ECR 11.29.12 Headach History and Diagnosis Flashcards Preview

ECR 2012 > ECR 11.29.12 Headach History and Diagnosis > Flashcards

Flashcards in ECR 11.29.12 Headach History and Diagnosis Deck (29):
1

What are primary headaches (4)

Migraine
Tension Type (TTH)
Cluster
Other (benign cough headache)

2

What are secondary types of headaches

Infection
Hemorrhage
Increased ICP (intracranial P -DO NOT MISS)
Brain Tumor

3

What Questions should you ask when taking Headach History (5)

1. Ask how many different types of headaches you have

2. How long have you had it?
(if chronic, okay; if sudden worst ever--> CAT scan)

3. What do you think it's due to?

4. Where is it lcoated?

5. What is it like?

4

What is temoporal pattern of Migraine

lasts 203 days
Episodic headaches

5

What is temporal pattern of Tension Headache

constant
~6 months

6

What is temporal pattern for cluster headache

painful stimulus ;

7

What is temporal pattern for Tumor/inracranial neoplasm

progressive with time

8

What are migraine triggers (7)

Phsyical exertion

Diet

Hormonal changes

Head Trauma

Stress and anxiety

Sleep deprivation or excess

Environmental factors

9

Why is pain localized to front of head (referred pain>

TRIGEMINAL N. above tentonum

If stretched--> Trigeminal N.

10

When do you have pain back of head

T9-T10

11

how deos IHS determine if its migraine?

> 5 attacks lasting 4-72h

12

What is timing of migrains (IHS)

>5 attacks lasting 4-72 h

13

What are qualities of migraines (IHS)- need >2

Unilateral
Puslating
Moderate to severe intensity
Aggravation by routine physical activity

14

What are >1 needed for migraine (IHS)

nausea
photopobia and phonophobia

15

Rate /timing of Tension headache (IHS)

>10 attacks lasting 30 mins-7 days

16

>2 of the following 4 tension headaches (IHS)

Bilateral
Not pulsating
Mild or moderate intensity
Not aggravated by routing physical activityIs

17

Is nausea/vomiting ass. with tension headaches?

NO!

18

Is photophobia or phonoboia ass with headaches

only ONE or NEITHER

19

What is the attack profile of a cluster headache

unilateral orbital/temporal severe pain

Rapid onset (5-15 mins)
Short duration (45-90 mins)

Agitation/restlessness (90%)

Migrainous syptoms (nausea, photophobia, phonobobia, aura)

Autonomic features

Rest doesn't help, position doesn't help
Pace in agitated/colicky staet

20

Worrisome headache RED FLAGS "SSNOOP"

Systemic symptoms (fever, weight loss)
or
SECONDRARY risk factors (HIB, Systemic cancer)

NEUROLOGIC SYMPTOMS or abnormal signs (confusion, impaired alertness, or consciousness)

ONSET- sudden, abrupt, or split-second

OLDER: new onset and progressive headache, esp.in middle-age >50 (giant cell arteritis)

PREVIOUS HEADACHE Hx: First headache or different (change in attack frequency, severeity, or clinical feature)

21

Acute Subdural Hematoma (pic)

Head injurty iwthout fraction of skull

Blood in subdural space, will be filled with density of CSF

Brain is shifted to opposite side
;ventricular system on the side of the hematoma is compressed

22

How can you treat Acute Subdual Hematoma (and what happens if you don't treat it)

Burr hole in skull to relieve pressure

If not treated, patient may herniate

23

What is the timing of Acute Subdural Hematoma

Cresendao headache from days to weeks; generally in frontal region

24

Epidural hematoma

. But as the epidural hematoma grows, symptoms will develop, including severe headache, nausea and vomiting.

The term epidural hematoma means blood buildup between the dura mater and the skull; hematoma translates to blood mass.

Natasah Richardson

25

Intracerebral Hemorrhage

~10% f all strokes

Starts suddenly, then cresendo

first and worst headache

When exercising or lifting weight

26

Primary Headaches- Sudden onset headaches (4)

1. Idiopathic thudnerclap headach (TCH)

2. Sexual Headache

3. Exertional Headache

4. Cough Headache

27

Seocndary headaches- Sudden onset-

SAH
Venous Sinus Thrombosis
Pituitary Apoplexy
Arterial Dissection
Meningoencephalitis
Acute Hydrocephalus
Acute hypertension
Spontaneous intracranial hypotension

28

What is SAH (subarachnoid hemorrhage)

Acute thunderclap as a prsentaitno of SAH

Rupture in aneurysm of anterior circle of willis

29

WHAT ARE CAUSES OF LOW PRESSURE HEADACHES

HANGOVER, dehydrateion

anxiety, fracture of dura' spontaneous rupture of dura