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9 Cards in this Set
- Front
- Back
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What are the 3 common types of headache?
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Common migraine
Classic migraine Tension |
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What are the signs of intracranial herniation?
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Altered mental status
Blown pupil Focal neurological signs |
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What are the common locations of berry aneurysms?
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Anterior communicating artery
Middle cerebral artery Branches of ACA and MCA |
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What is the immediate treatment for moderate-to-severe migraine?
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Triptan
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When is prophylactic therapy reccomended for migraines?
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Frequent (2-3/month)
Headaches complicated by persistent neurological deficits |
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Which drugs may be used for prophylaxis of migraine headaches?
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Amitriptyline, a tricyclic compound. Doses of 100 mg/day or more may be necessary. Many other tricyclics are not effective.
Propranolol, a beta-adrenergic blocking agent. Again, doses of 100 mg/day or more may be needed. Most other beta-adrenergic blockers are not effective. Calcium channel blockers. Both nifedipine and verapamil are useful. Anticonvulsants, especially valproic acid, are sometimes effective. |
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Describe the clinical features of tension headaches.
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Tension headaches are diffuse headaches, often described as a band around the head, usually bifrontal but sometimes occipital. Unlike migraine, these headaches are usually not paroxysmal but are constant and chronic. Like migraine, they are more common in women and generally begin early in life. About half of the patients have a family history. Usually, there are no associated neurologic symptoms (such as visual changes) or nausea and vomiting.
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What causes tension headaches?
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The cause is not known. There is no convincing evidence that they are due to psychological factors or emotional stress, nor do sound data show that they are related to muscle contraction. Some of them may be transformed migraines.
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How should tension headaches be treated?
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Amitriptyline, up to 75-150 mg/day, works independently of its antidepressant effects. NSAIDs are useful for common headaches but are seldom successful in chronic persistent tension headache. Muscle relaxants are not effective.
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