Flashcards in headache Deck (61)
what percentage of people have migraines?
1 in 10
what perecentage of people people seen in Neurology clinics have benign headaches?
1 in 10
if the onest of the headache is sudden, what does that indicate?
if the onset of headache evolves over hours to days what does it indicate?
Infection/inflammatory/↑ICP ( intra cranial pressure)
if the onset of headache evolves over weeks to months(chronic) what does it indicate?
Chronic daily headache/ ↑ICP
if the headache is constant and does not stop what is that a indication of?
Medication overuse/chronic migraine/hemicrania continua
If the headache is episodic in periodicity what is that a indication of?
Migraine /Cluster headache
what is hemicrania continua? How do you treat it?
is a persistent unilateral headache responds to indomethacin
what are the assoicated symptoms of headaches?
Diurnal variation/postural element
Nausea and vomiting
Autonomic features (lacrimation/Horners/red eye) runny nose
what are the red flags for headaches?
if a patient who has a headache lies down in a dark room to help relieve the pain what is that a indicate of?
if a patient who has a headache is agitated and paces to help relieve the pain what is that a indicate of?
is migraine familial?
on examination of someone with a headache what are you looking for?
Fundal changes (papilloedema)
Cranial nerve signs/Horners Syndrome
Long tract signs intracerebral space occupying lesion
what are the primary headache syndromes?
what are the secondary headache syndromes?
Intracranial venous thrombosis
Giant cell arteritis
Tumour with raised ICP
Benign intracranial hypertension
what is hypnic headache?
headache that wakes a person up at night
when does Coital headache occur?
during sexual activity
what is Cluster headache ?
a type of severe headache in which the pain is usually limited to one side of the head, tending to recur over a period of several weeks
what are symptoms of SAH?
Awoken with severe, sudden onset (seconds) head pains
Back of head
Vomitting and confused
Clinically apyrexial, refusing fundoscopy and globally hyper-reflexic
Ocular movements appear impaired --> SO and LR unnoposed -->right oculomotor nerve palsy
what is the most common cause of SAH?
Coiling/clipping berry aneurysm (85% of cases)
if the Ct scan of a person with suspected SAH what is the next step?
Lumbar puncture by experienced hand(>/= 12 hours)
Xanthochromia (bilirubin released from lysing red cells)
when should CT scan be done for a person with SAH??
95% sensitive if done within first 48 hours
why would you not give morphine for someone with SAH?
morphine increase ICP
if both the LP and CT are normal then should we still suspect SAH?
no we shouldn't unless if the tests were done 48hrs after the person had a SAH. Then it is not sensitive enough and a angiograph should be done
wht are diabetics at further risk of infection?
because they are immunocompromised
what are the reasons for increase ICP?
Mass Effect (brain tumour, abscess)
Brain swelling (Hypertensive encephalopathy)
Increased venous pressure
CSF outflow obstruction (hydrocephalus)
Increased CSF production (meningitis/SAH)
what are the symptoms of increase ICP?
Headache (worse on lying or awakening)
signs of increaes ICP?