PDF - HA Flashcards
How does brain feel pain?
It does not, it is the effect of stretching and changes in nerves and vessels
- Tension of muscles and inflammation of adjacent mucosal structures also can cause this
What happens to arteries in migraine?
They dilate
- This is a result of the disease, not a cause of it
- Cause is neuronal dysfunction
Who at most risk for migraine?
Women with family history
- Often arise at puberty with menstruation being a trigger
What causes and aura?
Wave a depolarization over certain parts of the cortex
- Visual is form depolarization of visual occipital cortex
What is a scotoma?
Patch of blindness often seen in migraine aura
Laterality migraine?
Starts unilateral, can generalize but often does not
- Described as throbbing or pounding
Duration migraine?
Hours - 2 days
- Malaise and hangover can continue after
How does migraine start?
Spreading wave of cerebral depolarization, which is often, but does not have to have a trigger
What happens when depolarization hits trigeminal?
Nausea, vomiting, and photophobia.
What to do if there is first migraine without an aura?
MRI
When to image MRI?
- If appears later in life
- If first and no aura
- If neuro deficit
- Cognitive change
- Seizure
Med or aborting migraine?
Triptans which come in nasal, oral, IM
What is Dihydroergotamine?
Drug helpful in aborting severe migraine, delivered by
injection or nasal spray
Prophylactic migraine meds?
- Propranolol
- Verapamil
- Amitriptyline,
- Valproate / gabapentin / topiramate
How are tension HAs described?
Pressure or band like feeling around head w/o warning signs or aura
