IPC

Question 1

What are common causes of headaches?

Answer 1

Tension, stress, sinus issues, underlying conditions

These factors can influence headache intensity.

Question 2

What are nociceptors?

Answer 2

Pain receptors in skin, organs, blood vessels, etc.

They transmit pain signals to the brain.

Question 3

What stimuli activate nociceptors?

Answer 3

• Mechanical pressure
• Temperature extremes
• Chemicals
• Tissue damage

These stimuli can lead to the sensation of pain.

Question 4

Name key chemicals that activate nociceptors.

Answer 4

• Prostaglandins
• Bradykinin
• Histamine
• Substance P
• ATP
• Acidic pH

These chemicals play a significant role in pain signaling.

Question 5

What are the two types of nociceptors and their pain characteristics?

Answer 5

• A-delta fibers: sharp, localized pain
• C fibers: dull, burning, poorly localized pain

Different fibers transmit different types of pain sensations.

Question 6

Describe the pain pathway.

Answer 6

Nociceptors → Peripheral nerves → Dorsal root ganglion → Spinal cord → Thalamus → Cortex

This pathway illustrates how pain signals travel to the brain.

Question 7

Which intracranial structures are pain-sensitive?

Answer 7

• Venous sinuses
• Tentorium
• Dura mater
• Blood vessels (e.g., middle meningeal artery)

Brain tissue itself is nearly pain-insensitive.

Question 8

What are referred pain areas above and below the tentorium?

Answer 8

• Above tentorium: Trigeminal nerve → front of head
• Below tentorium: Glossopharyngeal/vagal/C2 → back of head (occipital)

This indicates how pain can be perceived in different areas from a single source.

Question 9

What are some extracranial headache causes?

Answer 9

• Muscle spasm in scalp/neck
• Nasal/sinus infections
• Eye strain
• UV light exposure

These causes can lead to tension-type headaches.

Question 10

List red flag signs of headache.

Answer 10

• Systemic symptoms (fever, meningitis signs)
• History of neoplasm
• Neurological deficits (e.g., seizures)
• Sudden onset
• Age >50
• Pattern changes
• Positional or exertion-triggered headache
• Papilledema (increased ICP)
• Progressive or atypical features

These signs may indicate a more serious underlying condition.

Question 11

Define migraine.

Answer 11

Primary headache with recurrent, often unilateral pain + nausea, photophobia, phonophobia

Migraines can significantly impact the quality of life.

Question 12

What is the peak age for migraine occurrence?

Answer 12

30–39

Migraines are more common in females.

Question 13

What are common triggers for migraines?

Answer 13

• Certain foods (tyramine-rich)
• Stress
• Dehydration
• Sleep issues
• Hormones

Identifying triggers can help in managing migraines.

Question 14

Describe the pathophysiology of migraines.

Answer 14

Meningeal nociceptor activation → trigeminovascular pathway → neurogenic inflammation

This process is crucial in understanding migraine development.

Question 15

What are the four stages of a migraine?

Answer 15

• Prodrome
• Aura
• Headache
• Postdrome

Each stage has distinct characteristics and symptoms.

Question 16

What are the clinical features of a migraine headache?

Answer 16

Unilateral, throbbing, worsens with activity

Migraines can be accompanied by nausea and sensitivity to light or sound.

Question 17

How is a migraine diagnosed?

Answer 17

Clinical + rule out red flags

Diagnosis often relies on patient history and symptom patterns.

Question 18

What treatments are available for migraines?

Answer 18

• Avoid triggers
• Rest in a quiet, dark space
• NSAIDs, acetaminophen, caffeine combos
• Sumatriptan (serotonin receptor agonist)

Treatment can vary based on individual needs.

Question 19

Define tension-type headache (TTH).

Answer 19

Dull, non-pulsating, bilateral, ‘band-like’ headache

TTH is the most common type of headache.

Question 20

What is the epidemiology of tension-type headaches?

Answer 20

Most common headache (86% lifetime incidence), peak age 30–39, more in females

TTH can occur episodically or chronically.

Question 21

What worsens tension-type headaches?

Answer 21

Fatigue, stress, poor posture

These factors can contribute to the frequency and intensity of TTH.

Question 22

What are the clinical features of tension-type headaches?

Answer 22

Episodic, no nausea or aura, may have mild photophobia or phonophobia

TTH is not worsened by physical activity.

Question 23

How is tension-type headache diagnosed?

Answer 23

Clinical + normal neuro exam; headache diary helpful

A headache diary can assist in tracking patterns and triggers.

Question 24

What treatments are available for tension-type headaches?

Answer 24

• Non-pharmacologic: lifestyle changes, CBT, relaxation
• Pharmacologic: NSAIDs, acetaminophen

Treatment options may vary based on individual circumstances.

Question 25

Define cluster headache.

Answer 25

Severe unilateral periorbital headache with autonomic symptoms ## Footnote Cluster headaches are characterized by their intensity and duration.

Question 26

Who is predominantly affected by cluster headaches?

Answer 26

Adult males ## Footnote This demographic trend is notable for cluster headache occurrences.

Question 27

What are common triggers for cluster headaches?

Answer 27

* Alcohol * Histamine * Seasonal patterns (spring/autumn) ## Footnote Recognizing triggers can help in managing cluster headaches.

Question 28

What are the clinical features of cluster headaches?

Answer 28

Sudden onset, severe, short attacks (15 min – 3 hr), occurs in clusters, often nocturnal ## Footnote Autonomic symptoms may include eye redness and nasal congestion.

Question 29

How is cluster headache diagnosed?

Answer 29

Clinical based on classic pattern ## Footnote Diagnosis relies on the identification of specific symptoms and their patterns.

Question 30

What treatments are available for cluster headaches?

Answer 30

* 100% oxygen therapy * Sumatriptan ## Footnote These treatments can provide relief during acute attacks.