Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 Neuro > Headache > Flashcards

Headache Flashcards

(75 cards)

Start Studying
1
Q

What is headache?

A

Symptom

Half to three quarters of adults aged 18–65 years in the world have hadheadachein the last year and, among those individuals, 30% or more have reportedmigraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can categories can cause headaches?

A

Structural

Pharmacological e.g. blood dilators dilate vessels in brain

Psychological e.g. stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do we divide headaches into?

A

Acute single headache

Dull headache, increasing in severity

Dull headache, unchanged over moths

Recurrent headaches

Triggered headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause acute single headaches?

A 
Febrile illness, sinusitis
First attack of migraine
Following a head injury
Subarachnoid haemorrhage
Meningitis, tumour, drugs, toxins, stroke
Thunderclap (sudden onset), low pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause a dull headache that increases in severity?

A 
Usually benign
Overuse of medication (e.g. codeine)
Contraceptive pill, hormone replacement therapy
Neck disease
Temporal arteritis
Benign intracranial hypertension
Cerebral tumour
Cerebral venous sinus thrombosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can cause a dull headache that is unchanged over months?

A

Chronic tension headache

Depressive, atypical facial pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can cause a triggered headache?

A

Coughing, straining, exertion
Coitus
Food and drink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can cause recurrent headaches?

A

Migraine
Cluster headache
Episodic tension headache
Trigeminal or post-herpetic neuralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are red flags for headahces? (onset)

A

Thunderclap
Acute
Subacute
Strictly unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are red flags for headaches? (Meningism)

A
  • photophobia
  • phonophobia
  • stiff neck
  • non-blanching rash
  • vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are red flags for headaches? (systemic symptoms)

A

Fever, rash, weight loss

Orthostatic - better lying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are red flags for headaches? (neurological symptoms or focal signs)

A

Visual loss, confusion, seizures, hemiparesis, double vision, 3rd nerve palsy, Horner syndrome, papilloedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Horner syndrome?

A

Sympathetic supply to the eye is affected

Eye is droopy

Pupil is slightly smaller

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the features of subarachnoid haemorrhage?

A

Sudden generalised headache
‘blow to the head’.

Meningism - stiff neck and photophobia

Most are caused by a ruptured aneurysm, a few from arteriovenous malformations.

50% instantly fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is initial treatment for suspected SAH? How do you diagnose subarachnoid haemorrhage?

A

Nimodipine and BP control.

High risk of a further bleed
.
Early neurosurgical assessment will confirm the bleed
and establish the cause.

CT brain, Lumbar puncture (will be pink) (RBC and xanthochromia) and MRA, angiogram.

Blood is white on CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you treat subarachnoid haemorrhage?

A

Nimodipine

Aneurysms used to be clipped or wrapped.

Nowadays filled with platinum coils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is coning?

A

Causes raised intracranial pressure

Weak points in the brain

tumour or mass grows when volume becomes significant

Brain no longer compliant after a point and seeps into weak points

Causes herniation

Brainstem death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is papilloedema?

A

Papilloedema

Optic disc swelling due to raised ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why is neck pain common in headaches?

A

Headache can also arise due to pathology in the large arteries of the neck.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What often causes stroke in young people?

A

Carotid & vertebral artery dissection

20% of ischaemic strokes <45 years (young stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What imaging do you use to diagnose dissections?

A

MRI
MRA (Magnetic resonance angiography)
Doppler
Angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you try prevent stroke?

A

Aspirin or anticoagulation X 6/12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is SDH?

A

Chronic Subdural haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why are SDH common in older people?

