Quiz 1 Headache part 1 Flashcards
what criteria must be met to diagnose tension?
at least one of the following: photophobia, nausea, phonophobia
What are the types of primary headaches?
tension, migraine, cluster, idiopathic intracranial headache and htunderclap
What criteria must be met to diagnose migraine?
-At least 2 of the following: nausea, disabling pain, photophobia
-at least 2 of the following: pain iwht movement, one spot of pain and severe/ moderate pain
-at least 1 of the following: nausea/ vomiting or phonophobia/photophobia
How long does a tension headache last?
30 minutes to 7 days
-worsens with glare, eating, stress, noise etc
what symptoms will tension headache pt feel?
band of tightness, bilateral pain, low concentration, pericranial tenderness, nausea or photophobia or phonophobia
treatment options for tension headache?
NSAIDS or TCA as prophylaxis
what differentiates tension headache4?
there is NO pain with movement/ worsening of pain with activity
risks of TCA
-when used as a prophylaxis they can cause addiction, diahrrea or medication dependent headache
what is worse migrain with aura or wihtout
migraine without aura
-mostly affects women and kids
sympomts of migraine no aura
-pain with activity, vomiting, nausea, increase intensity, pulsation, POUND
pound
-pulsation
-one day duration no more than 72hrs
-unilateral location
-nausea/ vom
-disabling intensity
migrain treatments?
-TCA
-NSAIDS
-ergotamines
-seratonine agonists
-triptans that target 5-HT
-sumatriptan
-ubrogepant, lasmiditran, rimegepant, prochlorperazine and chlorpromazine
-antihystamines
-antiseizure meds
antizeizure meds
topiramate, valproate and gabapentin
analgesiac limits for treatment
-single NSAID no more than 15 days
-combo no more than 10 days
what do triptans not treat?
basilar migraine or hemiplegic migraine
criteria for migraine with aura symptoms
-aura symptom is reverisble, the onset is over 4 minutes or there are 2 aura symptoms back to back
-pound
t or f pain is worse with activity in migraine
t
what is a status migrainosus
longer than 72 hours with or without aura with vom and dehydration
what is a basilar migraine
-with aura
-comes from the brainstem
-lose consciousness, ataxia, vertigo, tinnitus etc
what affects more men than women?
cluster
how are cluster headaches timed?
episodic every o0her day for up to 8 days for 1-3 months
-may go into remission for years may not
unilateral pain, temporal pain, nasal congestion, conjuntival symptoms, swollen face and eyelids, ptosis are part of?
cluster headache
cluster headache treatment?
-triptans, oxygen, ergotamine, lidocaine, nsaids,
-verapamil and lithium as prophylaxis
ergotamine is?
cafergot
-ergotamine tartrate + caffeine
onset of thunderclap?
under one min increases intensity and lasts more than 5 min
diagnostic steps for thunderclap?
must do LP with CT to rule out SAH
-some pt have have papilledema
t or f thunderclap has papilledema
t in some cases not always present
-can be a hint that you NEED CT bc the brain will herniate with LP if the papilledema is from a mass or SAH
what am I? wake up with pain that improves as the day progresses
idiopathic intracranial headache
t or f idiopathic headache has papilledema?
true in some cases not always
idiopathic treatment?
LP may decrease CSF pressure leading to releif
-shunt may need to be placed
-acetazolamide or topiramate
population getting idiopathic headaches?
obese ppl and females pregnant
