Headache Flashcards
(25 cards)
Most common headache
tension
treatments for tension headache
relazation
reassurance (explain muscles around head)
reduce analgesia
low dose amitriptyline
headache described as tight and constant or worse towards evening
tension
acute treatments for migraine
triptans - agonists at 5-HT 1b and 5HT-1d Rs
aspirin, paracetamol
anti-nausea (prochlorperzine, metoclopramide)
prophylactic migraine treatment
if more than 2 a month beta blockers low dose amitriptyline pizotifen topiramate sodium valproate candesartan (ca channel bloc) flunarazine Methysergide (retroperitoneal fibrosis SE)
What type of headache is botox used for?
migraine every 90 days
what is trigeminal autonomic cephalgia (TAC)
recurrent pain trigeminal distribution with autonomic features (eye watering, nasal congestion, redness eye)
commonest example is cluster headache: unilateral (circadian rhythmn)
what’s a paroxysmal hemicrania?
a type fo trigeminal autonomic cephalgia
occurs in women > men
shorter than cluster headache, unilateral, more frequent,
RESPONDS TO INDAMETHACIN
determine cluster headache from paroxysmal hemicrania?
do they respond to indamethacin?
how do you treat TACs
triptans
oxygen
high dose verapamil
indomethacin for paroxysmal hemicrania
what’s a common SE with beta blockers in asthma
bronchoconstriction
how many days using medication to be defined as medication overuse headache
15 a month
STOP THE ANALGESIA
worst headache I’ve ever had
just hit me, feels like been hit on the back of a head with a baseball bat
and then i just started vomiting
thunderclap headache ?
subarachnoid haemorrhage?
must consider both
define thunderclap
instant/rapidly appearing
investigations for thunderclap vs something else
CT head
lumbar puncture AFTER 12 hours - look for bilirubin and oxyhaemaglobin (might be an aneurysm)
features of raised intracranial pressure
headache mild diurnal variation: worse in morning, gone by lunchtime mild nausea neurological features look for papilloedema tumours, abcess, CSF blockage u
signs/symp of meningitis
fever photophobia neck stiffness altered conciousness petechial rash
treat with ceftriaxone or benzyl penicillin
what is temporal arteritis
occurs in people over age of 50
features of polymyalgia
jaw claudication
tender temporal artries raised ESR
what is the danger in temporal arteritis and how can we prevent it
blindness - use steroids early!
steroid SE
osteoporosis hirsutism hypertension truncal obesity muscle wasting more prone to infections
cerebral venous sinus thrombosis
essentially a DVT in cerebral vein often female on oral contraceptive pill severe headaches seizures maybe bilateral
low intracranial pressure features
headache on standing, eased with lying
can occur spontaneously
treat with blood patch for post-LP headache
when commonly get low intracranial headache
post lumbar puncture
what is transient global amnesia
possible variant of migraine
often during stress or exposure to cold
period of amnesia, unable to lay down new memory, keep repeating same question
few mins to few hours
