Flashcards in Headache Deck (14):
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)
initial diagnostics for headache
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
blood in CSF causes?
what disease does this happen?
WBCs in CSF to inc
-1:500-1000, WBC:RBC = normal CBC
-seen in SAH
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)
-tension, cluster, migraine
-meningitis, SAH, tumor, temporal arteritis
tension headaches px, tx
-tightness of posterior neck muscles
-NO focal findings, stiffness, seizures, aura
-aggravated by movement, light, sound
-visual problems, flashing lights, "spectra fortification"
-focal neurologic findings = complicated migraine (stroke from vasospasm)
cluster headaches px
(wakes pt from sleep)
-men > women
-ipsilateral tearing*, rhinorrhea, red eye, Horner's
cluster headache tx
-100% O2 --> abortive therapy
-triptan, ergotamine --> abortive (constrict cerebral blood vessels)
-steroids, lithium --> chronic suppressive therapy
abortive therapy for migraines