Headache Flashcards
(41 cards)
Primary Headache?
Headaches without identifiable structural cause
Secondary Headache?
Headaches with underlying structural/metabolic cause
Acute Headaches?
abrupt-sudden onset, rapid worsening
Subacute Headaches?
Gradual onset, progressive buildup
Is the brain parechyma has how many sensory receptors? Is it sensitive to pain?
None
No
Underlying cause of headaches?
Inflammation or physical traction of pain sensitive nerve fibers
Through what nerves is headache pain transmitted?
CN V, VII, IX, X
Upper Cervical roots C 2-3
What innervates pain sensitive structures of the anterior/inferior fossa and scalp?
Ophthalmic branch of CN V
What innervates the posterior fossa, the cervical muscles and posterior scalp?
CN IX, X, C 2-3
Where do the pain sensitive nerve fibers synapse? Where do they go from there?
Trigeminal nucleus caudalis & Dorsal Horn of the upper cervical spine –>
VPL & VPM –> Sensory cortex
What is a migraine?
Chronic neurological disorder causing recurrent headaches
Features of migraines?
Freq. unilateral Pulsating Moderate to severe intensity Duratation of 4 - 72 hrs Photophobia and/or phonophobia May be preceded by a prodromal phase May be preceded by an aura "Triggers" are frequent Frequent FHx
Prodrome symptoms for migraines?
Mood swings Odd food cravings Malaise or vague feeling of un-wellness Fatigue Muscle aches and stiffness
Scotoma?
Blind spot
Most common location for aura to occur?
Occipital (Visual) Cortex
Cause of an aura?
A spreading depression wave
When does the occurrence of migraines begin to decline?
55
In what population are migraines seen more often?
Women
Is there a correlation between genetics and migraines? If so, what?
Yes
Polygenic - one loci at 10q23
Familial hemiplegic migraine (dominant gene)
What is the anatomical substrate for migraines?
Trigeminovascular System
What does the trigeminovascular system involve?
CN V1 innervation of pain receptors located in the dura, meninges, and medium/large cerebral arterys and veins that lie on the surface of the brain and above the tentorium
What mediates the vascular changes associated with migraines?
Trigeminovascular System
Pathogenesis of migraines?
In hypersensitized pain pathways, migraines may be triggered by either a so-called “Central Generator” located in the brainstem or by internal or external triggers that initiate an aura that stimulates neurogenic inflammation of meningeal vasculature that then excites already hypersensitive peripheral and central pain pathways
Where are auras typically located?
Cortex
