headaches

Question 1

what is the most common type of headache

Answer 1

migraine

Question 2

What are the primary types of headaches

Answer 2

tension, migrain and cluster

Question 3

what are the secondary types of headaches

Answer 3

rebound- medication overuse

Question 4

What is considered a frequent headache

Answer 4

HA 2-14 days a month

Question 5

what are chronic headaches

Answer 5

15+ days a month

Question 6

what usually cause tension headaches

Answer 6

peripheral m tenderness and stress, tension, posture etc

Question 7

What is the Ddx criteria for tension headaches

Answer 7

bilateral head pain, steady pain, mild to moderate, no aggravation
pain lasts 30 min to 7 days

Question 8

What are the acute Tx for tension headaches

Answer 8

NSAIDs tylenol, triptans, muscle relaxants

OMT

Question 9

What are the preventative methods for tension headaches

Answer 9

tricyclic antidepressants
SSRIs MAOIs
anticonvulsants
tizanidine
PT OMT
accupuncture

Question 10

what areas of body should be Tx with OMT for tension headaches

Answer 10

upper thoracics, ribs, cervicals, cranial dysfunction like TMJ
lumbar sacrum and pelvis

Question 11

What are the theories for migrains

Answer 11

vascular dilation or constriction
cortical spreading depression (depolarization)
trigemino-muscular( activation)
sensitization to nociceptive input

Question 12

What are believed to play a role in development of migrain and increase susceptibility

Answer 12

genetics.

most common from mom

Question 13

What are precipitating factors for migrains

Answer 13

emotional stress, hormonal changes, not eating, weather change, sleep problems, odors, neck pain, lights ETOH, smoke, computers

Question 14

What are the prodromal effects of migrains

Answer 14

euphoria, depression, irritabilitym food cravings, constipation and neck stiffness

Question 15

Which type of headache commonly has auras

Answer 15

migraines

usually visual

Question 16

What is the HA stage of migrains

Answer 16

throbbing unilateral, intensity increases, nausea/vomiting, photo/phonophobia
chills/sweating

Question 17

What are the postdromal effects of migraines

Answer 17

movement of head causes pain, exhaustion, mild elation or euphoria

Question 18

What is the acute Tx for mild migraines

Answer 18

NSAIDs, tylenol, caffeine, OMT

Question 19

what is the acute Tx for moderate/severe migraines

Answer 19

triptans, sumatriptan-naproxen
ergot alkaloids
opiates
OMT

Question 20

What are preventative actions for migrains

Answer 20

beta blockers, Ca ch blockers, ACE inhibitors, antidepressants, anticonvulsants
acupuncture, OMT, surgery
riboflavin B2
opoids etc

Question 21

What are of body is Tx with OMT for migraines

Answer 21

upper thoracic spine, upper ribs, cranial, cervical, abdomen and sacrum

Question 22

What are episodic cluster headaches

Answer 22

daily attacks with periods of remission. involve pain around one eye

Question 23

what are chronic cluster headaches

Answer 23

daily attacks with no significant periods of remission

Question 24

what are the theories of cluster headaches

Answer 24

hypothalamic activation with secondary activation of trigeminal autonomic reflex
neurogenic inflammation at wall of cavernous sinus that prevents venous drainage

Question 25

what can blocakge of cavernous sinue lead to

Answer 25

injury of SANs fibers in internal carotid a

Question 26

what are Sx of cluster headaches

Answer 26

ptosis miosis lacrimation, rhinorrhea, conjunctival injection, nasal congestion

Question 27

what is the Tx for acute cluster headaches

Answer 27

``` O2, triptans, (not in CV patients) octreotide (somatostatin) lidocaine ergots OMT ```

Question 28

What are the preventative methods for cluster headaches

Answer 28

``` verapamil glucocorticoids lithium methysergide topiromate surgery occipital n procedures deep brain stimulation OMT ```

Question 29

What are most common causes of medication abuse leading to HA

Answer 29

``` opoids aspiring tylenol butalbital triptans ergotamine NSAIDs ```

Question 30

If HA presents on waking what could it be

Answer 30

medication overuse HA

Question 31

What happens when withdraw abused HA medication

Answer 31

get worse then better

Question 32

what is the bridge theory

Answer 32

used to help people wean off their medication causing HA, give them a different kind

Question 33

What are indications for imaging for HA complaint

Answer 33

``` in setting of other disease worst HA ever "thunderclap" waking because of pain rapid increase in frequency frontal HA worse when leaning forward (CHILDREN) ```

Question 34

what is included in Patient Ed as DO

Answer 34

self Tx with CV4