Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 Oxford Cases > Headaches > Flashcards

Headaches Flashcards

1
Q

What are the categories of sinister causes of headaches

A 
Vascular
Infection
Vision-threatening
Intracranial pressure
Dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the sinister vascular causes of headaches

A

SAH, haematoma, cerebral venous sinus thrombosis, cerebellar infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the sinister infectious causes of headaches

A

Meningitis and encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the sinister vision-threatening causes of headaches

A

temporal arteritis, acute glaucoma, cavernous sinus thrombosis, pituitary apoplexy, posterior leucoencephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the sinister intracranial pressure causes of headaches

A

SOL (tumour, abscess cyst), cerebral oedema (trauma, altitiude), hydrocephalus, malignant hypertension, idiopathic intracranial hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the sinister dissection causes of headaches

A

Carotid dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can a decreased level of consciousness with a headache suggest

A

SAH, Subdural (after head injury, fluctuating) or extradural haematoma (after head injury, altered after lucid interval), encephalitis, meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can cause a sudden onset “worst headache” ever (and why)

A

SAH (blood enters the CSF and causes irritation to the meninges)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can a seizure or focal neurological deficit with a headache suggest

A

Intracranial pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

At what age group is temporal arteritis more common

A

A new headache in those over 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does a persistent headache that is worse when lying down suggest (and what is it normally coupled with)

A

Coupled with early morning nausea

Raised intracranial pressure, pain can also occur when bending over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does a headache that is worse when standing up suggest

A

Reduced intracranial pressure, often occurs after LP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does a progressive, persistent headache suggest

A

Expanding SOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does weight loss, night sweats and fever suggest with a headache

A

Malignancy, chronic infection, or chronic inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What in the PMC might be significant to a headache

A 
Previous malignancy (lung or breast)
HIV or immunosuppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What basic Obs do you look at for headache presentations

A

Temperature (infection)
BP and pulse (malignant hypertension)
Consciousness (GCS)

17
Q

What does a focal limb deficit with headache suggest

A

Intracranial pathology

18
Q

What does a 3rd nerve palsy with headache suggest

A

SAH due to rupture of the posterior communicating artery

19
Q

What would be seen in a 3rd nerve palsy

A

Mydriasis
Eye is down and out
Ptosis

20
Q

What does a 6th nerve palsy with headache suggest

A

Malignancy or raised intracranial pressure

21
Q

What does a 12th nerve palsy with headache suggest

A

Carotid artery dissection

22
Q

How does Horner’s syndrome present and what does it suggest on BG of headache

A

Partial ptosis, miosis, anhydrosis

Carotid artery dissection or cavernous sinus lesion

23
Q

What are some causes of non-sinister headache

A 
Tension-type
Migraine
Sinusitis
Medication overuse
Temperomandibular joint dysfunction syndrome 
Trigeminal neuralgia
Cluster headaches
24
Q

What is the difference between primary and secondary headaches

A 
Primary = if headache was removed, there is no harmful pathology 
Secondary = headache results from a harmful pathology
25
Q

How can you characterise non sinister headaches

A

Ask if they suffer from other types
Are there predisposing factors
How disablingn are they
Is there an aura before headache

26
Q

How does a tension type headache

A

Bifrontal pain (band around the head), episodic, variable frequency
NO other features
lasts a couple hours, not severely disabling
Triggered by fatigue and stress

27
Q

How does a migraine present

A

Typically unilateral with aura (1/3). Pain is throbbing or pulsatile.
Sensitivity to light, sound and smell + nausea
Lasts 4-72 hours

28
Q

How does sinusitis present

A

Tight facial pain coming on over hours to days in conjunction, with coryzal symptoms. Often exacerbated by movement.
Lasts several days (infection)
Moderate but not disabling

29
Q

How does medication overuse headache present

A

Common in women, migraine medication and analgesics

Resembles migraine and tension type headache

30
Q

How does temperomandibular joint dysfunction syndrome present

A

20-40yrs, common in women, dull ache in the muscles of mastication that can radiate to the jaw and ear. They hear a click of grinding noise when they move their jaw

31
Q

How does trigeminal neuralgia present

A

Common in women 60-70yrs
Unilateral stabbing , sharp facial pain involving one or more divisions of the trigeminal nerve
Lasts seconds, triggered by eating, laughing, talking or touching the area.
Rarely occurs during sleep (unlike migraine or cluster)

32
Q

How does cluster headaches present

A

Common in men. Occurs in clusters for 6-12 weeks every 1-2 years.
Attacks tend to occur at exactly the same time every day or night (alarm clock)
Intense pain focused over one eye, pain diminishes 20-30mins later
Red, watery eye, rhinorrhoea and Horners

33
Q

What are some treatments for migraine

A

triptans (5HT agonists - sumatriptan), analgesics (aspirin, paracetamol), antiemetics (metoclopramide)

34
Q

What investigations should you do in a suspected SAH

A

CT (within 6 hours is best)

LP after 12 hours -> look for xanthochromia (remains 12 days post headache)

35
Q

What is the management for SAH

A

Refer to neurosurgical unit
Nimodipine (CCB that reduces spasm and therefore ischaemia)
Cerebral angiopathy to find the source
Platinum coil insertion

36
Q

How do you differentiate between epilepsy and migraine with aura

A

Epilepsy produces positive gain of function symptoms (flashing lights, convulsions, odd skin sensation)
Migraine produces a mix of negative and positive
Epileptic seizures are often followed by a postictal phase where the patient is exhausted and sometimes confused.

Y3 Oxford Cases (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions