Neuro Flashcards
(18 cards)
Name the 3 types of primary headache
Tension
Migraine
Cluster
Features of a tension headache
Tight “band like” headache
Usually dull and frontal
Related to stress and analgesia overuse
Management of tension headache
Initially analgesia
Minimise in lasting
Features of migraine
Unilateral, pulsating headache
Photo/phonophobia
GI disturbance (nausea, vomiting)
Aura - visual disturbance, ~focal neurology
Triggers of migraine
Chocolate, cheese, menstruation, too much/little sleep, poor lighting, alcohol
Management of migraine
Trigger avoidance
Acute - analgesia, sumatriptan
Prophylaxis - propranolol, valproate (other antiE)
Features of cluster headaches
Short, rapid onset attacks Periorbital pain Red, watering eye Periorbital swelling Rhinorrhoea
Clusters over weeks then vanish & recur
Management of cluster headaches
100% O2
SC Sumatriptan
NSAID analgesia
~verapamil prophylaxis
Conditions presenting with meningism
Meningitis (infectious or sterile)
Subarachnoid haemorrhage
~ encephalitis
What are features of meningism
Neck stiffness
Photophobia
Headache
Associations and features of giant cell arteritis
Associated with polymyalgia rheumatica Temporal headache and tenderness Scalp tenderness Jaw and tongue claudication Sudden visual loss
Investigating GCA
FBC, ESR, CRP
Temporal artery biopsy (presteroids)
Management of GCA
High dose oral methylprednisolone
Reduced stepwise over long course
Associations of primary headaches
Tension - stress
Migraine - female
Cluster - male, smoker
Causes or raised ICP
Mass lesions (abscess, neoplasm) Inflammation (meningitis, encephalitis, SAH) Hydrocephalus Haemorrhage Oedema (water intoxication, trauma, DKA) Circulatory (venous sinus thrombosis)
Features of raised ICP
Morning headache, worse on straining/lying Vomiting Nerve palsies Fatigue & altered mental state ~seizures
Drugs helping to lower ICP
Mannitol (diuretic)
Corticosteroids
What is trigeminal neuralgia?
Severe facial pain with shock like attacks, usually unilateral
