Random Migraine Things Flashcards Preview

Paige: Neuro! > Random Migraine Things > Flashcards

Flashcards in Random Migraine Things Deck (33)
Loading flashcards...
1
Q

what is the vasogenic theory of migraines

A

afferent sensory fibers get activated; these innervate meningeal +/or cerebral vessels

2
Q

how does the vasogenic theory explain auras and the headache?

A

aura: internal carotid vasoconstriction
HA: rebound vasodilation of external carotid

3
Q

what is the neurogenic theory of migraines

A

trigeminal nerve fibers get activated; these innervate the meninges and cause neurogenic inflammation

4
Q

what does the neurogenic theory help explain?

A

N/V, photophobia, hallucinations, etc. symptoms

5
Q

what neurotransmitter plays a role in vasoconstriction and inflammation

A

serotonin

6
Q

what is a scintillating scotoma

A

a visual change with an aura

7
Q

are complex migraines common

A

no

8
Q

what is a complex migraine

A

a prolonged aura with neurologic deficits lasting from 1h to a week

9
Q

can a complex migraine cause permanent neuro deficits?

A

yes, even though there is no vessel occlusion

10
Q

how do you treat mild complex migraines?

A

ASA or NSAIDS early

11
Q

what is abortive tx for complex migraines?

A

ergotamine
cafergot-ergotamine-caffeine
tryptans

12
Q

what drug class should you AVOID with migraines?

A

opioids

13
Q

what drug class are the tryptans

A

serotonin agonists

14
Q

what do you rx for severe intractable migraine HAs?

A

subQ dihydroergotamine with anti-emetic, an injectable narcotic, indomethacin to prevent relapse, and steroids in the short-term
(seems a bit excessive, eh?)

15
Q

5 drug classes you and ppx migraines with?

A
BB
TCAs
CCBs
anticonvulsants 
botulism
16
Q

what is the MC type of HA?

A

tension

17
Q

do tension HAs worsen with physical activity?

A

NO

18
Q

do tension headaches have N/V?

A

NO

19
Q

what other sx might you have with a tension headache?

A

poor concentration, stress, fatigue, sensitive to noise and glare

20
Q

who gets cluster HA/migrainous neuralgia?

A

usually men in their 20s-50s

21
Q

what syndrome is associated with cluster HA?

A

horner’s syndrome

22
Q

what is the timing of cluster HA?

A

lasts 15min-2h

recurs daily

23
Q

what is the main trigger of cluster HA?

A

alcohol

24
Q

how do you treat cluster HA?

A

100% O2 for 1-2h

ergotamine, sumatryptan

25
Q

which type of HA occurs more than 15d/mo for 3mo or more

A

chronic daily HA

26
Q

what is a chronic daily HA most commonly due to

A

med overuse

27
Q

what type of tumor makes up 50% of intracranial mass lesions?

A

gliomas

28
Q

is a brain tumor a sharp or dull pain

A

dull

29
Q

where does the pain from a tumor occur?

A

bifrontal or occipital

30
Q

when do HAs from tumors usually begin?

A

in AM

31
Q

are HAs from tumors worse with exertion/changing posture?

A

yes

32
Q

is N/V associated with a HA from a brain tumor?

A

maybe

33
Q

what should make you start considering a brain tumor in a patient with a HA?

A

NEW ONSET headache at 45+ years with other neurological/psychological findings