Neurology 16 - Headaches Flashcards
name as many possible differentials as you can for headache (in a structured manner)
Vascular - any brain bleed, raised ICP
Infective - meningitis, encephalitis, sinusitis
Trauma - head injury, cervical spondylosis
Autoimmune -
Metabolic - CO poisoning, hormonal headache, analgesic headache
Inflammatory - secondary headaches, migraines, trigeminal neuralgia, GCA, cluster headaches
Neoplastic - brain tumour
Psych - tension headache
VITAMIN P
red flag symptoms with headache (10)
fever, photophobia, neck stiffness
new neurology signs
dizziness
sudden onset occipital headache
worse headache on coughing or straining
worse headache on standing, lying, bending over
headache wakes from sleep
vomiting
trauma history
pregnant
key aspect of headache assessment
all should get fundoscopy
assess for papilloedema in particular
tension headaches describe and treat
mild band-like ache across forehead
muscle aches cause
due to stress, dehydration etc
treat with basic analgesia and stress-relief
secondary headaches define and 4 causes
tension-like headache but clear cause
underlying medical condition
alcohol
head injury
CO poisoning
sinustitis define and treat
inflammation of sinuses, usually viral
facial pain behind nose, forehead and eyes
usually resolves by 3 weeks
consider nasal irrigation, steroid nasal spray
abx if bacterial
analgesic headache
long term analgesia use gives tension headache
need to withdraw meds and will resolve
hormonal headache
low oestrogen tension headache
cluster around period, early pregnancy and menopause
COCP can fix
cervical spondylosis describe
degenerative cervical spine change
neck pain worse with movement
may present as headache
exclude other causes and cord compression
describe and treat trigeminal neuralgia
3 branches (ophthalmic, maxiallary, mandibular)
can affects both sides, any roots
intense facial pain following dermatome lasting secs to hours
electric shooting pain
give carbamazepine, ensure they don’t have MS
