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Flashcards in test 2 - headaches Deck (35)
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1

less than __% of all brain tumors have headache as a significant presenting complaint

5

2

primary headache vs secondary

primary - no specific organic cause

secondary - caused by underlying organic disease

3

headache red flags

diplopia

loss of vision in single eye

stiff neck

unilateral weakness or paresthesia

ataxia

 

4

sudden and severe onsets tend to be

secondary headaches

think vascular: subarachnoid hem, acute ischemia, acute hemorrhagic stroke

5

if you have a neuro def then headache comes upon... headache usually

will go away

6

if you have a headache and then a neuro appears in exam... 

 

stroke on the way

7

what is the most common cause of severe recurrent headaches

migraine

8

key symptoms of a migraine

vascular headache

frontal-temporal most common

unilateral (how it starts)

severe

pulsatile/throbbing

last hours to days

nausea+vomiting common

9

few days prior to or at the onset of their period

reduction in pain after menopause 

may change with preg. / childbirth

most common: decrease in freq and intensity in mid-life, picks up after age 65

menstrual migraine

10

headache induced by foods that contain

tyramine

nitrates

migraine: provacative

11

usually visual: fortification spectra, scotoma etc

may be nonvisual: vasomotor, change in mood, numbness

precede the HA by 10-30 mins

evolve slowly over 5-10, fade as HA starts

prodrome (ora)

12

abdominal migraine most commonly seen in 

childhood migraine

13

basilar migraine

looks like a TIA: unilateral subjective paresis

subjective paresthesia/numbness "brainstem signs"

vasopastic migraine

worry about future stroke

14

prodrome without HA - typical or nontypical

HA without prodome - common or not common

 

prodrome without HA - not common

HA without prodrome - common

15

vestibular migraine has this affect

vertigo

16

what is the neurovascular theory of "prodrome"

uncontrolled synapses in the brain

sucks up all the O2

17

what is a seizure variant

wave of depolarization causes aura, resultant vasodilation causes HA

18

medical Rx of headaches

vasoconstrictions

anti-seizure meds

analgesics: dont do much, but opiates are frequently tried

hospital for status migrainous: continuous HA for 24+ hours

19

non-med Rx

cold on heck/neck

warm hands and feet 

20

when is the best time for acute care

prodrome

21

hortons headache, histamine cephalgia, hortons cephalgia, alarm clock HA

rapid onset

strong lacrimation, runny nose

eyes bloodshot

"acid poured in the nose or eye" ache

male 10:1

cluster headache

HA lasts from 10 mins to 2 hours

typically wakes pt from sleep

22

most common type of headache

tension HA

23

anxiety/depression

tight band around my head, head is in a vise

suboccipital to frontal - tight

 

tension HA

24

show some positive findings on a detailed exam of the cervical spine

cervicogenic HA

25

rebound HA are most commonly from

caffeine/stims

ergot

analgesics

narcotics

26

pain is transient, but leaves an ache behind

attacks may occur once or twice per day, up to once every minute or two

mouth-ear zone 70%

nose orbit zone 30%

trigeminal neuralgia

27

inflammatory HA

central retinal artery - blindness

needs ROIDS asap

temporal arteritis

28

typically non-specific headache, very similar to migraine

simultaneous onset of vertigo, nausea, and headache may be a clue

aneurism of vessels in the subarachnoid space

subarachnoid hemorrhage

29

whip lash 

irritation of greater occipital nerve

physical pressure on the nerve or its distribution usually PPt or increases sympt

occipital neuralgia

most common post trauma

30

200/120 mmHg +

worse in early AM while in bed

dull, throbbing, diffuse, aching

 

hypertension HA