Flashcards in Headache Deck (20):
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
What does TTH stand for?
In evaluating patients, what things should make you consider secondary headaches?
Red flags or atypical presentation of primary headache
What is the SNOOP mnemonic for headache red flags?
Systemic/secondary symptoms (fever, weight loss, HIV)
Past history (is this headache different than past headaches)
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
What phenomenon is thought to underlie spreading visual auras?
A wave of oligemia (hypovolemia) that radiates out from the occipital cortex
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).
What triggers cluster headaches?
How many recurring headaches do you need to have to be considered migraines?
5 that last at least four hours
What criteria determine migraine?
At least two of these:
Pain increase with activity
Moderate or severe discomfort
And one of these:
True or false: most migraine sufferers have auras.
False. Only 30% do
Tension-type headaches must have two of the following symptoms: _____________. Importantly, they must not have _______________.
Not aggravated by activity
Also, they can only have either photophobia or phonophobia... not both.
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."
What is the typical duration of trigeminal neuralgia?
Short (less than 2 min)
What is the most common risk factor for increased intracranial hypertension?
TTH and migraines are the ____ and _____ most prevalent diseases in the world.
TTH account for _____ percent of primary headaches.
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.
What med guidelines were given in this presentation?
Don't prescribe opioids.
Don't recommend frequent OTC med use.