Migraine + Cluster Headaches Flashcards
what is a new, severe, or acute headache most likely due to?
intracranial disorder
what is the likely pathophysiology of a migraine?
neuronal dysfunction that leads to vasodilation
euphoria, depression, irritability, food cravings, constipation, neck stiffness, and increased yawning associated with a migraine that occurs 24-48 hours prior to onset
prodrome
positive or negative symptoms associated with migraine that occur gradually and lasts 5-60 mins
aura
a patient is experiencing a pulsatile headache with unilateral distribution, N/V, photophobia, and phonophobia. Dx?
migraine
what is the diagnoses criteria for migraine? (5)
at least 5 attacks
lasts 4-72 hours
at least 2 attacks with aura
at least 2 (unilateral, pulsatile, mod-sev intensity, worse with activity)
at least 1 (N/V, photophobia/phonophobia)
what is the symptomatic treatment for migraines? (3)
acetaminophen/NSAIDs
triptan (subQ)
naproxen
what is the symptomatic treatment for a patient that has a migraine at presentation + N/V? (3)
SQ triptan
+
IV metoclopramide/prochlorperazine
+
IV diphenhydramine
what treatment can be added to reduce the risk of early headache recurrence?
IV/IM dexamethasone
how to prevent medication overuse of simple analgesics?
use less than 15 days/month
how to prevent medication overuse of combination analgesics?
use less than 10 days/month
when should preventative therapy be considered in patients with migraines? (3)
over 4 times/month
lasts longer than 12 hours
associated with disability
a patient presents with severe, unilateral, periorbital pain with horner syndrome. what’s the Dx?
cluster headache
how long do cluster headaches last?
15 mins - 3 hours daily for 4-8 weeks
what is the treatment for cluster headaches? (2)
100% oxygen
triptan SQ or intranasal spray
