Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
A progressive headache disorder, new onset of headache in middle or later life, headaches that disturb sleep or are related to exertion, and headaches that are associated with neurologic symptoms or a focal neurologic deficit usually require What imaging
|
MRI
or CT to exclude mass lesion |
|
|
|
What to do? Acute onset of "worst headache in my life." Increasing headache unresponsive to simple measures. • History of trauma, hypertension, fever, visual changes. • Presence of neurologic signs or of scalp tenderness.
|
Refer for imaging
|
|
|
|
Most common type of HA disorder. May complain of: Pericranial tenderness, poor concentration, and other vague nonspecific symptoms, also daily HA's that are often vise like and tight but are not pulsatile.
|
Tension HA
|
|
|
|
TX: if simple analgesics not effective, trial of anti migrainous agents. Relaxation techniques include massage, hot bath, biofeedback. Explore underlying cause of possible chronic anxiety.
|
Tension HA
|
|
|
|
HA usually pulsatile, pain typically though not always unilateral, Nausea, photophobia, vomiting, phonophobia are common. May have transient neurologic sx
|
Migraine HA
|
|
|
|
Build up gradually and last several hours or longer. Other focal disturbances such as aphasia or numbness, clumsiness, dysarthria, disequilibrium, or weakness may occur.
|
Migraine HA
|
|
|
|
Visual disturbances in both visual fields
dysarthria, dysequilibrium, tinnitus, perioral and distal paresthesias sometimes followed by transient loss or impairment of consciousness or confusion. Then throbbing HA with nausea and vomiting. |
Basilar artery migraine,
an uncommon variant |
|
|
|
Lateralized pain - usually around eye accompany by N/V and diplopia due to transient external ophthalmoplegia
|
Ophthalmoplegic migraine-rare
|
|
|
|
Ergotamine containing RX with high affinity for serotonin. Rapid when given sub-Q by auto injection.
Avoid in pts with hemiplegic or basilar migraines, stroke risk factors, pregnancy. Best to combine with naproxen (500mg). |
Sumatriptan, + Naproxin 500mg
symptomatic tx for migraine |
|
|
|
Rest in quiet dark room and take simple analgesics right away may work for some
|
Symptomatic tx for migraines
|
|
|
|
Clonidine,
Cyproheptadine, Amitriptyline, Fluoxetine, Verapamil. Imipramine, Propanolol, Sertraline, |
Prophylactic drugs for migraine
CCAF VIPS |
|
|
|
Predominantly affects middle aged men. Usually no family HX. -Episodes of severe unilateral periorbital pain occur daily for weeks
|
Cluster HA
|
|
|
|
Accompanied by one or more of the following:
Days that clump together w HA One eye or focal point on Face Ipsilateral nasal congestion Rhinorrhea, Lacrimation, Eye redness, Horner syndrome. Pts often restless and agitated in attacks. |
Cluster HA
|
In children, Horner's syndrome sometimes leads to heterochromia: a difference in eye color between the two eyes.[2] This happens because a lack of sympathetic stimulation in childhood interferes with melanin pigmentation of the melanocytes in the superficial stroma of the iris.
Horner's syndrome or Horner syndrome is a clinical syndrome caused by damage to the sympathetic nervous system. It is also known by the names Bernard-Horner syndrome or Claude Bernard-Horner syndrome or as oculosympathetic palsy. |
|
|
Often at night , awaken pt and last 15 min to 3 hours. Spontaneous remission and pt well for several weeks or months before more closely spaced. Bouts can last 4-8 weeks.
|
Cluster HA
|
|
|
|
Usually appears within a day or so following injury, may worsen over the ensuing weeks, and then gradually subsides. It is usually a constant dull ache, with superimposed throbbing that may be localized, lateralized, or generalized.
|
Posttraumatic HA
|
|
|
|
It is sometimes accompanied by nausea, vomiting, or scintillating scotomas. Headaches occurring more than 1-2 weeks after the inciting event are probably not directly attributable to the head injury.
|
Posttraumatic HA
A scotoma (Greek for darkness; plural: "scotomas" or "scotomata") is an area of partial alteration in one's field of vision |
|
|
|
Severe head pain caused by
(Straining, sneezing, laughing) lasting a few minutes. R/o intracranial lesions self-limited, may persist for several years. unknown why s/s clear completely after lumbar puncture. |
Cough HA
|
|
|
|
major symptom is headache,
often associated / preceded by myalgia, malaise, anorexia, weight loss, other nonspecific complaints. Loss of vision is the most feared manifestation and occurs quite commonly Also has locaized temporal Px |
Temporal arteritis
|
|
|
|
worsened by exertion or postural change
may be associated w nausea and vomiting, but this is true of migraine also. Progressive headache disorder or new onset of headaches in middle or later life |
Intracranial mass lesion
|
|
|
|
Present with chronic pain or with complaints of severe headache unresponsive to medication. Withdrawal of analgesics leads to relief of headache within several months.
|
Analgesic rebound HA
|
|
|
|
Dull or throbbing headache and may last for several days. It is aggravated by the erect posture and alleviated by recumbency. Sequelae of a certain procedure
|
Lumbar puncture HA
|
|
