MSRA: Headaches Flashcards
What are the red flags with headaches?
Older than 50
Younger than 10
Ww/ changes in posture, coughing, sneezing
Changes in personality
Neurological deficit
Cancer/immunosuppression
Recent head trauma (within 3 months)
What are the cautions for the use of triptans?
If less than 18 - nasal triptans
Triptans are not licensed for use in those 65+
CI w/ IHD, uncontrolled HTN
What medications do NICE recommend in the management of acute migraine?
Simple analgesia: paracetamol, aspirin, ibuprofen
Consider triptan alone or in combination with paracetamol/NSAID
What medications do NICE recommend for migraine prophylaxis?
Consider: Propranolol (first-line), Topiramate (teratogenic cleft lip + palate) or Amitriptyline
What are the features of migraine in children?
Headache is more commonly bilateral and GI disturbance is more common
What are the risk factors for idiopathic intracranial hypertension?
Young women, obesity, COCP
Which medication is used in the management of idiopathic intracranial hypertension?
Acetazolamide
Which medication is first line in the management of trigeminal neuralgia?
Carbamazepine
What are the risk factors for cluster headaches?
Male gender
Smoking
What is the acute management of cluster headaches?
100% oxygen
Subcut triptan
What medication is used for prophylaxis in cluster headaches?
Verapamil
Name one trigger for cluster headaches
Alcohol
What are the investigations for sub-arachnoid haemorrhage?
Non-contrast CT head
LP at 12 hours if CT negative - xanthochromia
Which medication is used to prevent cerebral vasospasm following SAH?
Nimodipine
What is the mechanism of action of triptans?
5HT1 agonist
