Headache Flashcards
(20 cards)
What is the most common type of headache?
Tension headache
What are common symptoms of a migraine headache?
Visual disturbance: Flashes, spark, starts, hallucinations
Photophobia
Aura
Relationship to menses
association with food
associated with N/V
What are common symptoms of a cluster headache?
frequent, short duration, high intensity
10x more common in men
What are common symptoms of Giant Cell (temporal) Arteritis?
Visual Disturbances
Systemic S/S: muscle pain, fatigue, weakness
Jaw Claudication
What are common symptoms of Pseudotumor Cerebri?
Obesity, venous sinus thrombosis, OCP, Vit A toxicity
Mimics brain tumor with: N/V, visual disturbance
What physical exam findings are associated with Tension headaches?
none
What physical exam findings are associated with Migraine headaches?
Rare cases of aphasia, numbness, dysarthira or weakness
Usually no physical exam findings
What physical exam findings are associated with Cluster Headaches?
Red, tearing eye with rhinorrhea
Occasionally Horner Syndrome
What physical exam findings are associated with Giant Cell (Temporal) arteritis?
Visual loss, tenderness of the temporal area
What physical exam findings are associated with Pseudotumor Cerebri?
Papilledema with diplopia from CN 6 (Abducens) palsy
What is the most accurate test for Giant Cell arteritis?
Biopsy
How do you diagnose Pseudotumor Cerebri?
CT or MRI must r/o a mass lesion + LP must show increased pressure
What treatments are used for all forms of headache?
NSAIDs and Analgesics
What is added to treatment for Giant Cell (Temporal) Arteritis?
Glucocorticoids
What is added to treatment for Pseudotumor Cerebri?
Acetazolamide: To decrease CSF production
What drugs are used as abortive treatments for Cluster and Migraine Headaches?
Ergotamine or a triptin (sumatriptan, zolmitriptan etc)
What is added to treatment to abort Cluster headaches?
100% oxygen: +/- octreotide or intranasal octreotide
What is added to abortive treatment for migraines only?
Lasmiditan (5-HT1 agonist that does not cause vasoconstricition)
-used if contraindication to triptans
Calcitonin gene-related peptide (CGRP) antagonist (ubrogepant)
-when contraindication to triptans
Antiemetics: Prochlorperazine, Metoclopramide
What drugs are used to prevent Migraine Headaches?
Beta-blockers: Propranolol
CGRP: ERenumab, Fremanezumab, Galcanezumab
TCA: amitriptyline
SSRI
Antiepileptics: Topiramate
What drugs are used to prevent migraine headaches?
Verapamil
Prednisone
Lithium