A

They fall

Often on blood thinners

> 65 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do SDH's show on CT?
Dark patches
26
What is temporal arteritis? What are the presenting features? Why can it cause blindness?
Constant unilateral headache, scalp tenderness and jaw claudication 25% of those with Polymyalgia Rheumatica-proximal muscle tenderness. Shoulder and pelvic pain worse in the morning. Involvement of the posterior ciliary arteries causes blindness (amaurosis fugax)
27
Who gets temporal arteritis?
Over the age of 55. Three times commoner in females. Polymyalgia rheumatica
28
How do you diagnose temporal arteritis?
Elevated ESR and CRP Temporal artery are usually inflamed and tortuous. Visible on ultrasound Temporal artery biopsy shows inflammation and Giant Cells - definitive test ^ should not delay treated
29
How do you treat temporal arteritis?
High dose steroids and aspirin. Oral prednisolone immediately
30
What are the main features of cerebral venous thrombosis?
Thrombosis in dural venous sinus or cerebral vein Unusual amount of headache due to raised ICP Non-territorial ischaemia “venous infarcts” Haemorrhage
31
What causes cerebral venous thrombosis?
Thrombophilia, pregnancy, dehydration, Behcets
32
What can cause meningitis?
Infections: Viral- Coxsackie, ECHO, Mumps, EBV Bacterial - Meningococci, Pneumococci, Haemophilus Tuberculous Fungal - Cryptococci Granulomatous- Sarcoid, Lyme, Brucella, Behçet’s, Syphilis Carcinomatous
33
What are the presenting symptoms of meningitis?
``` Malaise Headache Fever Neck stiffness Photophobia Confusion Alteration of consciousness ```
34
What is herpes simple encephalitis?
inflammation of the brain Affects temporal lobes haemorrhagic traces
35
What is the management plan for meningitis?
Treat then diagnose as it can kill in minutes
36
How do you treat meningitis?
Blood and urine culture Look for signs of raised ICP ``` If no: Lumbar puncture within an hour Increased White Cell Count, decreased glucose, Antigens IV Abs Dexa 10mg IV ``` If yes: ABs Airways support Fluid resus
37
What are the main symptoms of sinusitis?
``` Malaise, headache, fever. Blocked nasal passages. Loss of vocal resonance. Anosmia. Nasal or postnasal catarrh. Local pain and tenderness. ``` Frontal pain characteristically starts 1-2 hours after rising and clears up during the afternoon.
38
How can a brain tumour cause headache?
Oedema around tumor generates huge amount of pressure
39
What are the symptoms of idiopathic intracranial hypertension?
Headache, visual obscurations, diplopia, tinnitus | Papilloedema, +/- visual field loss
40
Who gets idiopathic intracranial hypertension?
Often young obese women
41
What causes idiopathic intracranial hypertension?
Weight gain Drugs: hormones, steroids, antibiotics, vitamin E
42
How do you treat idiopathic intracranial hypertension?
``` weight loss (bariatric surgery) diuretics optic nerve sheath decompression lumboperitoneal shunt stenting of stenosed venous sinuses ```
43
Can low pressure cause headaches?
Yes
44
What causes low pressure headaches?
CSF leak due to tear in dura | Traumatic post lumbar puncture or spontaneous
45
How do you treat low pressure headaches?
Treatment rehydration, caffeine, blood patch
46
What is characteristic of low pressure headaches?
Orthostatic
47
How do you diagnose low pressure headaches?
MRI shows meningeal enhancement
48
What is chiari malformation?
Normal brain that just sits very low within the skull
49
How doe chiari malformation cause headache?
Cerebellar tonsils descending through the foramen magnum Descend further when patient cough and tug on the meninges causing cough headache
50
How do you treat chiari malformation?
Operation to remodel base of brain
51
What are the features of obstructive sleep apnoea?
Hypoxia, CO2 retention, non-refreshing sleep Depression, impotence, poor performance at work Require sleep study Nocturnal NIV, Surgery
52
What is trigeminal neuralgia?
Electric shock like pain in the distribution of a sensory nerve. Often triggered by innocuous stimuli. Any division of the trigeminal can be affected. Neurovascular conflict at the point of entry of the nerve into the pons. Can be symptom of M.S.
53
How do you treat trigeminal neuralgia?
Carbamazepine, lamotrigine, gabapentin. | Posterior fossa decompression.
54
What is atypical facial pain?
Most commonly in middle aged women. Depressed or anxious. Daily, constant, poorly localised deep aching or burning. Facial or jaw bones, but may extend to the neck, ear or throat. Not lancinating. Not conforming to the strict anatomical distribution of any nerve. No sensory loss. Pathology in teeth, temporomandibular joints, eye, nasopharynx and sinuses must be excluded.
55
How do you treat atypical facial pain?
Unresponsive to conventional analgesics, opiates and nerve blocks. Mainstay of management tricyclics
56
What are the different mechanisms of post-traumatic headache?
Neck injury Scalp injury Vasodilation ? autonomic damage Depression - often delayed
57
What does post-traumatic headache depend on?
Correlates with previous history of headache Nature of head injury: High in victims of car accidents Low in perpetrators of car accidents Low in sports injuries
58
How do you manage post-traumatic headache?
Explanation Prevent analgesic abuse Non-steroidal anti-inflammatories - ibuprofen, naproxen Tricyclic antidepressants - Amitriptyline Be patient 3-4 years
59
What are the symptoms of cervical spondylosis?
``` Usually bilateral Occipital pain can radiate forwards to the frontal region Steady pain No nausea or vomiting Worsened by moving the neck ```
60
How do you manage cervical spondylosis?
Rest, deep heat, massage. Anti-inflammatory analgesics. Over-manipulation may be harmful.
61
Why is cervical spondylosis common in older patients?
Arthritis Narrowing of join space due to worn disc
62
What signs are found in meningitis?
Kernig's sign | Brudzinski's sign
63
What are the different properties of
Bacterial - turbid, low glucose, high protein Viral - clear TB - fibrin web
64
What ABs do you give in hospital for Meningitis?
Ceftriaxone Cefotaxime + amoxcicillin if immunocompromised
65
What is the most common cause of encephalitis in the UK?
Herpes Simplex Virus
66
How does encephalitis present?
Prodome Odd behaviour Seizure's
67
What investigations should be done for encephalitis?
Blood cultures LP EEG Contrast enhanced CT/MRI (will see bilateral temporal oedema)
68
What are RFs for Trigeminal neuralgia?
60-80 years MS Femal HTN
69
What are RFs for Trigeminal neuralgia?
60-80 years MS Female HTN
70
What are the investigations for subarachnoid haemorrhge?
Urgent CT < 12 hours LP > 12 hours if CT is normal Xanthochromic fluid
71
What is the difference between Subarach and SDH?
More gradual onset | Venous bleed
72
What are the features of extradural haemorrhage?
Extradural or Epidural Acute build up of blodd between dura and periosteum Due to trauma
73
What are the presenting features of EDH?
Acute onset after lucid interval Deteriorating of GCS and history of direct trauma
74
What would a crescent shape bleed be on a CT?
Sub-dural haemorrhage
75
What is the immediate management of haemorrhages?
``` A-E Immediate neurosurgical referral Cardiopulmonary support Maintain BP Raise head of bed to 30 degrees Osmotic diuretic ```

Year 3 Neuro (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions