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Exam 8 > Headaches > Flashcards

Flashcards in Headaches Deck (42):
1

Ventricles, choroid, brain parenchyma (except small part near midbrain), and small parenchymal and dural veins

are not pain sensitive

2

Activation of small area near ________ in midbrain, with high ______ conc., can cause migraines

dorsal raphe nucleus
serotonin

3

Benign reoccuring primary headache

migraine

4

Migraines begin in

brainstem

5

Usually last between 30 mins and 6 hrs

migraine w/o aura

6

Migraine with aura up to _________ before headache starts and up to _____ into headache

30mins
1 hour

7

Migraines are most common with or without auras?

With

8

Same as migraine with aura, but aura is very dramatic and can last for extended period of time. Mimics a stroke. Dx made by exclusion of more serious underlying pathology

Complicated migraine

9

Associated brainstem and PCA sxs including vertigo, dysarthria, ataxia, and diplopia. Neuro sxs onset ____________ headache

Basilar migraine
20-30 mins before

10

Occipital throbbing pain

basilar migraine

11

_________ is most severe and dramatic form of basilar migraine. Begins with ______ and followed by mixtures of vertigo, ataxia, dysarthria, and tinnitus.

Bickerstaff's migraine
total blindness

12

Abortive theraphy includes NSAIDS, serotonin agonists, and dopamine antagonists

Migraines

13

Triptans and ergots

serotonin agonists

14

Metoclopramide and prochlorperazine

dopamine antagonists

15

acetaminophen, aspirin, and caffeine

excedrin

16

acetaminophen, butalbital, and caffeine

fioricet

17

acetaminophen, isometheptene, and dichloralphenazone

midrin

18

Prophylactic agents include beta blockers, calcium channel blockers, tricyclic antidepressants, anticonvulsants, and serotonergic drugs

migraines

19

verapamil

calcium channel blocker

20

amitriptyline and nortriptyline

TCAs

21

gabapentin, valproic acid, topiramate, levetiracetam

anticonvulsants

22

Cyproheptadine

serotonergic

23

Cluster headaches derived in part from the ________, esp. in ppl with a prominent _______

hypothalamus
autonomic NS

24

With cluster headaches also have _____ activation of _______ via __________

secondary
trigeminal - autonomic reflex
trigeminal - hypothalamic pathway

25

Cluster headaches need to be treated acutely with

oxygen and triptan if pain hasn't subsided in 20 mins

26

Most affective abortive agent for cluster headaches

oxygen

27

prophylaxis for cluster headaches should only be started

at onset of cluster

28

Use high dose steroid (prednisone) and calcium channel blocker (verapamil) or maybe lithium for

prophylaxis of cluster headaches

29

High dose steroid (prednisone) will lessen _______ of attacks in cluster

frequency

30

Stress reduction, biofeedback, cognitive behavioral therapy, and improved sleep hygiene

tension headache

31

Abortive tx includes acetaminophen and NSAIDs

tension headache

32

Prophylaxis includes TCAs and antiepileptics

tension headache

33

gabapentin

antiepileptic

34

Increased ICP w/o evidence of mass, hydrocephalus, or dural venous stenosis/thrombosis

idiopathic intracranial hypertension

35

Idiopathic intracranial hypertension due to ____ CSF ________

decreased
absorption

36

Associated with tetracycline, oral contraceptives, hypervitaminosis A

idiopathic intracranial hypertension

37

New onset continuous daily headache, worsens with coughing, sneezing, and supine position. Sxs can progress to vision loss, diplopia, and pulsatile tinnitus

idiopathic intracranial hypertension

38

Scalp, periosteum of the sinuses, meninges, pial arteries, and arteries and major veins are

pain sensitive

39

Acetazolamide and topiramate are

carbonic anhydrase inhibitors

40

Transient monocular vision loss and jaw claudications

giant cell (temporal) arteritis

41

If missed could lead to permanent blindness via anterior ischemic optic neuropathy

giant cell arteritis

42

Tx for giant cell arteritis is

steroids