Neuro Cases 1 Flashcards
What are the basic types of primary headaches?
Tension-type, migraine, cluster, or other (cold stimulus) headaches
What is the usual location of a migraine headache?
Adults: 60-70% are unilateral; 30% are bifrontal or global
Children/Teens: majority are bilateral
What are the characteristics of migraine headaches?
Gradual onset, pulsating, moderate or severe intensity; aggravated by routine physical activity
What does the patient like to do when they have a migraine headache?
Patient prefers to rest in a dark, quiet room
How long do migraine headaches usually last?
4-72 hours
What are the associated symptoms for a migraine headache?
Nausea, vomiting, photophobia; may have aura (usually visual but can involve other senses or cause speech or motor deficits)
What is the usual location for tension-type headaches?
Bilateral
What are the characteristics for tension-type headaches?
Pressure or tightness which waxes and wanes
What does the patient like to do when they have a tension-type headache?
Patient may remain active or may need to rest
How long do tension-type headaches usually last?
30 minutes to 7 days
What is the usual location for cluster headaches?
Always unilateral, usually begins around the eye or temple
What are the characteristics for cluster headaches?
Pain begins quickly, reaches a crescendo within minutes; pain is deep, continuous, excruciating, and explosive in quality
What does the patient like to do when they have a cluster headache?
Patient remains active
How long do cluster headaches usually last?
15 minutes to 3 hours
What are the associated symptoms for a cluster headache?
Ipsilateral lacrimation and redness of the eye; stuffy nose, rhinorrhea, pallor; sweating; Homer syndrome; restlessness or agitation; focal neurologic symptoms are rare; sensitivity to alcohol
What does SNOOP stand for?
S: systemic symptoms
N: neuro symptoms or abnormal signs
O: onset is new
O: other associated conditions
P: previous headache history with headache progression or change
What could the presence of SNOOP represent?
Could represent a space-occupying mass, vascular lesion, infection, metabolic disturbance, or systemic problem
What are some things that signal a need for emergency evaluation?
Sudden “thunderclap” headache; acute or subacute neck pain or headache with Horner syndrome; headache with suspected meningitis/encephalitis; headache with global or focal neurologic deficit or papilledema; headache with orbital or periorbital symptoms; headache with possible carbon monoxide exposure
What can vertigo be the result of?
Asymmetry with vestibular system or disorder of peripheral labyrinth of its central connections
What does TiTrATE in the evaluation of dizziness consist of?
Timing of the symptom, triggers that provoke the symptom, and a targeted examination
What are the 3 possible clinical scenarios of dizziness?
Episodic triggered symptoms, spontaneous episodic symptoms, and continuous vestibular symptoms
What is BPPV?
Occurs when loose canaliths “get stuck” in semicircular canals; affect people at any age, but mainly 50-70
What is Meniere disease?
Vertigo with hearing loss +/- tinnitus; any age, most common 20-60; vertigo so severe it often requires rest; exact cause unknown
What are the classifications of syncope?
Cardiac, neurally mediated (reflex), or orthostatic hypotension
