NMS II- Headaches Flashcards
sharp pain
neurological
throbbing
more vascular in nature
inside pressure pushing outward
can indicate a throbbing headache, which is classified as vascular and could possibly be life threatening
outside to inward pressure
can indicate a tension headache
which type of pain can cause a “hat band” type pain?
outside to inward pressure
describe a migraine
aura type headache
dull pain
characteristic of toothache
unilateral headache
characteristic of a migraine of vascular/life threatening
bilateral headache
characteristic of a tension headache
other locations of a headache
frontal
occipital
generalized
radiating pain
who should receive valsalva’s maneuver?
any patient that is experiencing headaches as their chief complaint
who should receive triad of dejerine
anyone experiencing a headache as their chief complaint
positive valsalva’s maneuver means..
a possible SOL (tumor, aneurysm, hematoma)
precipitating factors that can cause a headache?
coughing, sneezing
emotional strain
what brings down a migraine?
quiet, dark room
duration and frequency of headaches
hours, days, weeks or monthly intervals
rapid or gradual onset
migraine headaches have short or long durations?
long
tension headache duration
gradually get worse as the day progresses
time of day for onset as well as initial age of onset
tension headaches are associated with what other symptoms
nausea or vomiting
mechanisms that produce headaches
traction on veins
displacement of dural venous sinus
traction or distention of meningeal arteries or large arteries at base of the skull
inflammation by masses upon any sensitive structure within cranium or outer surface of cranium
spasms of cervical musculature
vascular recurrent headaches
migraine, cluster, exercise or diet related, post concussion or HTN
muscular recurrent headaches
tension, inflammatory disorders of the cervical musculature
non recurrent type headaches
meningitis/encephalitis
subarachnoid hemorrhage: acute head trauma
life threatening headaches
meningitis
brain abscess
tumors
subdural hematomas
specific characteristics of life threatening headaches
relatively short history of onset
acute, seere headache pain
positive valsalva’s and triad of dejerine
exacerbated by recumbency and is more severe upon wakening but can become more tolerable throughout the day
why can life threatening headaches be worse in the morning and get better throughout the day?
recumbency increases the intracranial pressure from the distribution of the cerebral fluids
most common headache
tension
radiation of tension headaches
“hat band” or localize around occiput
onset of tension headache
begins during the day and increases severity as day progresses
past history of tension headaches
patient will usually have this headache before
patient may display anxiety or be chronically depressed
differentiate tension vs life threatening headache
tension increases as day progresses
life threatening decreases as day progresses
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tension feels like outside-inward pressure
tension is accompanied by stress most of the time
management of tension headaches
adjustments patient identify cause and try to reduce tension rest with nick in normal cervical curve moist heat cryotherapy drink plenty of water eliminate caffeine
categories of tension headaches
acute muscle contraction
subacute muscle contraction headache
chronic muscle contraction headache
migraines
acute muscle contraction headaches
most common type of tension headaches
pain is short in duration
aching pain
pain may begin in neck and become generalized throughout cranium
pain may be relieve by stretching or gentle massage of involved muscular area
subacute muscle contraction headaches (sick headache)
prolonged headaches for days
pain interferes with ADLs
pain is generalized throughout cranium
can have nausea or vomiting
chronic muscle contraction headaches
related to physical or emotional trauma
pain is present when patient goes to bed and can wake patient from sleep, pain can be present upon wakening
pain is generalized in the head and may include shoulders
pain is described as dull ache and outward to inward direction
types of migraine headaches
classical
atypical
cluster
basic characteristics of migraine headaches
retro-orbital or temporal in location vascular throbbing/pounding pain unilateral possible warning signs (aura) nausea and vomiting onset usually begins in childhood can be familial
classic migraine
frontal or temporal region unilaterally characteristically throbbing or pounding begins upon wakening patient experiences aura symptoms: visual disturbance nausea, vomiting
exacerbations of classic migraine
alcohol, bright lights, positional stress
relieving factors of classic migraine
rest, sleep, darkened room
atypical migraine
bilateral, one side more severe
dull ache or stabbing pain in or behind eye area
can occur upon wake or later in the day
dull and relentless pain
exacerbations of atypical migraines
bright lights, noise, tension
relieving facors of atypical migrains
rest and darkened room
cluster migraine
unilateral, sudden onset, orbital to remple, nose, upper jaw or neck
brief duration of pain (stabbing)
occurs in clusters, frequently during sleep and patient is wakened
middle aged (55 or older) males are more prevalent (6:1)
temporal pain unilaterally
knife like-stabbing, shooting
tenderness in scalp area
signs and symptoms of cluster migraines
redness of eye on affected eye increase in lacrimation rhinorrhea stuffiness of nostril swelling of temporal vessels on affected side cachexia generalized malaise/fatigue muscle aches around affected area
exacerbations of cluster headaches
combing hair, pain may shoot down into cervical spine area and touching area of pain exacerbates pain
etiology of post concussion syndrome
head injury
local pain with tenderness at site of impaction
pain will last a few hours to several days and then patient may be symptom free
signs and symptoms of post concussion syndrome
headache
vertigo
impairment of memory and concentration
possible skull fracture
type I post concussion syndrome
most common dull, aching, pressure like sensation described as weight on top of head location is entire scalp patient may be anxious
type II post concussion syndrome
pain is local to injury site
tender zone at point of pain
