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MS2 - Nervous System > Headache > Flashcards

Flashcards in Headache Deck (20):
1

Differentiate primary and secondary headaches.

Primary headaches: 90% of all headaches, no underlying pathology

Secondary headaches: 10%, underlying intracranial or systemic pathology, red flags, often constant

2

What does TTH stand for?

Tension-type headache

3

In evaluating patients, what things should make you consider secondary headaches?

Red flags or atypical presentation of primary headache

4

What is the SNOOP mnemonic for headache red flags?

Systemic/secondary symptoms (fever, weight loss, HIV)

Neurologic symptoms

Onset (sudden/abrupt)

Older patients

Past history (is this headache different than past headaches)

5

Migraine used to be thought of as a vascular headache, but now it's thought to be ______________.

related to the trigeminal ganglion activation – it is not known where migraines start

6

What phenomenon is thought to underlie spreading visual auras?

A wave of oligemia (hypovolemia) that radiates out from the occipital cortex

7

What is the key difference between migraines and cluster headaches?

Cluster headaches have autonomic involvement, particularly with restlessness. The classic example is a man who paces around with throbbing head pain (cluster headache) vs a woman with throbbing head pain who lies down in a dark, quiet room (migraine).

8

What triggers cluster headaches?

Alcohol
Vasodilators

9

How many recurring headaches do you need to have to be considered migraines?

5 that last at least four hours

10

What criteria determine migraine?

At least two of these:
Pulsating
Unilateral
Pain increase with activity
Moderate or severe discomfort

And one of these:
Nausea/vomiting
Photophobia/phonophobia

11

True or false: most migraine sufferers have auras.

False. Only 30% do

12

Tension-type headaches must have two of the following symptoms: _____________. Importantly, they must not have _______________.

Bilateral
Moderate/severe pain
Not aggravated by activity
Pressing/tension sensation

Nausea/vomiting

Also, they can only have either photophobia or phonophobia... not both.

13

What are cluster headaches?

Headaches that have ipsilateral periorbital or temporal symptoms, such as the following: lacrimation, conjunctival injection, ptosis, rhinorrhea, eyelid edema, ear "fullness."

14

What is the typical duration of trigeminal neuralgia?

Short (less than 2 min)

15

What is the most common risk factor for increased intracranial hypertension?

Obesity

16

TTH and migraines are the ____ and _____ most prevalent diseases in the world.

2nd; 3rd

17

TTH account for _____ percent of primary headaches.

90

18

What neuroimaging advice was given in this presentation?

Don't do neuroimaging when a primary headache meets migraine criteria.
Use MRI over CT except in emergencies.

19

What med guidelines were given in this presentation?

Don't prescribe opioids.
Don't recommend frequent OTC med use.

20

Explain Brudzinski's sign.

If a person is lying down, raise their head. If they have meningismus, then their legs will likely rise, too.

Decks in MS2 - Nervous System Class (111):