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Flashcards in Headache Deck (26):
1

What are things to ask about in regards to a headache?

Onset/Peak
Relieving factors
Exacerbating factors
Assoc. features
Demographics

2

What are red flags for headaches?

New onset headache >55
Known/previous malignancy
Immuno-suppressed
Early morning headache
Exacerbation by valsalva (coughing/sneezing which raise ICP)

3

What is released in response to stress?

Serotonin

4

What chemical irritates nerves and blood vessels resulting in pain?

Substance P

5

What are 3 types of visual aura?

Central scotomata (blurred portion)
Central fortification (weird lines)
Hemianopic loss (half is lost)

6

What are triggers?

Sleep
Dietary
Stress
Hormonal
Physical exertion

7

What drugs are good treatment for headaches?

NSAIDs
+/- anti-emetic

8

What are triptans?

5HT agonist

9

When would you consider Prophylaxis?

3+ attacks a month or very severe

10

How long must each dose of prophylaxis be trialed at?

minimum of 4 months

11

What drug reduces the frequency of migraines by 60-80%?

Propranolol
Avoid in asthma, PVD heart failure.

12

What are side effects for Topiramate (Carbonic anhydrase inhibitor)

Weight loss
Paraesthesia
Impaired concentration
Enzyme inducer

13

What other drugs can help treat migraines?

Amitriptyline
Gabapentin
Pizotifen
Sodium valporate

14

What are the Ipsilateral Cranial Autonomic features?

Ptosis
Miosis
Nasal stuffiness
Nausea/Vomiting
Tearing
Eye lid oedema

15

What are the 4 main types of TCA?

Cluster
Paroxysmal hemicrania
Hemicrania continua
SUNCT

16

What are treatments for a cluster headache?

High flow O2
Sub cut Sumatriptan 6mg
Steroids
Verapamil for prophylaxis

17

What's the treatment for Paroxysmal hemicrania?

Indomethicin

18

What is a paroxysmal hemicrania?

Severe unilateral headache, unilateral autonomic features
10-30 mins
1 to 40 per day

19

What is a cluster headache?

Severe unilateral headache
1 to 8 per day
45-90 mins a time

20

What does SUNCT stand for?

S = short duration (15-120 secs)
U = unilateral
N = Neuralgiaform headache
C = Conjunctival injections
T = Tearing

21

What is the treatment for SUNCT?

Lamotringe
Gabapentin

22

What two imaging techniques should be used with new onset unilateral cranial autonomic features?

MRI brain
MR angiogram

23

What is trigeminal neuralgia?

Severe stabbing unilateral pain
1 sec to 90 secs
10-100 times per day

24

What are treatments for trigeminal neuralgia?

Carbamazepine
Gabapentin
Phenytoin
Baclofen

25

What are surgical options for trigeminal neuralgia?

Ablation v Decompression

26

What should you also consider with a headache?

Eyes
Ears
Sinuses
Teeth
TMJ