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Headache
Types of Headache
11
Medical
Graduate
10/25/2010

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Term
CLUSTER HEADACHE
Definition
A. Mechanism: Dilation of extracerebral cranial arteries.
B. Symptoms: Pain in eye, usually unilateral; short duration (about 30 min); episodic
(Spring and Fall); throbbing associated with lacrimation, rhinorrhea.
C. Differential diagnosis: Episodic eye pain with greater occurrence in men;
precipitated by vasodilators, alcohol; arouses from sleep.
D. Treatment: Ergotamine; lithium carbonate for prophylaxis.
Term
SINUS HEADACHE
Definition
A. Mechanism: Referred pain from inflammation in sinuses.
B. Symptoms: dull aching pain; tenderness over maxilla and/or frontal regions.
C. Differential diagnosis: Correlated with barometric pressure changes. Allergic reaction versus infection: press over sinuses for infection.
D. Treatment: drain sinuses; antihistamines, decongestants.
Term
TENSION HEADACHE
Definition
A. Mechanism: muscle contraction and ischemia from chronic anxiety; release of lactic acid, serotonin, bradykinins, prostaglandins.
B. Symptoms: Tense muscles; bilateral temporal tightness; gradual onset of head discomfort; related to specific stress situation, emotional conflict; sleep problems, irritability; sleep OK when fall asleep; outbursts of aggression; associated with stress, psychological problems.
C. Differential diagnosis: Tense muscles, usually bilateral; no nausea, no prodromal symptoms.
Term
MIGRAINE
Definition
A. Mechanism: Vasospasm, vasodilation, edema of cranial arteries.
B. Symptoms: Prodromal: mood disturbance. Neurological: visual disturbances,
monocular hemianopsia-loss of ½ visual field in one eye, unilateral paresthesia,
aphasia.
Headache: unilateral throbbing, photophobia=hypersensitive to light
, vomiting, nausea, diarrhea,
phonophobia=avoidance of sounds
. Post-Headache: Exhaustion, hypersensitivity. (Common
migraine: no neurological symptoms, longer duration; can awaken pt from sleep.)
C. Differtial diagnosis: Aura , nausea, familial occurrence, females more common than
males.
D. Treatment: Acute: Ergotamine. Chronic: beta-blocker, verpamil, methylsergide,
pizotylline (tricyclic).
Term
Brudzinski’s nape of the neck sign, indicative of irritation of the meninges
Definition
With the patient lying on his/her back (dorsal decubitus position), the examiner places the hand under the head and flexes the neck until the chin reaches the sternum. If positive, there will be resistance to flexion of the head.If the same test produces flexion of the patient’s thighs at the hips and the legs at the knees and the feet at the ankles then this is positive for:
Term
Brudzinski’s contralateral sign
Definition
In meningitis, when passive movement of the lower limb on one side, a similar movement will be made on the other side
Term
Kernig’s sign for meningeal irritation
Definition
With the patient lying on his/her back, the examiner flexes one of the patient’s lower limbs at the hip and knee, bringing the lower limb up against the abdomen. If pain or resistance is experienced as the lower limb is extended at the knee and hip, a positive "---" sign for meningitis
Term
Migraine HA
Definition
Type of headache: Pulsating, aggravated by activity, moderate or severe, one-sided
Term
Migraine HA w/o aura
Definition
Common migraine HA
Term
migraine HA w/aura
Definition
classic migraine HA
Term
Cluster HA DX criteria
Definition
A)At least 5 attacks fulfilling criteria B-D
B) Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 min if untreated
C) Headache is accompanied by at least one of the following: 1)ipsilateral conjunctival injection and/or lacrimation
2)ipsil nasal congestion and/or rhinorrhea
3)ips eyelid edema
4)ips forehead and facial sweating
5)ips miosis and/or ptosis
6)a sense of restlessness or agitation
D) Attacks have a freq from one every other day to 8 per day
E) Not attrib to another disorder
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