Clin: Headache Flashcards
(33 cards)
What are the 4 most common associated symptoms with a common migraine?
- Nausea
- Vomiting
- Photophobia
- Phonophobia
How long does the aura associated with Classic Migraines usually last?
Usually 15-30 mins, but sometimes longer
Any patient presenting with a headache who has a “worrisome history” or abnormal examination needs what?
- Urgent imaging study
- Perhaps even a L.P. and possibly arteriogram
What is the location, patient description of pain, and patient behavior with a common migraine?
- Location: unilateral or bilateral
- Description: throbbing/sharp/pressure
- Behavior: retreat to dark, quiet room
What are the common visual symptoms associated with Classic Migraines?
- Scintillations: flashes of light
- Scotoma: an interruption or break in the visual field (blind spots)
*Often hemianopic
A group of headache disorders characterized by unilateral trigeminal distribution pain that occurs in association with prominent ipsilateral cranial autonomic features, describes what?
Trigeminal autonomic cephalgia (TAC’s)
What are the 5 primary types of HA?
- Classic migraine
- Common migraine
- Chronic migraine
- Tension type HA
- Cluster HA
As a general rule, many physicians (including neurologists) believe that any person with HA should have what type of evaluation?
A one-time, thorough neuroimaging study (CT head with AND w/o contrast or MRI of head)
What 5 types of headache disorders are classified as Trigeminal Autonomic Cephalgias (TAC’s)?
- Cluster HA
- Paroxysmal hemicrania
- Hemicrania continua
- SUNCT syndrome
- SUNA syndrome (similar to SUNCT, but with autonomic sx’s)
What is the normal duration for a Cluster HA?
- 30 minutes to 2 hours
- Classic is 45 min
What is the most common location/distribution of Cluster HA’s?
- 100% unilateral
- Generally orbitotemporal
What are the characteristics of SUNCT syndrome?
Location?
Onset and which sex is most commonly affected?
- Shortlasting, unilateral, neuralgiform headache attacks w/ conjunctival injection and tearing
- Excruciating, burning, stabbing electrical HA in periorbital area lasting seconds to a few mins, occuring frequently throughout the day
- Onset typically over 50 in men
The most widely discussed theory about the cause of migraines says that they are caused by?
Neurogenic inflammation
Paroxysmal Hemicrania (HA) is exquisitely reponsive to which drug?
Indomethacin
What is the intensity, age of peak prevalence, and gender ratio for common migraines?
- Intensity: moderate to severe
- Prevalence peaks between 35-40 years
- Gender ratio: F:M = 3:1
What are the 10 worrisome signs which may indicate headache of pathologic origin (secondary HA)?
- “Worst HA”
- Onset of HA after age 50
- Atypical HA for patient
- HA w/ fever
- Abrupt onset (max. intensity in sec. to min.)
- Subacute HA w/ progressive worsening over time
- Drowsiness, confusion, memory impairment
- Weakness, ataxia, loss of coordination
- Paresthesias/Sensory loss/ Paralysis
- Abnormal medical or neurological exam
What is the only FDA approved treatment for chronic migraines?
BOTOX injections
What are some of the associated symptoms of Cluster HA’s?
- Ipsilateral ptosis
- Miosis
- Conjunctival injection
- Lacrimation
- Stuffed or runny nose
What is the treatment for SUNCT syndrome?
- Usually anticonvulsants
- Particularly lamotrigine
What is the intensity and gender ratio for Cluster HA?
- Intensity: severe, excruciating
- Gender ratio: F:M = 1:6
To be defined as a chronic migraine which criteria must be met?
Headache for 15 or more days/month, lasting 4 hours or longer, for a period of at least 3 months
Differentiate a common migraine from a classic migraine.
- Common migrarine = without aura
- Classic migraine = with aura
What’s Trigeminal Neuralgia?
Treatment?
- Excruciating sharp, shooting, electrical quality pain occuring in paroxysms in one or more distributions of the trigeminal nerve, often freqent through the day
- Treatment is usually carbamazepine or oxcarbamazepine
Secondary headaches are a sign of?
Organic disease
