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Neurology > Headache > Flashcards

Flashcards in Headache Deck (23):
1

Red flag headache symptoms- as many as possible...

-Compromised immunity
-History of malignancy
- Abrupt onset
- Diurnal or postural variation
- Getting progressively worse
- New onset neurological deficit (focal, generalised e.g. cognition, consciousness)
- triggered by cough, sneeze
-head trauma
- Systemic symptoms/signs (e.g. pyrexia, vomiting)
- Neck stiffness
- Papilloedema
- Tender temporal arteries

2

Potential investigations in headache (6)

Imaging
CSF (if normal imaging in suspected raised ICP)
FBC, plasma viscosity, CRP

3

What is papilloedema a sign of?

Raised ICP

4

Symptoms of idiopathic intracranial hypertension (3)

Headache, nausea and vomiting, visual loss

5

Typical patient for idiopathic intracranial hypertension

Obese female

6

Treatment of idiopathic intracranial hypertension (3)

Weight loss
Acetazolamide
Shunt

7

Symptoms of migraine (5)

Aura or prodrome
Pulsating character
Nausea and vomiting
Photophobia
Phonophobia

8

Possible migraine precipitants (4)

Menstruation
Stress
Cheese, red wine, citrus fruits
Caffeine (may also help)

9

Treatment of migraine (2)

Aspirin + paracetamol (first-line)
Triptan + paracetamol (second line)

10

Prophylaxis of migraine (4)

Propanolol
AEDs (topiramate, sodium valproate)
Gabapentin
Amitriptylline

11

Symptoms of tension headache (2)

Bilateral non pulsatile headache
Lack of aura/nausea and vomiting

12

Treatment of tension headache (2)

Relaxation therapy
Antidepressants

13

Symptoms of cluster headache (3)

Severe unilateral pain around eye
Lacrimation
Rhinorrheoa

14

Management of cluster headache:
a) acute
b) prophylaxis

a) 100% oxygen and nasal/subcut triptan
b) verapamil, prednisolone, topiramate, lithium, lignocaine infusion

15

Symtpoms suggestive of giant cell arteritis (3)

Tender scalp
Jaw claudication
Associated polymyalgia rheumatica

16

Main investigations in GCA (2)

Elevated ESR
Temporal artery biopsy

17

Mechanism of action of triptans

5-HT (serotonin) agonists

18

Management of GCA (2)

High dose prednisolone
Urgent review by opthalmology

19

Unilateral facial pain evoked by light touch is a history suggestive of...

Trigeminal neuralgia

20

Causes of an acute single episode of headache (6)

Meningitis
Encephalitis
Sinusitis
Glaucoma
SAH
Head injury

21

Other causes of a chronic headache (3)

Psychological
Chronic raised ICP
Paget's disease of the skull

22

"Triptan sensations" (3)

Tinging
Heat
Tightness/heaviness/pressure

23

Contraindication to triptans

History/significant risk factors for IHD/CVA