Headaches I Flashcards

1
Q

when do you worry about headaches?

A
  • systemic symptoms
  • neurologic signs
  • onset
  • old
  • prior history
  • secondary illness
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2
Q

what are common causes of a traction headache?

A
  • neoplasm
  • abscess
  • chronic SDH
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3
Q

what tests are ordered for subarachnoid hemorrhage?

A
  • LP

- CT

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4
Q

what is the pathophysiology of reversible vasoconstriction syndrome?

A
  • transient disturbance of cerebral arterial vascular tone in segmental and multifocal fashion
  • leads to various areas of constriction and/or dilation
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5
Q

acute hydrocephalus is due to _____________

A

ventricular obstruction or shunt malfunction

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6
Q

what are the features of intracranial HTN (pseudotumor cerebri)?

A
  • generalized headache
  • papilledema
  • opening pressure 220-600 mm H20 (CSF studies normal)
  • pulsatile tinnitus
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7
Q

how do you treat intracranial HTN (pseudotumor cerebri)?

A

diuretics (acetazolamide)

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8
Q

which conditions can cause permanent blindness?

A
  • intracranial HTN (pseudotumor cerebri)

- cranial arteritis

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9
Q

what are the features of cranial arteritis?

A
  • age over 50
  • tender artery
  • ESR over 60 mm/hr
  • throbbing / boring / often burning headache
  • jaw claudication
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10
Q

what treatment is required to prevent blindness in cranial arteritis?

A

steroids (do not delay)

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11
Q
  • generalized headache
  • papilledema
  • opening pressure 220-600 mm H20 (CSF studies normal)
  • pulsatile tinnitus
A

intracranial HTN (pseudotumor cerebri)

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12
Q
  • age over 50
  • tender artery
  • ESR over 60 mm/hr
  • throbbing / boring / often burning headache
  • jaw claudication
A

cranial arteritis

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13
Q

what are the mainstays of trigeminal neuralgia therapy?

A

AEDs (carbamazepine, OXC, lamotrigine)

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14
Q

what is CADASIL?

A

cerebral autosomal dominant arteriopathy with subcortical infarcts and leukencephalopathy

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15
Q

what is HANDL? is it benign or malignant?

A
  • headache with neurological deficit and CSF lymphocytosis

- benign

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16
Q

what is usually the diagnostic test of choice for acute hemorrhage?

A

CT

17
Q

when is MRI indicated for headaches?

A

high index of suspicion

18
Q

what is the most common primary HA? what are the symptoms?

A

episodic tension type headache

  • non-pulsatile pressing, squeezing pain
  • N/V rare
  • photo/phonophobia rare
  • non-disabling sufferers go on with their day
19
Q

what are the diagnostic criteria for migraine?

A
  • any 2 of:
  • unilateral
  • throbbing
  • worsened by movement
  • moderate or severe

any 1 of:

  • N/V
  • photophobia and phonophobia

2 plus 1 equals migraine

20
Q

what is cortical spreading depression?

A
  • wave of intense cortical neuron activity (increased cerebral blood flow)
  • followed by neuronal suppression (decreased cerebral blood flow)
  • possibly underlies visual aura
21
Q

what possibly underlies the visual aura of migraines?

A

cortical spreading depression

22
Q

what are the substances that lead to vasodilation in the context of migraine?

A
  • CGRP (calcitonic gene related peptide)
  • NO
  • substance P
23
Q

what are the substances that lead to mast cell degranulation in the context of migrane?

A
  • CGRP

- substance P