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Neurology > Headache > Flashcards

Flashcards in Headache Deck (14):
1

if headache px, must rule out..?

-tumor (focal deficits, papilledma, n/v)
-SAH (sudden onset, stiff neck, photophobia, loss of consciousness)
-temporal arteritis (vision changes, scalp/ temporal tenderness)

2

initial diagnostics for headache

CT

3

pt px with visual changes & temporal tenderness. what do you do next?

give steroids while waiting for temporal artery biopsy

-steroids = best initial
-biopsy = most accurate
-not a CT

4

blood in CSF causes?
what disease does this happen?

WBCs in CSF to inc

-1:500-1000, WBC:RBC = normal CBC
-seen in SAH

5

SAH dx, tx

-CT or LP

-angiogram --to find origin of bleed & determine surgical repain

-dexamethasone (dec inflammation)
-embolization, clipping (via angiogram)
-nimodipine = CCB; dec risk of stroke by preventing vasospasm
-shunt (to prevent hydrocephalus)

6

primary headaches

-recurrent
-tension, cluster, migraine

7

secondary headaches

-sudden, severe
-meningitis, SAH, tumor, temporal arteritis

8

tension headaches px, tx

-bilateral
-band like*
-tightness of posterior neck muscles

-NO focal findings, stiffness, seizures, aura
-tx: NSAID

9

migraine px

-unilateral
-aura
-pulsatile, throbbing
-aggravated by movement, light, sound
-visual problems, flashing lights, "spectra fortification"

-focal neurologic findings = complicated migraine (stroke from vasospasm)

10

migraine tx

-beta blockers
-CCB
(prevent vasospasm)

11

cluster headaches px

-excruciating*
(wakes pt from sleep)
-men > women
-unilateral
-ipsilateral tearing*, rhinorrhea, red eye, Horner's

12

cluster headache tx

-100% O2 --> abortive therapy
-triptan, ergotamine --> abortive (constrict cerebral blood vessels)
-steroids, lithium --> chronic suppressive therapy

13

abortive therapy for migraines

-NSAIDS
-ASA
-acetaminophen
-triptans
-ergotamine

14

prophylactic therapy for migraines

-beta blockers (propanolol = best initial)
-CCBs (verapamil, diltiazem)
-TCAs
-SSRIs
-valproic acid
-topiramate
-lithium & steroids
-seizure medications --> phenytoin, carbamazepine, topiramite, lamotragine,valproic acid