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Diff Dx > Headaches 2 > Flashcards

Headaches 2 Flashcards

1
Q

migraines with aura tend to occur in who?

A

females

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2
Q

how do migraines with aura usually present?

A

unilateral throbbing headaches that are preceeded by an aura

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3
Q

the prodome of a migraine with auraconsists of what?

A

a progressively increasing scotoma (blind spot) surrounded by flashing lights lasting for about 30 minutes

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4
Q

triggers for migraines with aura

A

sleeping or eating habits
environmental pollutants
certain medications
food

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5
Q

primary food triggers for migraines with aura

A 
chocolate
caffeine
nitrates
cheese
nuts
wine
etc
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6
Q

what neurological manifestations can be seen with migraines with aura?

A

aura
olfactory
paresthesias
temporary weakness of facial muscles/limbs

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7
Q

how long do migraines with aura last?

A

4-72 hours

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8
Q

migraines without auras are usually..

A

female

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9
Q

what do patients complain of with a migraine with aura?

A

unilateral, pulsatile headache that is recurrent, having begun as a young adult

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10
Q

what neurological signs and symptoms are associated with migraines without aura?

A

there are none

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11
Q

what is unique about migraines without aura?

A

the headache is severe, but they can still function

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12
Q

what can relieve the migraine without aura?

A

vomiting (sometimes)

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13
Q

are migraines more common with or without auras?

A

without

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14
Q

what is the management for migraine without aura?

A

same as migraine with aura

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15
Q

how will a patient describe a tension type headache?

A

frequent occurence that is often worse in the afternoon or early evening

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16
Q

where is the pain for a tension headache?

A

bilateral in the suboccipital or supraorbital region

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17
Q

are tension headaches due to muscle tension?

A

no, there is no higher incidence of muscle hypertonicity with tension headaches

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18
Q

clinical features of tension headaches

A

bilateral headache
mild to moderate intensity
pressing or tightening quality (non-pulsating)
non aggravated by routine physical activity
absence of nausea and vomiting
may have photophobia or phonophobia, but NOT BOTH

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19
Q

pure cervicogenic headache without overlap can present as?

A

daily headaches with no associated neurological signs
one sided
reduced neck motion in the neck helps
associated with neck pain

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20
Q

cervicogenic headache is due to?

A

referral from soft tissues and articular structures in the neck

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21
Q

cluster headaches occur in who mostly?

A

middle aged men

22
Q

what are the S&S of a cluster headache?

A

incredibly painful
unilateral, orbital in location
occur over days or weeks and then reappear again several weeks or months later
history of smoking an possible alcohol use

23
Q

what is the average frequency of cluster headaches?

A

several times per day, often at night, lasting for one to several weeks

24
Q

what might the patient experience during a cluster headache?

A 
lacrimation
associated with a runny nose on the same side as the headache
agitated and animated
beat head against wall for relief
they may attempt suicide
25
Q

does chiropractic help those with cluster headaches?

A

not clear

26
Q

what can be helpful in those with cluster headaches?

A

electrical stimulation of hypothalamus

similar treatment to migraine with oxygen therapy

27
Q

who does temporal arteritis occur in?

A

patients older than 50

28
Q

what might the patient complain of with a tempral arteritis headache?

A

unilateral headache in temporal region
tender nodule at the superficial temporal artery on side of forehead
generalized aching and muscular tatigue int he upper trunk
visual dysfunction or blindness of sudden onset

29
Q

what do you do with people with temporal arteritis?

A

immediate referral (because blindness can result)

30
Q

how is temporal arteritis treated?

A

corticosteroids

31
Q

what is elevated in temporal arteritis?

A

ESR and C reactive proteins

32
Q

what S&S would make you want to do advanced imaging on a headache patient

A

worsening with fever
sudden onset w/ max intensity at 5 minutes
new onset neurologic deficit or cognitive dysfunction
change in personality
impaired level of consciousness
trauma within last 3 months
headache from cough, valsalva or sneeze
triggered by exercise
orthostatic headache
symptoms suggestive of giant cell arteritis, or acute glaucoma
substantial change in characteristics of their headache

33
Q

what are the two types of stroke?

A

ischemic*

hemorrhagic

34
Q

what do you do with someone who you suspect is having a stroke?

A 
FAST
face drooping
arm weakness
slurred speech
time counts (911)
35
Q

S&S of a hemorrhagic stroke

A

worst headache of my life
extremely sudden onset
if the doc can’t distinguish between migraine or tension type
preceeded by sentinel*** headache in a lot of patients

36
Q

sentinel headache

A

sudden, intense and persistene, preceeding spontaneous subarachnoid hemorrhage by days or weeks

37
Q

warning signs of a potential dissection

A 
sudden onset of headache, neck pain, face pain
pain that is different than patient has experienced before
5Ds And 3Ns
Dizziness
Drop attacks
Diplopia
Dysarthria
Dysphagia
Ataxia
Nausea
Numbness
Nystagmus
38
Q

papilledema

A

optic swelling that is secondayry to elevated intracranial pressure

39
Q

what happens to vision with papilledema?

A

nothing, usually well preserved acutely

40
Q

what will you see in someone’s eye if they have papilledema

A

obliteration of physiologic cup

tortuous vessels

41
Q

what are the intracranial structures that are pain sensitive?

A 
meningeal arteries
proximal protions of cerebral arteries
dura at the base of the brain
venous sinuses
CN 1, 2, 3, 5, 7, 9
42
Q

brain tumor symptoms

A 
headaches
seizures
sensory and motor loss
hearing loss
vision loss
fatigue
depression
behavioral and cognitive changes
endocrine dysfunction
43
Q

describe the headaches of people who have brain tumors

A

steady pain, worse upon waking, better in a few hours
persistent, progressive, non migraine
aggravated by valsalva
maybe vomiting
maybe throbbing
maybe worse with coughing, exercise or change in body position
doesn’t respond to regular headache remedies
maybe associated with new neurologic findings

44
Q

symptoms specific to the location of the tumor

A

pressure or headache near the tumor

45
Q

symptoms specific to a tumor of a cerebellum

A

loss of balance and difficulty with fine motor skills

46
Q

symptoms specific to a tumor of the cerebrum

A

changes in judgement
loss of initiative, sluggishness, muscle weakness, paralysis (frontal lobe)
partial or complete loss of vision (occipital or temporal lobe of cerebrum)
changes in speech, hearing, memory, or emotional state (aggressiveness)(frontal and temporal lobe of cerebrum)
altered perception of touch or pressure, arm or leg weakness on one side of the body or confusion with left and right sides(frontal or parietal lobe)

47
Q

pineal gland tumr

A

inability ot look upward

48
Q

pituitary tumor

A

lactation and altered menstrual periods in women

growth in hands and feet in adults

49
Q

brain stem tumor

A 
difficulty swallowing, facial weakness or numbness, double vision
vision changes (temproal, occipital lobe, brain stem)
50
Q

most prevalent brain tumor types

A

gliomas (glioblastoma multiforme, ependymomas, astrocytomas, oligodendrogliomas)
meningiomas

51
Q

most prevalent tbrain tumor types on children

A

astrocytoma
medulloblastoma
ependymoma

Diff Dx (17 decks)

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