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neuro > headache > Flashcards

headache Flashcards

1
Q

what is a primary headache

A

no underlying structural or biochemical causes

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2
Q

what is a secondary headache

A

identifiable structural or biochemical cause

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3
Q

what is a tenstion type eheadache

A

treated with NSAIDS and can carry on with their day

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4
Q

what is a migrane

A

gradually builds up

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5
Q

what is aura

A

can be confused with TIA. loss of vision, speech, sensory

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6
Q

how do you classify a chronic migraine

A

headache more than 15 days a month and more than 8 days has to be a migraine for more than 3 months

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7
Q

how do you manage migraines

A

modify lifestyle triggers (stress, diet, hunger, sleep disturbance)
abortive treatment
preventative treatment

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8
Q

what is a medication overuse headache

A

> 15 days a month which is worse when taking regular symptomatic medication

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9
Q

acute treatment of a migraine

A

aspirins, triptans, CGRP antagonist

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10
Q

name some prophylactic (prevent) treatment for migraines

A

propranolol, tricyclic antidepressants
topiramate

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11
Q

what is cranial neuralgias

A

an intense or stabbing pain
pain is brief but severe
pain extends along the affected nerve

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12
Q

what nerves are involved in cranial neuralgias

A

trigeminal, glossopharyngeal and vagus
nervus intermedius
occipital

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13
Q

what is trigeminal neuralgia

A

unilateral maxilliary or mandibular pain

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14
Q

triggers of trigeminal neuraligia

A

wind, cold, touch, chewing

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15
Q

what are the common causes of trigeminal neuralgia

A

vascular compression of trigeminal nerve

uncommon: MS, intracranial tumour

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16
Q

medical treatment for trigeminal neuraliga

A

carbamazepine, oxcarbazepine, lamotrigine

17
Q

surgical treatment of trigeminal neuraliga

A

glycerol ganglion injection
stereotactic radiosurgery
microvascualr decompression

18
Q

describe the cluster headache

A

pain in orbital or temporal region
attacks striclty unilateral
15mins to 3 hrs

19
Q

abortive treatments for cluster headaches

A

sumatriptan
nasal zolmatripan

20
Q

transitional treatment for cluster headache

A

oral prednisolone taper
greater occipital nerve block

21
Q

preventative treatment for cluster headache

A

verapamil
ECG monitoring
lithium
melatonin
surgical- occipital nerve stimulation or deep brain stimulation

22
Q

what is paroxysmal hemicrania

A

rapid onset which lasts 2-30mins

23
Q

what headache responds to indometacin

A

paroxysmal hemicrania

24
Q

what features predict a sinsiter headache

A

head injury, sudden thunderclap headache, change in headache pattern

25
Q

red flags for headaches

A

new onset headache over 50
neck stiffness or fever
headache worse lying down

26
Q

treatment of a subarachnoid haemorrhage

A

early treatment of aneurysm
nimodipine (calcium channel blocker for vasospasm)
HHH therphy (hydration, hyperoxia, hypertension)

27
Q

features of a high pressure headache

A

headache when patient wakes up
cough or other valsalva headache
seizures

28
Q

investigations for subarchnoid haemorrhage

A

CT as soon as possibel
LP>12 hrs after headache onset
CT angiogram if SAH is confirmed

29
Q

what is giant cell arteritis

A

inflamation of large arteries

30
Q

features of giant cell arteritis

A

headache is non specific
scalp tenderness, jaw claudication, visual disturbance

31
Q

treatment for giant cell arteritis

A

high dose prednisolone
temporal artery biopsy arranged

32
Q

what investigations support diagnosis of giant cell arteritis

A

elevated ESR (blood test)
raised CRP and platelet count

33
Q

treatment for intracranial hypotension

A

bed rest, fluids, analgesia
i.v caffeine
epidural blood patch

neuro (28 decks)

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