test 2 - headaches

Question 1

less than __% of all brain tumors have headache as a significant presenting complaint

Answer 1

5

Question 2

primary headache vs secondary

Answer 2

primary - no specific organic cause

secondary - caused by underlying organic disease

Question 3

headache red flags

Answer 3

diplopia

loss of vision in single eye

stiff neck

unilateral weakness or paresthesia

ataxia

Question 4

sudden and severe onsets tend to be

Answer 4

secondary headaches

think vascular: subarachnoid hem, acute ischemia, acute hemorrhagic stroke

Question 5

if you have a neuro def then headache comes upon… headache usually

Answer 5

will go away

Question 6

if you have a headache and then a neuro appears in exam…

Answer 6

stroke on the way

Question 7

what is the most common cause of severe recurrent headaches

Answer 7

migraine

Question 8

key symptoms of a migraine

Answer 8

vascular headache

frontal-temporal most common

unilateral (how it starts)

severe

pulsatile/throbbing

last hours to days

nausea+vomiting common

Question 9

few days prior to or at the onset of their period

reduction in pain after menopause

may change with preg. / childbirth

most common: decrease in freq and intensity in mid-life, picks up after age 65

Answer 9

menstrual migraine

Question 10

headache induced by foods that contain

tyramine

nitrates

Answer 10

migraine: provacative

Question 11

usually visual: fortification spectra, scotoma etc

may be nonvisual: vasomotor, change in mood, numbness

precede the HA by 10-30 mins

evolve slowly over 5-10, fade as HA starts

Answer 11

prodrome (ora)

Question 12

abdominal migraine most commonly seen in

Answer 12

childhood migraine

Question 13

basilar migraine

looks like a TIA: unilateral subjective paresis

subjective paresthesia/numbness “brainstem signs”

Answer 13

vasopastic migraine

worry about future stroke

Question 14

prodrome without HA - typical or nontypical

HA without prodome - common or not common

Answer 14

prodrome without HA - not common

HA without prodrome - common

Question 15

vestibular migraine has this affect

Answer 15

vertigo

Question 16

what is the neurovascular theory of “prodrome”

Answer 16

uncontrolled synapses in the brain

sucks up all the O2

Question 17

what is a seizure variant

Answer 17

wave of depolarization causes aura, resultant vasodilation causes HA

Question 18

medical Rx of headaches

Answer 18

vasoconstrictions

anti-seizure meds

analgesics: dont do much, but opiates are frequently tried

hospital for status migrainous: continuous HA for 24+ hours

Question 19

non-med Rx

Answer 19

cold on heck/neck

warm hands and feet

Question 20

when is the best time for acute care

Answer 20

prodrome

Question 21

hortons headache, histamine cephalgia, hortons cephalgia, alarm clock HA

rapid onset

strong lacrimation, runny nose

eyes bloodshot

“acid poured in the nose or eye” ache

male 10:1

Answer 21

cluster headache

HA lasts from 10 mins to 2 hours

typically wakes pt from sleep

Question 22

most common type of headache

Answer 22

tension HA

Question 23

anxiety/depression

tight band around my head, head is in a vise

suboccipital to frontal - tight

Answer 23

tension HA

Question 24

show some positive findings on a detailed exam of the cervical spine

Answer 24

cervicogenic HA

Question 25

rebound HA are most commonly from

Answer 25

caffeine/stims

ergot

analgesics

narcotics

Question 26

pain is transient, but leaves an ache behind

attacks may occur once or twice per day, up to once every minute or two

mouth-ear zone 70%

nose orbit zone 30%

Answer 26

trigeminal neuralgia

Question 27

inflammatory HA

central retinal artery - blindness

needs ROIDS asap

Answer 27

temporal arteritis

Question 28

typically non-specific headache, very similar to migraine

simultaneous onset of vertigo, nausea, and headache may be a clue

aneurism of vessels in the subarachnoid space

Answer 28

subarachnoid hemorrhage

Question 29

whip lash

irritation of greater occipital nerve

physical pressure on the nerve or its distribution usually PPt or increases sympt

Answer 29

occipital neuralgia

most common post trauma

Question 30

200/120 mmHg +

worse in early AM while in bed

dull, throbbing, diffuse, aching

Answer 30

hypertension HA

Question 31

increased intercranial pressure

waxes and wans, but never goes away

changes with body position, WORSE WHEN LYING DOWN

Answer 31

intercranial mass

Question 32

pain in centered over the affected sinus

increases with flexion, pressure, pounding etc

thickening of the mucosa

Answer 32

sinusitis

Question 33

same signs and sympt as subarachnoid hemorrhage with

FEVER

Answer 33

meningitis/encephalitis

Question 34

obese women of childbearing age

elevated intracranial pressure and most important neurlogical manifestation is papilledema

may lead to progressive optic atrophy and blindess

Answer 34

pseudo tumor cerebri