Headache Flashcards
what should you ask women of child bearing age
is there any possibility you could be pregnant?
-> preeclampsia
are you taking hormone contraception?
could it be related to menses?
what anti emetics can be considered in a migraine
domperidone, prochlorperazine and metoclopramide
also improve gut motility
what drugs can be used as prophylaxis for migraine
beta blockers
amytriptaline
what should you look for on examination
papilloedema peripheral field loss enlarged blind spots sixth nerve palsy (giant cell arteritis) extensor plantar response ataxia oral hairy leukoplakia rash
what is second line drug migraine prevention
sodium valproate or topiramate
calcium channel blockers
verapamil
amlodipine
antihypertensive agents including ACE and ARB
headaches with malaise, sweats and proximal muscle aching in someone over 55
GCA
GCA symptoms
blindness headache pain over temples double vision difficulty opening the mouth aortic aneurysm polymyalgia rheumatica
what might you find in someone with raised ICP
papilloedema (optic disk heads are blurred due to swelling, haemorrhagic changes around the disk margins) restricted visual fields blind spots headache vomiting deteriation of consciousness bradycardia hypertension papilloedema
how might people with brain tumours present
raised ICP symptoms neurological defects due to damage or compression cortical or meningeal irritation hormonal effect systemic effects
what is the most common primary brain tumour
glioma
what is normal ICP
<15 mmHg in adults
lower in children and very low in neonates
what are the causes of raised ICP
increase in brain tissue mass
increase in CSF
increase in blood volume
what is the worst type of glioma
multiform
how do you tell the difference between a tumour on a scan and another SOL
-usually different colours suggesting the tumour is made of different consitsncecy
may have area of oedema around
why is dexamethasone sometimes helpful in SOL
can reduce the odema
