Scott - Headaches

Front 1

Leading cause of missed work is

Back 1

Migraine

Front 2

Migraine syndromes tend to be ______ and are a ____ female to male ratio

Back 2

Inherited

4:1

Front 3

Onset of migraines is ______

Back 3

teenage years

Front 4

Frequency of migraine can be

Back 4

rare to daily

Front 5

A piercing, throbbing, squeezing head pain that typically begins on one side (and usually the same side) and spreads. Associated with nausea, photophobia, phonophoibia, and smell sensitivity; NOT associated with aura

Back 5

common migraine

Front 6

duration of common migraine tends to be

Back 6

4 hours to couple days

Front 7

This headache begins with an aura, the most common being visual. 30-60 minutes after aura begins a headache of piercing, throbbing, squeezing quality ensues

Back 7

Classic Migraine

Front 8

Aura in classic migraine typically ends _______ the initial phase of the headache

Back 8

before or during

Front 9

Migraines with neurological deficits as seen in stroke (aphasia, hemiplegia, rarely coma)

Back 9

complicated migraine

Front 10

complicated migraines tend to be _____

Back 10

inherited

Front 11

Presents like a brainstem stroke, occasionally with coma. SXS tend to be more vertigo like, at times w/o head pain. Frequency complaint is N-V

Back 11

Basilar migraine

Front 12

This infrequent migraine variant presents predominantly with visual loss/blindness and rarely with head pain. Duration can be minutes - hours

Back 12

Retinal migraine

Front 13

Common migraine that doesn't go away. Day-to-day variability

Back 13

chronic daily migraine

Front 14

Auras without headache

Back 14

Migraine without cephalgia

Front 15

Almost an exclusively-male headache syndrome that typically occurs at night and is always unilateral

Back 15

cluster headache

Front 16

Other non-cephalic features of cluster headache include

Back 16

injected sclera
hemifacial swelling
erythemia
sweating
lacrimation

Front 17

Treatment of cluster headaches is usually _____ with what agents?

Back 17

preventative

Ca-channel blockers, B-blockers, anticonvulsants

Front 18

_____ can be used to break a cluster of cluster headache

Back 18

pulse dosed steroids

Front 19

emergency tx of cluster headache includes ...

Back 19

100% O2 via non-rebreather mask, tripans, narcotics

Front 20

Paroxysmal hemicrania occurs almost entirely in ...

Back 20

females

Front 21

The quality of pain in paroxysmal hemicrania is

Back 21

sharp, lancinating pain of brief duration occuring almost always on the same side

Front 22

What is diagnostic of paroxysmal hemicrania?**

Back 22

Response to indocin

Front 23

Trigeminal neuralgia presents in what decade(s) of life?

Back 23

6th/7th; more common in females

Front 24

Pain of trigeminal neuralgia can be triggered by ...

Back 24

mild tactile stimulus

Front 25

Other methods of managing trigeminal neuralgia other than medically include

Back 25

surgical decompression
trgeminal blocks
gamma-knife surgery

[reserved for medically refractory cases]

Front 26

In pts under 50, what other causes of trigeminal neuralgia must be considered?

Back 26

V nerve neuroma, MS, Lyme Dz, carcinomatous meningitis

Front 27

All pts with suspected trigeminal neuralgia require ...

Back 27

MRI w/ contrast of brain along with thorough lab eval

Front 28

Headache in which the pain is less severe, but quality is global and throbbing. Occurs at end of day

Back 28

Tension headache

Front 29

Tension headache is thouht to be due to

Back 29

muscle tension and strain

Front 30

Tension headaches frequency evolve into ...

Back 30

chronic headaches with analgesic rebound from OC meds

Front 31

Only headache syndrome that is a neurological emergency

Back 31

temporal arteritis (may cause blindness and stroke)

Front 32

Headache syndrome in 6th-7th decade of life consisting of pain along the temples, painful to touch, with visual blurring or loss

Back 32

temporal arteritis

Front 33

Headache condition seen in fertile, obese women that causes a rise in intracranial CSF leading to detachment at optic disc

Back 33

Pseudotumor cerebri

Front 34

The headache of pseudotumor cerebri is described as

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worse when supine and occasionally associated with pulsatile tinnitus

Front 35

_______ causes the headache of pseudotumor cerebri to cease

Back 35

compression of ipsilateral jugular v

Front 36

Tx/management of pseudotumor cerebri includes

Back 36

LP (both dx and tx)
Wt loss (can cure condition)

Front 37

Medications used in the tx of pseudotumor cerebri include

Back 37

diamox
HCTZ
lasix
Topamax

all with carbonic anhydrase inhibition can also lower P

Front 38

Sharp, splitting-like feel when pt stands or sits up; relieved when pt is supine. Results from complication of LP or epidural

Back 38

low pressure headache

Front 39

tx of low pressure headache includes ...

Back 39

fluids esp caffeine beverages, IV caffeine, blood patches for refractory cases

Front 40

New onset of headache with a neurologica deficit must ...

Back 40

have a neuroimaging study to exclude strokie, tumor, vascular malformation, aneurysm, etc

Front 41

LP need be performed when there is ...

Back 41

suspicion of infection

suspicion of subarachnoid hemorrhage (post coital headaches)

Front 42

Trigeminal neuralgia in a young person requires what dx study ..

Back 42

MRI, as this is frequenctly seen with MS

Front 43

If temporal arteritis is suspected, labs such as _______ are mandatory along with temporal artery bx

Back 43

WESR
C-reactive protein

Front 44

TCAs are effective in the prophylaxis of

Back 44

migraine and tension headaches
trigeminal neuralgia

Front 45

Cymbalta is effective in the tx of

Back 45

chronic tension or migraine headaches

Front 46

Verapamil is useful in the tx of

Back 46

migraine, especially retinal migraines and cluster headaches

Front 47

AEs of verapamil include

Back 47

foot/ankle edema
constipation
SOB

Front 48

The use of B-blockers to tx headaches must be used with caution in pts with ...

Back 48

asthma
depression

Front 49

Anticonvulsants FDA approved for tx of migraine

Back 49

depakote
topamax

Front 50

Anticonvulsant FDA approved for tx of trigeminal neuralgia

Back 50

Tegratol

Front 51

Muscle relaxants are useful in the tx of

Back 51

migraine, trigeminal and occipital neuralgias, chronic tension headache

Front 52

_____ is effective up to 3 months and used in pts who have failed other medical therapies

Back 52

BOTOX

Front 53

abortive tx with Periactin or ceproheptadine are antihistamines useful to tx

Back 53

elderly and children

Front 54

Powerful vasoconstrictor that targets the serotonin receptors of the trigeminal nucleus

Back 54

Triptan

Front 55

Used in hospital for pateitns in status migrainous. Potent vasoconstrictor contraindicated for use in elderly or those with heart conditions

Back 55

DHE