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28 Cards in this Set
- Front
- Back
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the most common cause of headache is |
tension headache |
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some distinguishing features of a migraine |
photophobia phonophobia N/V relation to menses or emotional distress associated wtih foods |
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frequent short duration high intensity headache more common in men and associated wtih autonomic manifestations around the eye |
cluster headache |
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visual disturbacne msucle pain and fatigue jaw claudication
in an elderly woman |
GCA |
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obese woman with nausea, vomiting, visual disturbances and chronic headache |
idiopathic intracranial hypertension (IIH) |
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3 other links to developing IIH |
oral contraceptives Vitamin A toxicity venous sinus thrombosis |
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what physical findings do you expect with a tension headache? |
none |
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what about with a migraine |
usually nothing but occasionally you can have dysarthria, weakness, aphasia, numbness |
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what are PE findings for a cluster headache? |
red, teary eye
rhinorrhea
Horner syndrome occasionally |
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big PE finding in GCA? |
tenderness of temporal area |
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what should you see on PE for IIH? |
papilledema
diplopia from abducens nerve palsy |
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specific diagnostic test for tension headache, migraine and clusters? |
none- sometiems a CT/MRI may be indicated if it's new in onset or you really feel that you should exclude intracranial mass lesions |
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but if it's a clear hx do you need to perform a CT or MRI? |
no |
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2 dx tests for IIH? |
you have to do imaging and exclude a true tumor
then LP shows elevated opening pressure |
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hallmark lab finding in giant cell arteritis? |
elevated ESR |
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most accurate test for GCA thugh |
is temporal a. biopsy |
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do you need to wait for the biopsy results to start prednisone high dose in this patient? |
no, go ahead and start it |
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treatment for a tension headache |
NSAIDs or other analgesics |
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mgmt for acute migraine |
triptans
ergotamines
(as abortive therapies)
B blockers, TCAs etc. as preventive
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treatment for cluster headache |
triptans ergotamines
high-flow O2 |
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treatment for psuedotumor cerebri (IIH)? |
weight loss acetazolamide
steroids help
repeated LP rapidly lowers ICP |
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if they fail medical therapy though and need to have repetitive LP's then what should you do? |
VP shunt fenestrate the optic nerve if medical therapy doesn't control it |
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what is the ppx for cluster headache |
verapamil |
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what is the indication for giving prophylactic treatment for migraines? |
if they have 3 or more migraines per month |
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the best preventive therapy is |
propanolol |
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but there are many other preventive meds however |
CCBs TCAs SSRIs topiramate botulinum toxin injections |
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is preventive therapy with verapamil really necessary for clusters? |
it's controversial because they can resolve for many years at a time with no clear need for tx at those times
cluster headaches tend to happen very rapidly and then disappear for a while |
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how long does it take for preventive medications to take effect? |
takes up to months
usually several weeks |
