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D&T2 Exam 2 > Common Headache Disorders - Ferguson > Flashcards

Common Headache Disorders - Ferguson Flashcards

(49 cards)

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1
Q 
scalp 
sinuses
meninges 
pial arteries
arteries and major veins
midbrain 
are these sensitive to pain
A

yes

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2
Q 
ventricles
choroid
brain parenchyma (except midbrain)
small parenchymal and dural veins
sensitive to pain
A

no

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3
Q

What specific area of the brainstem is known to cause headaches

A
  • midbrain
  • dorsal raphe nucleus
  • high concentration of serotonin
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4
Q

What causes migranes

A
  • brainstem: abnormal instability or activation of certain cells which spread peripherally and stimulate the
  • trigeminal nerve
  • chemoreceptors
  • autonomic nervous system
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5
Q 
what type of headache am i?
unilateral headache  
deep ache or throbbing sensation 
phonophobia, photophobia, and/or nausea vomiting 
worsen with exertion 
relieved by rest
A

migraine without aura

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6
Q

what is aura

A 
perceptual distrubace experienced prior to headache onset with can manifest as
visual disturbance
sensory disturbance
motor disturbance
auditory disturbance
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7
Q

what is complicated migraine

A

same as migraine with aura but aura is quite dramatic and can last longer

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8
Q

complicated migraines can mimic what

A

stroke

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9
Q

basilar migraine is associated with what part of the brain

A

brainstem

posterior cerebral circulation

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10
Q

what are common symptoms of basilar migraine

A

vertigo
dysathra
ataxia
diplopia

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11
Q

what is the most severe form of basilar migraine

A

Bickerstaff’s migraine

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12
Q

what are clinical symptoms of Bickerstaff’s migraine

A

total blindness followed by vertigo, ataxia, dysarthria and/or tinnitus

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13
Q

For Basilar migraine, compare the onset of headache and neurological symptoms onset

A

headache onset follows 20-30 min following neurologic symptom onset

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14
Q

describe the pain and location for basilar migraine

A

occipital throbbing pain

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15
Q

what are types of drugs used for abortive or rescue therapy for migraines

A

NSAIDS
5HT1
dopamine antagonists
combinations

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16
Q

what 5HT1 agonists are available orally

A

Triptans

Ergots

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17
Q

what 5HT1 agonists are inhaled or comes in a subcutaneous form

A

Sumatriptan
Zolmitriptan
Frovatriptan

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18
Q

When should prophylactic therapies be used for migraines

A

severe enough to cause functional impairment

OCCRUS 3 TIMES PER MONTH

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19
Q

What type of drug is used for prophylactic use of migraines ? Specific categories?

A

Beta- adrenergic blockers

  • calcium channel blockers
  • Tricyclic antidepressants
  • anticonvulsants
  • serotonergic durgs
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20
Q

Propranolol

Atenolol

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A

Beta adrenergic blockers

21
Q

Verapamil

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A

Calcium channel blockers

22
Q

Amitriptyline

Nortriptyline

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A

Tricyclic antidepressants

23
Q

Gabapentin
Valproic acid
Topiramate
Levetiracetam

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A

Anticonvulsants

24
Q

Cyproheptadine

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A

Serotonergic drugs

25
define cluster headache
episodic headache: 1-3 short duration (15-30 min in length) - severe unilateral stabbing periorbital or temporal pain - 3-6 weeks
26
what are some associated symptoms for cluster headache
``` conjunctival injection/lacrimation miosis ptosis eyelid edema rhinorrhea/nasal congestion perspiration remarkable circadian rhythm ```
27
Where in the brain do cluster headaches derive from
hypothalamus: prominent autonomic symptoms | secondary activation of trigeminal-autonomic reflex via trigeminal-hypothalamic pathway
28
what are 2 acute treatment options for cluster headaches? which one is more effective
oxygen: high concentration for 15 minutes, MOST EFFECTIVE ABORTIVE AGENT, if pain is still present prescribe--> Triptans
29
when should prophylactics be used for cluster headaches
should only be started at onset of cluster
30
What are two prophylactic options for cluster headaches
high dose steroids | calcium channel blockers
31
what is the most prevalent headache syndrome
tension headache
32
what do tension headaches feel like
squeezing or pressure around the head
33
What are symptoms that are never associated with tension headaches
NAUSEA OR VOMITING
34
what are non-pharmacologic treatment options for tension headaches
stress reduction biofeedback cognitive behavioral therapy improved sleep hygiene
35
what are abortive treatment options for tension headaches
acetaminophen | NSAIDS
36
what are two prophylaxis treatment options for tension headaches
tricyclic antidepressants | antiepileptic: Gabapentin
37
Idiopathic intracranial hypertension IIH is a disturbance that causes what
increased intracranial pressure without evidence of an intracranial mass, hydrocephalus or dural venous stenosis
38
Idiopathic intracranial hypertension is usually seen in what patients? what can create this problem
young obese females | and if they take tetracylcines, oral contraceptive pills, hypervitaminosis A
39
describe the symptoms of idiopathic intracranial hypertension
new onset continuous daily headache that worsens with cough, sneezing, and moving into the supine position
40
what is the initial work up of idiopathic intracranial hypertension
MRI, find nothing then LP: done in lateral decubitus position in order to obtain accurate opening pressure ophthalmologic exam
41
what is the non-pharmacologic treatment for idiopathic intracranial hypertension
weight loss
42
what are medical treatment options for diopathic intracranial hypertension
removal of offending drugs | use drugs that decrease CSF production
43
name 2 drugs that decrease CSF production
Acetazolamide | Topiramate
44
what are the 2 secondary headache disorders
idiopathic intracranial hypertension | Giant cell arteritis
45
symptoms of Giant cell Arteritis
- unilateral throbbing headache in temporal scalp - complain of concomitant jaw claudication, diffuse joint pains, visual disturbances, and transient monocular vision loss - seen in 50 yrs or greater
46
what is the gold standard for making the diagnosis for giant cell arteritis
temporal artery biopsy
47
treatment for Giant cell arteritis
Steroids
48
what is the diagnostic criteria for common migraine
at least 5 attacks fulfilling the following: - lasts 4-72 hours - unilateral, pulsating, debilating - nausea or photophobia
49
what makes classic migraine different from common migraine
presence of an aura

D&T2 Exam 2 (14 decks)

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