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42 Cards in this Set
- Front
- Back
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Patient presents with headache and slowly progressive neurologic deficits
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think tumor or abscess as cause
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patient presents with headache, fever, and neck stiffness
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meningitis
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patient presents with sudden onset headache with neck stiffness
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subarachnoid hemorrhage - berry aneurysm rupture
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examples of referred pain that cause headache
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eye pain - glaucoma, iritis
ear pain - otitis media dental pain sinusitis cervical arthritis |
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common cause of headaches in the elderly with pain in the posterior neck and occipital area
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cervical arthritis
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physiology associated with essential headache
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wave of neuronal excitation followed by wave of cortical spreading depression - in tandem the blood vessels are simultaneously dilatated and then constricted
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headaches are associated with increased or decreased blood flow at the time of the headache
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increased blood flow
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only ruptured aneurysm with specific focal findings
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posterior communicating artery - with CN III palsy
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defect in the CSF absorption by the arachnoid granulations
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pseudotumor cerebri
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characteristics of pseudotumor cerebri
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young and obese women
visual disturbances papilledema increases ICP - opening pressures elevated during LP |
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what can falsely elevate opening pressure during lumbar puncture
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if the patient is sitting up - 500 mmH2O
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normal opening pressure during LP
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150-180 mmH20
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treatment for psuedotumor cerebri
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acetazolamide - reduces CSF production
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affects exclusively the elderly with new onset headache associated with jaw claudication
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temporal arteritis
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polymyalgia rheumatica
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temporal arteritis with systemic symptoms: fever and myalgia
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what does sedimentation rate (ESR) indicate
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inflammation
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what disorder is associated with elevated sedimentation rate
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temporal artitis
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treatment of temporal arteritis
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steroids
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classic migraine
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headache preceded by neurologic defects, visual changes
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common migraine
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not associated with neurlogic deficits
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migraine equivalent
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recurrent neurologic deficits without an associated headache
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complicated migraine
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may have neurologic deficits that do not resolve completely
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serotonin agonist used to treat migraine headaches
specific receptor |
Sumatriptan
selective 5-HT1 receptor agonist |
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contraindicated for use of Sumatriptan
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CAD
uncontrolled HTN |
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IV dopamine bocking agents used to relieve migraine headaches
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Metoclopramide
Prochlorperazine |
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Used to prevent migraine headaches
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SSRIs: amitriptyline, Nortriptyline
B- blocker: propranolol Anti-convulsants - topiramate Botox |
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contraindicated for use of propranolol
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patients with co-existing asthma and depression
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most commonly prescribed migraine preventive medication
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topirmate - anti-convulsant
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headache more common in men
occurs at precise intervals during the day associated with nasal stuffiness, rhinorrhea, conjunctival injection |
cluster headache
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treatment used to relieve cluster headaches
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Sumatriptan
Inhalation of 100% oxygen |
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preventative medication for cluster headaches
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Verapamil and prednisone started together, prednisone is tapered off over 10 days until verapamil kicks in
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pressure-like headache associated with stress and fatigue
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tension headache
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headache is prevent at least 50% of the time commonly seen in patients that are depressed, medication overload
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chronic daily headache
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medication used when chronic daily headaches are not relieved with discontinuation of medication
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TCAs
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severe, brief, jolting pain associated with jaw movements
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Trigeminal neuralgia
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treatment of trigeminal neuralgia
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carbamazepine - anticonvulsant
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sharp, brief pain that may occur dozens of time per day. associated with exertion such as post-organsmic
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Indomethancin responsive headache
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ominous signs when patient presents with headache
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new onset (especially older person)
sudden onset fever focal neurological findings signs of ICP |
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diagnoses of subarachnoid hemorrhage
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Head CT
if normal do LP |
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diagnoses of temporal arteritis
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sedimentation rate (ESR)
temporal artery biopsy |
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diagnoses of meningitis
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LP
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diagnoses of pseudotumor cerebri
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LP after MRI was clear of masses
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