Headaches Flashcards
(46 cards)
Headache is a common symptom, and it is associated with many conditions.
Name the two types of headaches
Primary headaches
Secondary headaches
What is the difference between primary and secondary headaches
Primary headaches – those that are not associated with an underlying condition e.g., migraine, tension headache, cluster headache
Secondary headaches – those that are associated with an underlying pathology e.g., trauma, intracerebral infection, vascular disorders, medication overuse, neoplasm
Name some of the red flag symptoms that may be associated with headaches if the patient had meningitis
Fever, photophobia or neck stiffness
Name the red flag symptom that may be associated with headaches if the patient had temporal arteritis or glaucoma
Visual disturbance
Why is fundoscopy examination important in patients presenting with a headache
- Checking for papilloedema (oedema of the optic disc)
- Papilloedema indicates raised intracranial pressure, which may be due to a brain tumour, benign intracranial hypertension or an intracranial bleed
Papilloedema, seen of fundoscopy, indicates?
Indicates raised intracranial pressure
What are the characteristic features of a migraine
Recurrent, severe headache which is usually unilateral and throbbing in nature
Name some of the associated symptoms for a migraine
Aura, nausea and photosensitivity
The aura may be visual e.g., zigzags, sensory e.g., paraesthesia spreading from fingers to face
Name some of the triggers that can bring about a migraine
Aggravated by, or causes avoidance of, routine activities of daily living
In women may be associated with menstruation
How long can a migraine last?
4-72 hours
How do you diagnose a migraine
Clinical diagnosis i.e. history
Presence of aura confirms diagnosis
How do you manage an acute migraine attack
Oral triptan e.g., Sumatriptan
AND
Paracetamol and/or NSAID
Triptan e.g., Sumatriptan is contraindicated in what patient group
Those with ischaemic heart disease
What are the characteristic features of a tension headache
Chronic recurring, bilateral headache, often described as a “tight-band” around the head
Non-pulsatile
In what gender is tension headaches most common in?
Females
Name some of the associated symptoms that may accompany a tension headache
Tenderness of the scalp muscles
Name some of the triggers that can bring about a tension headache
Stress
Not aggravated by routine activities of daily living
How long can a tension headache last?
30mins to 7 days
How do you diagnosis a tension headache
Clinical diagnosis i.e. history
What is the long term mangement of migraines
Avoid triggers
Prophylaxis with Propranolol (beta blocker) or Topiramate
What is the management of tension headaches
Symptomatic relief
Analgesia e.g, paracetamol or NSAIDS
Lifestyle e.g, sources of stress
What are the characteristic features of a cluster headache
Recurrent attacks of sudden-onset unilateral periorbital pain i.e. pain around one eye, which is affect the same.
In what gender is cluster headaches most common in?
Males
What is the typical age of onset of a cluster headache
Age of onset is usually between 20 and 40 years
