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Flashcards in Headaches Deck (38)
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1

What are some of the possible causes of headaches?

Tumour
Meningitis
Vascular disorders
Systemic infection
Head injury
Drug induced

2

What are the different types of primary headaches?

Tension type headache
Migraine
Cluster headaches

3

What are the clinical features of a tension type headache?

Mild pain
Bilateral
Pressing or tightening
No significant associated features
Not aggravated by routine physical activity

4

What abortive treatment is used for tension type headaches?

Aspirin
Paracetamol
NSAIDs

5

What preventative treatments are used for tension type headaches?

Tricyclic antidepressants

6

What is a migraine?

Chronic disorder with episodic attacks due to complex changes in the brain

7

What are the clinical features of a migraine?

Headache
Nausea
Photophobia
Phonophobia
Functional disability

8

What are some of the triggers of a migraine?

Stress
Diet
Dehydration
Environmental stimuli
Changes in oestrogen level in women
Sleep disturbance
Hunger

9

What are the different stages of a migraine?

Premonitory
Aura
Early headache
Advanced headache
Postdrome

10

What is an aura?

Neurological symptoms resulting from cortical brainstem dysfunction, may involve visual, sensory, motor or speech systems

11

What can make headaches worse?

Medication overuse
Caffeine overuse

12

What is the abortive treatment for migraines?

Aspirin or NSAIDs
Triptans

13

What is the prophylactic treatment for migraines?

Propanolol or candesartan
Anti- epileptics
Tricyclic antidepressants
Venlafaxine

14

What effect can pregnancy have on migraines?

Migraines with aura get better
Migraines without aura usually don't change

15

What is the effect of OCP on migraines?

Contraindicated in migraine with aura

16

What are the different types of trigeminal autonomic cephalagias?

Cluster headaches
Paroxsymal hemicrania
SUNCT
SUNA

17

What are the clinical features of a cluster headache?

Mainly orbital and temporal
Strictly unilateral
Rapid onset
Excruciatingly severe
Restless and agitated

18

What are the clinical features of paroxysmal hemicrania?

Mainly orbital and temporal
Strictly unilateral
Rapid onset
Restless and agitated
Absolute response to indometacin
CHRONIC

19

What are the clinical features of SUNCT?

Unilateral orbital, supraorbital or temporal pain
Stabbing or pulsating pain
Short lived
No refractory period
Conjunctival injection and tearing

20

What are the clinical features of trigeminal neuralgia?

Unilateral maxillary, mandibular or ophthalmic pain
Stabbing
Short lived
Has a refractory period

21

What are the triggers of trigeminal autonomic cephalagias?

Wind, cold
Touch
Chewing

22

What is the abortive treatment for cluster headaches?

Subcutaneous sumatriptan
Nasal zolmatripan
Occipital depomedrone injection

23

What is the preventative treatment for cluster headaches?

Verapamil
Lithium

24

What is the treatment for paroxysmal hemicrania?

No abortive treatment
Indometacin
Topiramate

25

What is the treatment for SUNCT/SUNA?

No abortive treatment
Topiramide
Lamotrigine

26

What is the treatment for trigeminal neuralgia?

No abortive treatment
Carbamazepine
Oxcarbazepine
Glycerol ganglion injection
Steriotactic radiosurgery

27

What presentations of headache are more likely to have a sinister cause?

Associated head trauma
First or worst
Sudden (thunderclap) headache
New daily persistent headache
Change in headache pattern or type

28

What are the red flag symptoms associated with headache?

Neck stiffness
Fever
High or low pressure
New onset or change in headache
Abnormal neurological examination

29

What is a thunderclap headache?

High intensity headache reaching maximum intensity in less than 1 minute

30

What is the differential diagnosis of a thunderclap headache?

Subarachnoid haemorrhage
Intracerebral haemorrhage
TIA/stroke
Carotid/vertebral dissection
Meningitis/encephalitis
Cerebral venous sinus thrombosis