Tension Headaches Flashcards

1
Q

A type of headache where it is the condition. E.g. Migraine, Tension

A

Primary Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A type of headache where it is the result of an underlying pathology. E.g. head trauma, hypertension

A

Secondary Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

True or False?

There are 14 categories of headaches according to the International Headache Society (IHS)

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  • Tension-Type Headaches
  • Migraine
  • Cluster
A

Most Common Primary HA’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • Cervicogenic
  • Cervical neuralgia
  • Sinus, Ear, Nasal
  • Hypertension
A

Most Common Secondary HA’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

HA attributed with cervicovascular, infection, Paget’s disease, drug use or withdrawal, alcoholism, caffeine withdrawal, food, environmental sensitivities.

99.5% of headaches are benign, 1/300 headaches are pathological

A

Other Secondary HA’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common type: 30 to 80% of prevalence in the general population, least studied despite the highest socio-economic impact.

A

Tension-Type Headache (TTH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  • Stress (musculoskeletal or emotional)
  • Muscle origin: Myofascial trigger points that refer pain to the head and neck (see perpetuating factors, triggering stimuli)
A

Causes of Tension-Type HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Viselike, tight, binding

A

Quality of Pain for TTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  • Less than 15/ month-30 minutes to 7 days, can also be Chronic (CTTH) with fluctuations in pain levels
A

Frequency of TTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
At least 2 of the following:
- Bilateral
- Pressing/tight NOT throbbing
- Mild to moderate ADL modifications i.e. can still f’n
- Not aggravated by walking stairs/exertion
And BOTH of the following:
- NO photo or phonophobia
- NO nausea or vomiting
A

Criteria for Assessment/Dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 Types:

  • With Aura “Classic” 20%-visual or olfactory distortions, also sensory pins & needles, cold hands and feet, fluid retention gradually over 20 minutes ~ 1 hour prior to onset of headache(could be days)
  • Without Aura 80%
A

Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  • Unknown
  • Imbalances in serotonin, stress, attention, mood
  • Vascular theory: vasospasm causing aura (does not explain non-aura migraines)
  • Neurogenic theory-primary disorder of CNS
A

Causes of Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Throbbing, intense pain

A

Quality of Pain for Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sensitivity to light (photophobia), sensitivity to noise (phonophobia), nausea, vomiting

Results in person withdrawing from activity; suffering pain and disability

A

Associated Symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • Stress or post stressful event (weekend)
  • Tension HA’s can progress into migraines
  • Cyclical: PMS, menopause, puberty
  • Blood sugar changes, dieting
  • Seasonal allergies
  • Tyramine rich foods-red wine, aged cheese, chocolate, nuts
  • Food additives: MSG, aspartame
  • Visual stimuli: bright light, computer screens
  • Olfactory: perfumes
  • Auditory: loud music
A

Migraine Triggering Factors

17
Q
  • 5% of all children
  • In early childhood boys are more affected than girls, in puberty girls are more affected.
  • Headache is less predominant; instead abdominal pain, cramping, vertigo
A

Migraine in Children

18
Q

Primary or secondary?

  • Recurrent brief attacks of sudden, severe unilateral periorbital , temporal or frontal pain.
  • Episodes last 4 to 8 weeks affecting m > f
  • AKA Cluster histamine HA, Trigeminal Autonomic Cephalalgia
A

Cluster Headaches

19
Q
  • Episodic: occuring in periods of 7 days to 1 year separated by pain-free intervals lasting ~ 2 weeks
  • Chronic: more than 1 year without remission
A

Types of Cluster Headaches

20
Q

Piercing, boring deep-rarely throbbing

A

Quality of pain for Cluster HA’s

21
Q

Ipsilateral sweating, tearing, nasal discharge, eyelid swelling

A

Associated Symptoms of HA’s

22
Q

Unknown, associated with peptic ulcers, heart disease

A

Cause of Cluster HA’s

23
Q

Stress, glare, bright lights, allergies, alcohol, tobacco, sex, extreme temperature ∆’s

Acute episode tx-Pure oxygen, abortive analgesics, anesthetic nasal spray

A

Triggers of Cluster Ha’s

24
Q
  • Headache associated with problems in the muscles, ligaments, joints, discs of the cervical spine.
  • Affects F > M
A

Cervicogenic Secondary HA’s

25
- Dull, achy, moderate-intensity | - May trigger migraine or cluster type HA’s
Quality of Pain of Cluster HA's
26
May be prior history of neck trauma such as acceleration, deceleration injury (could be an acute HA with recent trauma). Nerve Roots C1-C3
Causes of Cluster HA's
27
Specific neck movements, sustained postures
Triggers of Cluster HA's
28
- CNS infection: meningitis - Neoplasm brain tumor - Hemorrhage: subarachnoid, subdural, epidural - Stroke - Blunt trauma - Brain swelling: high altitudes - Diabetes: hypoglycemia
Headaches with Potentially Life-threatening Origin
29
- Abrupt, very severe onset, client reports worst HA ever experienced - Persistent, progressive HA - New HA in older patient - Associated neurological symptoms: cognitive ∆’s - Nuchal rigidity: marked neck stiffness - Anticoagulant therapy - Blood Pressure Diastolic > 115 mm Hg - Persistent, severe HA in a Child - Suspicion of alcohol or drug dependence - Signs of papilledema
Headache Warning Signs suggesting a possibility of Pathology
30
Temporal Arteritis, Herpes Zoster (shingles), Trigeminal neuralgia, TMJ, Caffeine withdrawal, Paget’s disease, Medication side effects, medication withdrawal, glossopharyngeal neuralgia
Other Causes of Headaches