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Flashcards in HA, Cohen Deck (58)
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1

Primary HA

no obvious pathologic cause
migraine, cluster, tension type

2

secondary HA

pathological cause: tumor hemorrhage infection

3

warning signs and Sx of secondary HA

single HA
sudden onset
onset HA after age 50
recent onset HA <6 mo
systemic disease
change in HA pattern
neuro Sx or abnormal neuro exam

4

PE for HA

general appearance
fever or abnormal vital signs, supple neck
mental status, speech, LOC
vision and retinal discs, pupils, EOMI, papilledema
asymmetry of strengths or reflexes
babinski

5

imaging for recurrent migraines

no CT or MRI unless recent change in HA pattern, focal neurologic signs or Sx

6

imaging for nonmigraine HA

CT MRI role unclear

7

imaging more likely to show cause for HA

MRI

8

imaging for HA in pregnancy

MRI w/o contrast

9

LP necessary for

Dx meningitis or encephalitis or possible carcinomatous meningitis
confirm subarachnoid hemorrhage but no blood on CT or MRI

10

increased opening pressure in LP

it can help Dx pseudotumor cerebri or idiopathic intracranial HTN

11

Dx primary headache syndrome

clinical features

12

characteristics of migraine features

sick HA with light and sound sensitivity
worse with activity
build up intensity
4-72 hours
aura or sensory or motor deficits before pain

13

migrain criteria

>5 attacks
>2 of following:
-unilateral
-pulsating
-mod- severe intensity
-aggravation routine physical activity
>1 of following:
-nausea and/or vomiting
-photophobia, phonophobia
No evidence of Hx or exam of disease that might cause HA

14

most common HA type that patients seek medical care

migraine

15

migraine demographics

W>africans>asians

16

genetics in migraines

possible 80% close family members with migraines too

17

transmission of migraine genetics

mother to daughter

18

mutations for familial hemiplegic migraine

Na and Ca Channels in neurons

19

causes of migraines

environmental factors "triggers"
psychiatric disorders
hormones: migraines can end with menopause

20

triggers for migraines

fasting, medication, circadian rhythms, environment, hormones, stress/overexertion

21

visual auras before migraines

blurred vision or blind spots
seeing flashing lights
seeing jagged lines
difficulty in focusing

22

sensory or motor changes before migraines

numbness or tingling of lips, face of hands on one side body
weakness in arms or legs, usually one side body

23

speech or language changes before migraines

inability to understand words
loss of speech or inability to speak normally

24

wolff concluded migraine pain from

reduction blood flow to occipital Cx in visual aura and the frontal or parietal cortices with other auras
actual pain from increase blood to brain

25

cortical spreading depression

sudden brief depolarization of cortical neurons, followed by reduction in neuronal depolarization and synaptic transmission

26

pain for migraine on PET

region of pons active up to 30 minutes before there is an increase in blood flow to brain

27

increased activity to CN V leads to what

secondary vasodilation and inflammation of dura mater
"trigeminovascular activation"

28

what NT are released from pons in migraine

serotonin
CGRP
substance P
NO

29

what is increased in urine from migraine attack

increased 5-hydroxyindoleacetic acid in urine from increased release serotonin 5-hydroxytyptamine

30

migraine ends with what

when neurons stop releasing more serotonin