Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

29 Cards in this Set

  • Front
  • Back
What patient population typically presents with migraine headaches?
3:1 female to
True/False. Migraines follow an autosomal dominant inheritance pattern.
What are the different types of migraines?
1. Classical- occur with visual aura
2. Common-without aura
3. Complicated-aura that outlast the headache phase
4. Acephalgic-aura with no headache
What is the typical presentation of migraine headaches?
Unilateral, pulsating frontal-temporal pain severe enough to impair functioning. Often accompanied by nausea, photophobia , osmophobia& phonophobia (buzz if a fridge)
What are major triggers of migraine headaches?
1. Menses- the drop in estrogen before cycling
2. Foods (chocolate, red wine, cheeses)
3. MSG
4. Sodium
5. Stress
6. Sleep dysrthmia
Define visual auras and the two ways in which the present.
Visual abnormalities lasting <30 min usually preceeding headaches associated with cortical depression, depolarization & hyperemia presenting with:
1. Positive effects- scintilating scintomata (little flashing light), fortification of spectra
2. Negative effects-loss of vision of blindness...obscured vison
What is considered the generator for migraines?
Dorsal raphe nucleus (midbrain)- which houses neuronal cell bodies for serotoninergic cells.
How are migraines treated?
1.Symptomatically- triptans (imitrex), isomethapine, narcotics
2. Prophylactically- themral biofeedback, beta-blockers, calcium channel blockers, ergot
Discuss rebound headache.
Headache secondary to ingestion of analgesics.
What is the typical patient presenting with cluster headache?
Male wtih leonine facies...seen far less frequently then migraines.
What is Horners Syndrome?
Sympathetic dysfunction presenting with ptosis, miosis and annhydrosis
Discuss symptoms associated with Cluster Headaches?
1. Unilaterally localized incapacitating pain not associated with aura
2. Horners syndrome on the side of pain
3.erythroprosopalgia- red face
4. parasympathetic symptoms such as tearing, lacrimation and periorbital inflammation
5. chronobiological clock- present at the same time of the day
From what neural locus do cluster headaches originate?
Superior chiasmitic nucleus (posterior hypothalamus)
Discuss the pathophysiology of cluster headaches?
Trigneminal nerve dysfunction with elevation of calcitonin gene reactive protein (CGRP) a marker of trigeminal actiivity, vasoactive intestinal protein (VIP) a marker of facial nerve parasympathetic activity
True/False. All headaches share involvement of V1 of the trigeminal.
Discuss treatment of cluster headaches in a responsive patient.
Triptans (Imitrex) if used quickly, inhalation of oxygen, also may use ca-channel blocker such as verapamil
Discuss treament of cluster headaches in a non-responsive patient.
If Sx not improved in 3 days, double dose and add a second drug such as lithium.
If Sx not improved in two weeks, admit for five days and treat with IV dehydro ergortamine or valrproate.
What is chronic paroxysmal hemicrainia? Discuss treatment.
Subcategory of cluster lacking severity, parasympathetic features and male predominance.
Treat with indomethacin- an anti-inflammatory.
What is the most common headache?
Tension headache.
Discuss symptoms associated with tension headaches.
Pain distributed over topography of the skull (bilat) associated with pressure or constriction that improve with activity. and craniocervical muscle hypertonicity
Patients are either chronic or episodic.
True/False. Involvement of the medullocervical descending portion of V1 is associated with referred pain tension, cluster and migraine headaches.
False. Cluster does not have referred pain.
What is the etiology of most chronic headaches?
analgesic rebound or frequncy transformed by analgesics.
How are tension headaches treated?
1. Anti-inflammatories (butalbital)
2. Preventitives- TCAs and antidepressents
True/False. There is no generator associated with tension headaches.
What is the typical manifestation of sinusitis?
Focal pain, fever with pain in response to pressure over the sinuses.
True/False. Stroke caused by arterial thrombosis is frequently preceded by ipsilateral headache.
True/False. Sudden and severe headache in adult patient not prone to headache should be considered a subarachnoid hemorrhage until proven otherwise.
Discuss the pathophysiology of temporal or giant cell arteritis.
Vascular dz characterized by subendothelial inflammation typically observed in patients >55 accompanied by visual impairment, fatigue and jaw claudication abd elevated ESR. Blindness is a serious complication.
Name two serotonin receptor agonists utilized to treat headache.
sumitriptan (imitrex), dihyroergotamine (DHE)