Flashcards in LG 1.5 Headache Scheme Introduction Deck (17)
What is a primary Headache?
-Intrinsic to the brain without any underlying structural, infectious toxic/metabolic cause/psychiatric cause.
What defines a migrane?
i. A Neurologic Disorder
ii. Various symptoms
iv. Usually headaches
What are the 3 types of migraines?
i. *Common no aura/headache;
ii. *Classic with aura and headache
iii. *Aura only/ no headache
What are common symptoms of migraines?
1. Usually one-sided. Throbbing. Incapacitating
2. Nausea Vomiting
3. Sensitive to light and sound
4. Worse with movement or straining.
What is the normal duration of a migraine?
Duration of 4-72 hours.
How long does the aura normally last?
Aura lasts 5 to 60 minutes
What are the four stages of migraines?
1) Prodrome: a day or so before the following migraine stages; Fatigue, Difficulty Concentrating; Irritability, Discomfort
2) Aura: generally right before the headache; usually resolves right before the headache starts
3) Headache: often one sided, throbbing
4) Post (postdrome)-after headache resolves there may be vague lethergy, confusion, difficulty with recognition, sluggishness
What are some examples of migraine triggers?
ii. Hormones (women)
iii. Skipped meals
v. Sleep changes
What is the brainstem involvement with migraines?
It is the origin of the migraine; when activated can send pain centers directly to the brain and can initiate CSD.
What is the Third cortical pathway involvement in migraines?
Some migraine sufferers have Abnormal Sensory Processing of pain signals; (that is, some people have a lower pain/migraine perception threshold; genetically based)
What is the current migraine mechanism?
1) CNS Event trigger
2) Cortical Spreading Depression
3) Surface cortex
4) aura (neurons)
5) Depolarization (scintillations)
6) Depression (scotoma) Interior cortex
7) No aura (white matter) CSP (at 2-3mm./min.)
What is involved with meningeal irritation?
Meningeal irritation (pain) to Trigeminal nerve (Cr.N V) to brainstem to pain sensitive areas of the brain via the thalamus
What is a secondary headache?
Headache attributed to head and/or neck trauma,; cranial or cervical vascular disorder: non-vascular intracranial disorder; substance or its withdrawal; infection, disorder of homeostasis; psychiatric disorder; Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures
What is a thunderclap headache?
so called because of its rapid onset and severity of pain. (like being hit with a bolt of lightening). Defining features include maximal pain intensity reached in seconds to a minute. (migraine generally reaches its peak over tens of minutes to hours).
Why must you treat a thunderclap headache as an emergency?
-Must rule out a sudden intracranial bleed from ruptured intracranial aneurysm.
What is a valsalva maneuver?
Forceably exhale while keeping mouth and nose closed