Cluster Headaches

Question 1

Primary headaches = no known cause
Secondary headaches = have a known cause

Which of these is more common?

Answer 1

• primary

Question 2

Cluster headaches are a form of headaches that occur as clusters of multiple headaches. What is the incidence of cluster headaches?

1 - 1000 cases per 100,000
2 - 100 cases per 100,000
3 - 10 cases per 100,000
4 - 1 cases per 100,000

Answer 2

3 - 10 cases per 100,000

• 0.1% of the population

Question 3

Cluster headaches are a form of headaches that occur as clusters of multiple headaches. Are these more common in men or women?

Answer 3

• men

3:1 ratio

Question 4

Cluster headaches are a form of headaches that occur as clusters of multiple headaches. What age does the incidence of these typically peak?

1 - 60-70
2 - 50-60
3 - 40-50
4 - 20-30

Answer 4

2 - 50-60

Question 5

Which 2 of the following are risk factors for cluster headaches?

1 - smoking
2 - hypertension
3 - male gender
4 - COPD

Answer 5

1 - smoking
3 - male gender

Question 6

Typically which 2 of the following are said to be triggers for cluster headaches?

1 - dehydration
2 - alcohol
3 - sleep disorders
4 -

Question 7

What is the most common type of primary headache?

1 - migraines
2 - thunderclap
3 - tension type
4 - cluster

Answer 7

3 - tension type
- migraine is the 2nd most common form of primary headache

• incidence of 0.5-5%
• difficult to identify exact incidence

Question 8

What is the most common debilitating headache?

1 - tension headache
2 - thunderclap headache
3 - Migraine
4 - Cluster headaches

Answer 8

3 - Migraine
- also 2nd most common type of primary headaches

• 7th highest cause disability globally
• 2.9% of years of life lost to disability
• twice as likely in women

Question 9

Are patients with comorbid psychiatric disorders such as anxiety & depression more or less likely to experience medication overuse headaches?

Answer 9

• more likely

Question 10

When performing a history on a patient with a headache, if there is an increase in headache symptoms when performing a Valsalva manoeuvre bad?

Answer 10

• Yes

Indicates a space occupying lesion in cranial cavity

Causes an increased intracranial pressure

Question 11

When performing a history on a patient with a headache, which of the following is NOT typically a red flag?

1 - patient wakes up with headache
2 - change in character
3 - age of onset
4 - sudden onset (thunderclap)
5 - focal neurological deficits
6 - constitutional symptoms (fever, meningism, rash, weight loss)

Answer 11

1 - patient wakes up with headache

A RED FLAG here would be if the headache wakes the patient whilst they are asleep

Question 12

When examining a patient, all of the following are RED FLAGS except which one?

1 - patient appears sick-appearing, skin changes
2 - evidence of trauma
3 - altered cognitive state
4 - ocular: hyphema, pupil non-reactivity, optic disc swelling, proptosis, restricted eye movements
5 - meningism
6 - weight gain
7 - focal neurological findings (eg limb weakness)

Answer 12

6 - weight gain

Weight loss is a red flag as it could be caused by malignancy