LG 2.9 Scheme Wrap Up Headache 2014

Question 1

What are the three types of migraines?

Answer 1

i. *Common/migraine no aura/headache;
ii. *Classic/migraine with aura and headache
iii. * Migraine Aura only/ no headache

Question 2

What are the defining features of subarachnoid hemorrhage?

Answer 2

• Often presents with severe acute headache

- Usually occipital/nuchal with nuchal rigidity).

Question 3

What is Pseudotumor Cerebri?

Answer 3

• Idiopathic/benign
• Intracranial hypertension
• Increased pressure inside the skull.

Question 4

Who is most likely to get Pseudotumor Cerebri?

Answer 4

Young obese women of childbearing age, many are post partum, pregnant, or with menstrual irregularities

Question 5

What is the symptoms of Pseudotumor Cerebri?

Answer 5

a. Headache (can be moderately severe) usually behind the eyes and worsened with eye movements.
b. Blurred vision, nausea, neck or upper back pain.
c. Increased intracranial pressure due to too much production (or inadequate clearance) of Cerebrospinal Fluid.

Question 6

What is the risk of unresolved Pseudotumor Cerebri?

Answer 6

• Risk is permanent visual loss from optic nerve compression

- Papilledema, normal/or ventricles compressed MRI/CT scan.

Question 7

What is Cerebral Venous Sinus Thrombosis?

Answer 7

• Sinovenous thrombosis:occurs from a blood clot forming in the venous sinuses of the brain.
• Results in a hemorrhage, stroke

Question 8

How do Cerebral Venous Sinus Thrombosis occur?

Answer 8

• Can result from head injury (Hillary Clinton)
• dehydration
• Sickle cell anemia
• Infections
• Pregnancy
• Certain blood clotting disorders
• Obesity.

Question 9

What are symptoms of Cerebral Venous Sinus Thrombosis?

Answer 9

• Headache
• Blurred vision
• Seizures
• Stroke like symptom

Question 10

What are red flags of headaches?

Answer 10

a. New onset after age 50 or with pregnancy
b. Worse headache of my life
c. Progressive nature
d. Headache beginning with exertion
e. Altered mental status
f. Meningeal irritation
g. Presence of fever, or of being immunocompromised (HIV +, immunosuppressant therapy)
h. Abnormal neurologic exam (focal findings, papilledema)
i. Headache with position changes
j. Headache unlike prior headaches (migraine patients can have subarachnoid bleeds)