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Year 3 Conditions > Headache > Flashcards

Headache Flashcards

1
Q

Mnemonic for remeering sinister causes of headache

A

Vascular
Infective
Visual threatening- GCA, apoplexy, cavernous sinous thrombosis, acute glaucoma
Intracranial pressure- SOL, HTN, cerebral oedema from trauma, hydrocephalus
Dissection- carotid

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2
Q

What needs to be considered with headache and LOC

A

SAH must be ruled out
If trauma could be haematoma
Infective causes can lead to this

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3
Q

What is implied by LOC following lucid interval

A

Extradural haematoma

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4
Q

What is implied by fluctuating LOC

A

Subdural haematoma

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5
Q

How would felt like hit in back of head indicate

A

SAH

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6
Q

What do seizures or focal neurology suggest about a headache

A

Intracranial or could be migraine aura

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7
Q

What does recurrent headaches suggest about overall pathology

A

Not that sinister

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8
Q

What is most common cause of amaurosis fugax

A

TIA

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9
Q

What to think when amaurosis fugax alongside headache

A

Any under VIVID

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10
Q

What to ask about if suspect GCA

A

Scalp tenderness
Jaw pain
Shoulder pain

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11
Q

If suspect carotid dissection what should ask about

A

Yoga

Neck chiropractic manipulation

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12
Q

What does headache worse when lying or bending over suggest

A

Raised ICP as no support on head

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13
Q

What does headache with morning nausea suggest

A

Raised ICP

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14
Q

What does headache worse when standing up suggest

A

Low ICP- very common after LP and will resolve after analgesia and time

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15
Q

What do constitutional Sx with headache suggest

A

TB
Malignancy
Chronic inflammation like temporal arteritis

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16
Q

What would be considered if PMH of immunosuppression such as HIV or recent transplant in headache Px

A

Increased risk of infection

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17
Q

What would history of TB in headache presentation suggest

A

Potential tuberculoma, abcess and toxoplasmosis

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18
Q

What would history of cancer and headache suggest

A

Metastases

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19
Q

What does tongue deviation suggest

A

12th nerve palsy

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20
Q

What can cause 12th nerve palsy

A

Carotid dissection

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21
Q

What is most likely cranial nerve palsy

A

6th as has longest route

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22
Q

What appears as convergent squint inwards or failure to abduct eye

A

6th nerve palsy

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23
Q

Common cause of 6th nerve palsy

A

Something compressing eye, can be from ICP

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24
Q

What does exopthalmos with headache suggest

A

Cavernous sinus thrombosis

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25
What does a cloudy cornea suggest
Acute glaucoma
26
What does reduced visual acuity and headache indicate
Acute glaucoma and GCA
27
Non sinister headaches
``` Tension Migraine Sinusitis Medication overuse TMJ syndrome Trigeminal neuralgia Cluster headache ```
28
What are 2 types of headache
Primary and secondary | In primary if removed headache then would be no harmful pathology
29
Questions for non-sinister headaches
Suffer any headaches usually- migraine users susceptible to medication overuse Triggers- migraines and tension types How disabling? Aura?
30
What does stress fatigue dehydration and hunger trigger
Tension headaches
31
How do tension headaches present
``` Feel like tight band around head Bilateral Can radiate to shoulders and neck No more than few hours Only disabling if for regular basis ```
32
What are migraine aura differentials
TIAs
33
Which sex are medication overuse headaches particularly prevalent in
Females
34
Presentation of sinusitis
Facial pain that worsens with movement | Associated with coryzal symptoms
35
Who does TMJ syndrome most commonly occur in
20-40
36
How does TMJ syndrome present
Get headache and dull ache in muscles of mastication that radiates to ears and jaw
37
What headache can lead to hearing click when move neck
TMJ
38
How does trigeminal neuralgia present
Stabbing pain that only comes about when patient touches or does anything involving face
39
What can separate trigeminal neuralgia from cluster and migraines
Trigeminal rarely wakes people up at night
40
Pain over eye differentials
Cluster Migraine GCA
41
When is only time you give preventative medication for migraines
If occur on a fortnightly basis
42
Examinations ordered for non-sinister headaches
Obs- rule out malignant HTN Head and neck examination- muscle tenderness and stiffness Focal neurology signs suggest something more sinister Fundoscopy- ICP and HTN
43
What looking for SAH on CT
Blood in fissures and in CSF
44
Management of SAH if CT positive
Give Nimpodipine a CCB that reduces spasm of arteries preventing a stroke Angio to find location of bleed and platinum coil to clot the bleed
45
How are visual problems described in migraines
Slow march where gradual worsening of visions and resolves in similar way
46
Other than TIA what else can cause positive signs sporadically
Epilepsy
47
Common epilepsy signs
Feeling sensation in her skin Convulsions Flashing lights seen
48
Most common brain tumour in children
Medulloblastoma of cerebellum- ataxia symptoms
49
IF brain tumour is strongly suggested what are steps to management
Do urgent MRI | Will treat with dexamethasone to reduce swelling and ease headache in mean time then will have surgery
50
What are examples of primary headache
Migraine Cluster Tension
51
RFs tension headache
Stress | Disturbed sleep
52
Management of tension headaches
Avoid triggers and make a headache diary Simple analgesia Beware of medication overuse headaches
53
First line management of migraines
Avoid triggers and make a headache diary | Simple analgesia
54
If simple analgesia doesnt work with migraines what is given
Triptans
55
If want to prevent migraines what is first line
Propanolol or topiramate
56
If Propanolol or topiramate dont work in preventing migraines what is given
Amitryptiline
57
What is topiramate
An anti-epileptic
58
What is amitriptyline
An antidepressant
59
When do cluster headaches normally happen
At night
60
Where is pain in cluster headache
Behind the eye
61
What can trigger cluster headaches
Alcohol or strong smells
62
Assocaited symptoms of cluster headache
Watery, red eye Facial flushing Nasal congestion
63
Signs on examination of cluster headache
Partial horners with ptosis and miosis

Year 3 Conditions (33 decks)

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