6- headache Flashcards Preview

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Flashcards in 6- headache Deck (18)
1

main HA in ER

tension - 50%
migraine -10%
benign non-specific - 30%
potentially serious 8%
life threatening -1%

2

Sx of migraine

- gradual onset that may wake from sleep - may have aura
- mod- severe
- typically unilateral
- pounding or throbbing
- N/V, photo/phono phobia
- may last 1-2 days

3

migraine triggers

- foods
- stress
- sleep changes
- OCP
- menstrual

4

3 main classes of migraine Tx

1. neuroleptics - haloperidol, chlorpromazine
2. Dopa antag. - metoclopramide, prochlrperazine
3. vasoactives
+ non specific pain mgmt

5

common migraine approach

5-10mg prochloroperazine again in 30 minutes if needed and IV ketrolac (NSAID)

6

ways to diff. tension from migraine

- never occur during sleep
- gradually over the day
- may occur daily
- posterior often
- less bad then mingraine
- associated with stressors
- no N/V photophobia

7

11 serious causes of non-trauma HA

1. subarachnoid
2. temporal arteritis
3. HT encephalopathy
4. pseuodtumor cerebri
5. CO poisoning
6. tumoir
7. meningitis
8. pre-eclampsia
9. cervical artery dissection
10. central venous thrombosis
11. acute angle closure

8

Sx of subarachnoid

- sudden
- occurs with exertion (excercise, sex)
- worst headache of life
- worst at onset
- N/V
- look for: pupil changes, meningismus, alter LOC, focal deficit

9

how helpful is CT in subarachnoid

great if done quickly

10

what to do if suspect and CT normal

LP - may find red cells, xanthochromia

11

causes of raised ICP

mostly tumors, but also
- abscess
- hemmorage
- subdural hematoma

12

Sx of ICP

gradual onset - days-months
- worse when lying/bending
- neuro and focal Sx
- sublte changes in cog., mood, memory
- no N/V photophobia

13

what to do for suspected ICP

CT, maybe MRI

14

5 Sx of meningitis

1. gradual HA
2. fever
3. altered LOC
4. focus of infection
5. meningisus

15

how to Dx meningitis

LP

16

how to manage meningitis

ABx before getting back CT or LP results
- possible dexa

17

4 patient profile of temporal arteritis

1. middle or elderly aged
2. gradual onset over days
3. may have visual changes
4. tenderness

18

tests for GCA

ESP/CRP
- biopsy