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Flashcards in Clinical- 6 Deck (50)
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1

Which nerve innervate the anterior/middle fossa?

V

2

Which nereves supple the posterior fossa?

IX and X

3

What are the common causes of acute headaches?

SOMATIC DYSFUNCTION UP IN THIS BITCH
Subarachnoid Hemorrhage
Other Cerebrovascular diseases
Meningitis/encephalitis
Ocular Diseases (glaucoma)

4

What are the common causes of Subacute headaches?

Giant Cell (temporal) arteritis
Intracranial Mass (tumor, subdural hematoma, abcess)
Pseudotumor cerebri (benign intracranial hypertension)
Trigeminal neuralgia
Glossopharyngeal neuralgia
Postherpetic neuralgia
Hypertension
Atypical Facial Pain

5

What are the common causes of chronic headaches?

Migraine
Cluster Headache
Tension headache
Cervical Spine Disease
Sinusitis
Dental Disease

6

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

7

SAH- Sx

Worst headache ever. new headache. ↑ BP, global Sx (except AVMs and PCA aneurysms).

8

SAH- Dx

CT for confirmation, CSF has blood, u can do a cerebral arteriography

9

SAH- Tx

↓ BP. Nimodipine blocks Ca channels to reduce vasospasm. Surgery for mild cases

10

SAH- complications

recurrence, intraparenchymal extension, ischemia from arterial vasospasm, hydrocephalus, szrs

11

SAH- prognosis

60% die within the 1st day, but survivors can be either in a coma or Sx free. 1/2 have brain dmg.

12

Giant cell arteritis (GCA)- cause

granulomatous inflammation of the external carotids (sup temporal a.), women > 55

13

GCA- Sx

pain in jaw during chewing, blindness in 50% of pts

14

GCA- Dx

Bilateral biopsy for patchy inflammation, ESR is ↑↑↑

15

GCA- Tx

initially it's prednisone (antinflamm)

16

GCA- consequences

blindness is irreversible

17

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)

18

Intracranial mass- Dx

CT/MRI right away

19

Intracranial mass- Tx

removal of the offending lesion via surgery, radiotherapy, chemotherapy.

20

Idiopathic intracranial HTN (IIH)- cause

unknown, so u gotta rule out other disorders that cause intracranial HTN

21

IIH- Sx

headache, papilledema, visual loss, floaters, blurring, diplopia, pulsatile tinnitus

22

IIH- Dx

rule everything out by CT/MRI/LP. optic nerve sheath dilation is key.

23

IIH- Tx

acetazolamide or furosemide

24

Trigeminal neuralgia- cause

vascular compression of V

25

Trigeminal neuralgia- Sx

pain in V2/V3 region of the face, super hyperalgesia

26

Trigeminal neuralgia- Dx

nothing really. the vascular structures are too small to see

27

Trigeminal neuralgia- Tx

use of carbamazepine, or phenytoin (IV for acute attacks, oral for regular use); Lamotrigine or baclofen for refractory cases

28

Postherpetic neuralgia- cause

Herpes Zoster reactivation of VZV, specifically in a dermatome fashion, occurs mostly in older >70 patients

29

Postherpetic neuralgia- Sx

severe buring pain in a dermatome, usually V1, scarring

30

Postherpetic neuralgia- Dx

Hx of VZV infection, decreased sensations