Week Integration Flashcards
What causes the pain of a headache?
From traction, inflammation, irritation of structures that are innervated
These include scalp, sinuses, skull, blood vessels, and meninges
NO pain receptors in the brain parenchyma
Red flags
New or progressive headache (esp in children under 5 or older than 50) Fever or new systemic symptoms Hx of cancer or HIV Postural or positional headache Exertional headache Sudden onset/thunderclap headache
Headache symptoms that point to an increased ICP
Worse in the morning/lying down
Diplopia or blurred vision
Transiet visual obscurations or black out of vision upon standing or changing postures
Pulsatile tinnitus
Headache symptoms that point to a decreased ICP
Severe headaches only upon standing up
Complete relief in supine position
Pain is better in the morning, worsens throughout the day
5 investigations you can use for secondary headaches
CT scan CTA MRI Blood tests Lumbar puncture
DDx of things that can cause thunderclap headache
Aneurysmal SAH Acute ischemic stroke ICH RCVS Venous sinus thrombosis Cervical artery dissection Bacterial meningitis Acute HTN Spontaneous intracranial hypotension Colloid cyst of the 3rd ventricle Pituitary apoplexy Retroclival hematoma
2 ways migraine happens
Cortical spreading depression
Trigeminovascular complex activation
Positive aura symptoms
Flashes Colours Shapes Prisms Patterns
Negative aura symptoms
Scotoma
Hemianopsia
Obscures the vision
