* - Clinic - Headaches - Merck

Front 1

cause of headaches

Back 1

activation of pain-sensitive structures in or around the brain, skull, face, sinuses, or teeth

Front 2

3 primary headache types

Back 2

- tension-type H/A
- migraine H/A

- cluster H/A

Front 3

main characteristics of tension-type headaches

Back 3

- frequent or continuous,
- mild,
- bilateral, and
- vise-like occipital or frontal pain that spreads to entire head
- worse at end of day

Front 4

main characteristics of migraine headaches

Back 4

- frequently unilateral and pulsating,
- lasting 4–72 h;
- occasionally with: aura, nausea, photophobia, sonophobia, or osmophobia

- worse with activity, preference to lie in the dark, resolution with sleep

Front 5

main characteristics of cluster headaches

Back 5

- unilateral orbitotemporal attacks at the same time of day
- deep, severe, lasting 30–180 min; - often with: lacrimation, facial flushing, or Horner's syndrome; restlessness

Front 6

headache and vomiting

Back 6

- migraine,
- increased intracranial pressure

Front 7

headache and fever

Back 7

infection eg.:
- encephalitis,
- meningitis,
- sinusitis

Front 8

headache and visual field deficits, diplopia, or blurring vision:

Back 8

- ocular migraine,
- brain mass lesion,
- idiopathic intracranial hypertension

Front 9

headache and red eye, visual symptoms (halos, blurring)

Back 9

acute narrow-angle glaucoma

Front 10

headache and lacrimation and facial flushing

Back 10

cluster headache

Front 11

meningismus

Back 11

A condition characterized by neck stiffness, headache, and other symptoms suggestive of meningeal irritation, but without actual inflammation of the meninges (MENINGITIS). Spinal fluid pressure may be elevated but spinal fluid is normal.

Front 12

glaucoma

Back 12

progressive optic nerve damage at least partly due to increased intraocular pressure

Front 13

headache and rhinorrhea

Back 13

sinusitis

Front 14

headache and pulsatile tinnitus

Back 14

idiopathic intracranial hypertension

Front 15

headache and preceding aura

Back 15

migraine

Front 16

headache and focal neurologic deficit

Back 16

- encephalitis,
- meningitis,
- intracerebral hemorrhage,
- subdural hematoma,
- tumor
- other mass lesion

Front 17

headache and seizures

Back 17

- encephalitis,
- tumor
- or other mass lesion

Front 18

headache and syncope at headache onset

Back 18

subarachnoid hemorrhage

Front 19

papilledema

Back 19

papilledema is swelling of the optic disk due to increased intracranial pressure

Front 20

headache with myalgias, vision changes (people > 55 yr)

Back 20

giant cell arteritis (GCA)

Front 21

red flags for headaches

Back 21

- neuro Σs or signs (eg, altered mental status, weakness, diplopia, papilledema, focal neurologic deficits)
- mmunosuppression or cancer
- meningismus
- onset of headache after age 50
- thunderclap headache (severe headache that peaks within a few secs)
-Σs of giant cell arteritis (eg, visual disturbances, jaw claudication, fever, weight loss, temporal artery tenderness, proximal myalgias)
- systemic Σs (eg, fever, weight loss)
- progressively worsening headache
- red eye and halos around lights

Front 22

headaches - key points

Back 22

- recurrent headaches that began at a young age in patients with a normal examination are usually benign.
- immediate neuroimaging is recommended for patients with altered mental status, seizures, papilledema, focal neurologic deficits, or thunderclap headache.
- CSF analysis is required for patients with meningismus and usually, after neuroimaging, for immunosuppressed patients
- patients with thunderclap headache require CSF analysis even if CT and examination findings are normal.

Front 23

4 types secondary headaches

Back 23

Extracranial disorders
Intracranial disorders
Systemic disorders
Drugs and toxins

Front 24

extracranial disorders that cause headaches

Back 24

Carotid or vertebral artery dissection (which also causes neck pain)
- dental disorders (eg, infection, temporomandibular joint dysfunction)
Glaucoma
Sinusitis

Front 25

intracranial disorders

Back 25

Brain tumors and other masses
Chiari type I malformation
CSF leak with low-pressure headache
Hemorrhage (intracerebral, subdural, subarachnoid)
Idiopathic intracranial hypertension
Infections (eg, abscess, encephalitis, meningitis, subdural empyema)
Meningitis, noninfectious (eg, carcinomatous, chemical)
Obstructive hydrocephalus
Vascular disorders (eg, vascular malformations, vasculitis, venous sinus thrombosis)

Front 26

systemic disorders

Back 26

Acute severe hypertension
Bacteremia
Fever
Giant cell arteritis
Hypercapnia
- Hypoxia (including altitude sickness)
- Viral infections
- Viremia

Front 27

drugs and toxins

Back 27

- analgesic overuse
- caffeine withdrawal
- carbon monoxide
- hormones (eg, estrogen)
- nitrates
- proton pump inhibitors