminal neuralgia headaches. Which V roots are typically affected?

A

Brief paroxysms of electric-like, intense pains; V2 and V3

43
Q

Trigeminal neuralgia headaches caused (by age, treatment option for one)?

A

In young: MS; in old: looping SCA abutting trigeminal nerve

44
Q

Treatment for SCA abutting trigeminal nerve?

A

Surgery: microvascular decompression

45
Q

If you have >6 migraines/month, what kind of therapies (2)?

A

Preventative and acute

46
Q

What is pulsating in migraines?

A

Spinal fluid

47
Q

How is inflammation generated in migraine?

A

Release of neurochemicals from the nerve terminals leads to vasodilation and inflammation of vessels in meninges

48
Q

T/F: Central sensitization plays a role in migraine.

A

True! TNC sensitization

49
Q

Are opioids good for treating headache? Why (4)?

A

No. Pro-inflammatory, increases N/V, increases CSD via glutamate, sedating

50
Q

What responds to triptans? Importance?

A

Headaches; does not diagnose type of headache

51
Q

NSAID advantages for headache (4)

A

Does not induce headache, safe if you have vascular disease, non-sedating, no increase in nausea

52
Q

What are prodromal symptoms due to? What drug class can be used to treat migraines? Advantages/disadvantages

A

DA activation; neuroleptics (D2 receptor blockers); effective, reduce N/V; cause sedation, prolonged QT, orthostatic hypotension

53
Q

Dihydroergotamine: derived from and concerns

A

Ergot; vascular disease

54
Q

What larger 5-HT families are were interested in migraine? Mechanism. What drug family?

A

5-HT1s (B: targets blood vessels and D: neural inhibition); agonists –> stimulating decreases neurogenic inflammation; triptans

55
Q

Describe triptans

A

Reduce all aspects of migraine disability, minimal/no sedation, does not increase nauseau

56
Q

Triptans we need to know (2)

A

Sumatriptan, eletriptan

57
Q

Describe “triptan effect” and contraindications

A

Chest/back of the neck pressure; heart disease/HT

58
Q

Serotonin syndrome (def and triad) and triptan

A

Life threatening condition associated with increased serotonin in CNS; mental status changes, autonomic hyperactivity, neuromuscular abnormalities; triptan + SSRIs might increase risk of serotonin syndrome

59
Q

Theory of treating acute migraine

A

Treat early!

60
Q

Model: drugs that are useful in the prophylaxis of migraine suppress…what’s a lab test demonstrating this?

A

Cortical spreading depression; plasma glutamate increased with migraine and reduced with prophylaxis

61
Q

Some SEs for migraine prophylactic drugs?

A

Weight gain, memory loss, depression, tremor

62
Q

Classes and examples for prophylactic migraine treatment (4)

A

Beta-blockers (propranolol), tricyclic antidepressants (amitriptyline), antiepileptic (valproate, topiramate), anticholinergic (botox)

63
Q

What is the one drug approved for chronic migraine?

A

Botox

brain and behavior (56 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions