Unit 1: Headaches Flashcards
Types of Headaches
What type of spontaneous non-traumatic headache has the following symptoms: nuchal rigidity, vomiting and is said to be “worse ever”?
Subarachnoid
a. What is the triad for meningitis?
b. What other symptom can be observed with this type of headache?
a. Nuchal rigidity, sudden high fever and altered mental status
b. vomiting
Lumbar puncture aka is
Low-pressure Headache
What type of HA has CSF leakage from site of injury and described as a feeling of Dull/Throbbing.
Lumbar Puncture AKA Low-Pressure headache
What headache is associated with Kernig sign/Brudzinski’s sign and is fatal if untreated?
Meningitis
Berry aneurisms (congenital), anterior-vensous rupture and loss of pupillary light reflect are associated w/what type of HA?
Subarachnoid
What are the symptoms observed in Giant Cell Arteritis?
unilateral temporal pain
visual disturbances
diplopia insidious onset
What HA is associated with polymyalagia rheumatic (all joints hurt), kit provoked by anything touching the Temporal artery?
Giant cell arteritis
a. Name the condition would you expect to see elevated ESR, ALP and CRP on lab work?
b. What is the gold standard for this DX?
a. Giant cell arteritis
b. Biopsy; Halo sign on ultrasound
What headache has generalized pain that occurs every few days and is worse in the a.m?
Hypertension HA
What HA is 90% genetic, made worse with estrogen in females and has subtle changes?
Migraine
Classic migraine must have what lasting up to 60 mins?
it must have a Reversible aura
What is the triad symptoms for a classic migraine?
Aura, photophobia and nausea
What is the difference between a classic migraine and a common migraine?
Common migraines do NOT have an aura and is provoked by stress/alcohol and last up to 3 days.
Rebound HA are also known as
Medication overuse HA
A pt frequently taking meds or drinking caffeine may experience anxiety, memory problems and irritability from what type of HA?
Medication overuse HA (MOH) aka Rebound HA
This HA has a male predilection (pt in his 20s) and occurs same time of day/night.
Cluster HA
What HA is episodic lasting weeks to months w/remissions months to years? Pt might say it feels deep, constant, piercing around one eye.
cluster HA
Horner’s Syndrome is a rare condition. a. What is it characterized by? b. What can be observed?
a. miosis (constriction of the pupil),
b. ptosis (drooping of the upper eyelid), and anhidrosis (absence of sweating of the face).
a. Which HA is worse at the end of the day?
b. What regions of the brain does this condition effect?
a. Tension HA
b. effects Frontal/Temporal. it can also cause tachycardia
Tension headaches have what type of treatment?
over the counter meds and ADJ’s
What HA has its source of pain on one side of the neck and effects the occulofrontal region of the brain?
Cervicogenic HA
Which HA is associated with CN XI, C1-4 (MC C2).
Cervicogenic HA
Cervicogenic HA must have to be diagnosed?
Postural distortions
What headache is provoked by bending down and can have pain in the low back?
Dehydration HA
Which HA generally viral lasting less than 10 days but can be bacterial if it last longer than 10 days?
Sinusitis. symptoms are facial pain over sinuses
Sinusitis HA MC effects what sinus?
maxillary
What is known as the suicide disease or tic douloureux during these sever attacks?
Trigeminal neuralgia
What is the cornerstone diagnostic testing of meningitis?
CSF/Lumbar puncture
Spinal cord tumors are best seen on
MRI
Name the condition commonly associated with polymyalgia rheumatic.
Giant cell (Temporal) arteritis
Name the risk for a lumbar puncture
headache
infection
lumbar nerve damage
bleeding into spinal cord
An acute onset of a headache has what time and intensity?
Acute
Time: onset w/I 2-3 dys max
Intensity: severe
A subacute onset of a headache has what time and intensity?
Subacute
Time: onset wks-months, may be acute presentation
Intensity: Not as severe
A chronic onset of a headache has what time and intensity?
Chronic/Recurrent
Time: onset usually years
Intensity: varied
According to lecture material, most HA’s are the result of
vaso-dilation and vaso-constrictive events
What are the 4 categories or causes of HA?
neuromuscular events
tension/cervical spine dz
metabolic
miscellaneous
HA’s can be characterized or described as
pulsating, tightness, dull and steady, sharp/lancinating (cutting, piercing, or stabbing), ice pick
What are some associated symptoms for HA?
weight loss, fever/chills, dyspnea, visual disturbances, nausea/vomiting, photophobia
Physical exam for HA: Respiratory insufficiency can cause elevated what
intracranial pressure
Tachycardia can occur with pt’s experiencing
anxiety, tension, tension HA
What conditions has the classic symptom of a “thunder clap”, “like being kicked in the head” or the “worst ever” over the matter of secs to mins?
Subarachnoid hemorrhage
Pulsating towards occiput, vomiting, confusion, orbital pain, visual loss/diplopia and seizures are symptoms seen with what dz?
Subacrachnoid hemorrhage
What condition can occur d/t rupture of arterial venous malformation and damage to anterior or middle meningeal artery and what will be loss?
Subarachnoid hemorrhage and visual loss/diplopia
Which is worse an arterial venous malformation HA or Berry aneurysm HA?
Berry aneurysm HA
