Primary Headaches Flashcards
What is the typical history associated with primary headaches without systemic pathology?
Recurrent headaches. Migraine: unilateral, throbbing pain, nausea, photophobia. Tension-type: bilateral, pressing/tightening pain. Cluster: severe, unilateral, around the eye.
What are the key physical examination findings in primary headaches without systemic pathology?
Often normal physical exam. Possible tenderness in neck or scalp (tension-type). Redness or tearing in eye (cluster). No neurological deficits.
What investigations are necessary for diagnosing primary headaches without systemic pathology?
Clinical diagnosis based on history and symptoms. Headache diary. Imaging (MRI/CT) only if red flags are present or atypical features.
What are the non-pharmacological management strategies for primary headaches without systemic pathology?
Lifestyle modifications: regular sleep, hydration, avoid triggers. Stress management techniques. Cognitive-behavioral therapy (CBT).
What are the pharmacological management options for primary headaches without systemic pathology?
Acute treatment: NSAIDs, triptans (for migraines). Preventive treatment: beta-blockers, antiepileptics, antidepressants (for frequent migraines). Oxygen therapy for cluster headaches.
What are the red flags to look for in headache patients?
Sudden, severe headache (“thunderclap”). Neurological symptoms: weakness, vision changes. Fever, neck stiffness. New or different headache in older age.
When should a patient with primary headaches be referred to a specialist?
Treatment-resistant headaches. Atypical or complex cases. Need for advanced diagnostic testing. Severe impact on quality of life.
What is one key piece of pathophysiology related to primary headaches?
Dysfunction in pain pathways and neurotransmitter imbalances. Migraine involves cortical spreading depression and trigeminovascular activation. Tension-type headaches linked to muscle tension and stress.
