Flashcards in Clinical- 6 Deck (50)
Which nerve innervate the anterior/middle fossa?
Which nereves supple the posterior fossa?
IX and X
What are the common causes of acute headaches?
SOMATIC DYSFUNCTION UP IN THIS BITCH
Other Cerebrovascular diseases
Ocular Diseases (glaucoma)
What are the common causes of Subacute headaches?
Giant Cell (temporal) arteritis
Intracranial Mass (tumor, subdural hematoma, abcess)
Pseudotumor cerebri (benign intracranial hypertension)
Atypical Facial Pain
What are the common causes of chronic headaches?
Cervical Spine Disease
Subarachnoid hemorrhage (SAH)- causes
ruptured berry aneurysm from sites of branching arteries. can be from AV malformations too. polycystic kidney disease is assocaited with berry aneurysms
Worst headache ever. new headache. ↑ BP, global Sx (except AVMs and PCA aneurysms).
CT for confirmation, CSF has blood, u can do a cerebral arteriography
↓ BP. Nimodipine blocks Ca channels to reduce vasospasm. Surgery for mild cases
recurrence, intraparenchymal extension, ischemia from arterial vasospasm, hydrocephalus, szrs
60% die within the 1st day, but survivors can be either in a coma or Sx free. 1/2 have brain dmg.
Giant cell arteritis (GCA)- cause
granulomatous inflammation of the external carotids (sup temporal a.), women > 55
pain in jaw during chewing, blindness in 50% of pts
Bilateral biopsy for patchy inflammation, ESR is ↑↑↑
initially it's prednisone (antinflamm)
blindness is irreversible
Intracranial mass- Sx
headaches with different Sx depending on where the mass is and what the mass it.
Key: bifrontal pain, worse ipsilaterally, worse when u change position, worse when you INCREASE ICP (pooping, sneezing, coughing)
Intracranial mass- Dx
CT/MRI right away
Intracranial mass- Tx
removal of the offending lesion via surgery, radiotherapy, chemotherapy.
Idiopathic intracranial HTN (IIH)- cause
unknown, so u gotta rule out other disorders that cause intracranial HTN
headache, papilledema, visual loss, floaters, blurring, diplopia, pulsatile tinnitus
rule everything out by CT/MRI/LP. optic nerve sheath dilation is key.
acetazolamide or furosemide
Trigeminal neuralgia- cause
vascular compression of V
Trigeminal neuralgia- Sx
pain in V2/V3 region of the face, super hyperalgesia
Trigeminal neuralgia- Dx
nothing really. the vascular structures are too small to see
Trigeminal neuralgia- Tx
use of carbamazepine, or phenytoin (IV for acute attacks, oral for regular use); Lamotrigine or baclofen for refractory cases
Postherpetic neuralgia- cause
Herpes Zoster reactivation of VZV, specifically in a dermatome fashion, occurs mostly in older >70 patients
Postherpetic neuralgia- Sx
severe buring pain in a dermatome, usually V1, scarring