H/A

Question 1

Cervicogenic Hx

Answer 1

Ipsilateral head P localised to the neck + occiput
May refer over neck

Question 2

Cervicogenic SSx

Answer 2

Dec ROM due to P (Csp)
Neck tenderness
Symptom reproduction with palp

Question 3

H/A DDX

Answer 3

Rule out other causes of H/A

Question 4

Migraine Hx

Answer 4

Possible podrome (visual changes)
Triggers (stress, rapid hormonal changes, rapid blood sugar changes, seasonal allergies, meds)

Question 5

Migraine SSx

Answer 5

Unilateral mod/severe throbbing pulsating
Photophobia
Nausea

Question 6

Cluster H/A

Answer 6

Severe ipsilateral head P
M>W

Question 7

Cluster SSx

Answer 7

Lacrimation (flow of tears)
Rhinorhea (runny nose)
15 mins- 3 hours
Can’t sit still

Question 8

Pathologic H/A

Answer 8

Recent head trauma
Abrupt H/A for first time
Pt age- worrisome over 50 or a child with persistent H/A

Question 9

Pathologic H/A red flags

Answer 9

Abrupt onset
Very severe “worst H/A ever experienced”
Nuchal rigidity (diffitculty flexing head- neck extensors wont relax)
High diastolic pressure (>115)
Persistent/severe H/A in child
Drug/alcohol abuse
Known Ca
Papilledema (swollen optic disc)
Fever (meningitis)

Question 10

General H/A red flags

Answer 10

Systemic symptoms- e.g., meninigtis triad
Neuro symptoms/deficits
Onset- worse/sudden/awaken from sleep
Older >50
Papilldema
Positional
Precipitated by valsalva
Progressive H/A, pattern changw