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Definition
| characterized by watery eyes, nasal congestion, periorbital pain, and Horner’s syndrome (miosis, ptosis, and anhydrosis). Alcohol is a common trigger. These headaches are usually brief and recurring. Men tend to experience this type of headache more than females. Sumatriptan and removal of the offending agent are effective |
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Definition
| unilateral and are exacerbated by light, noise and movement. They may or may not be preceded by an aura. They are usually longer acting and are caused by irritation of CN V and the release of vasoactive substances. Propranolol and NSAIDS are the standard of treatment with sumatriptan effective acutely to prevent the exacerbation of such a headache. Aura can involve seeing spots or lights flashing, experiencing odd sensations, or experiencing a disturbance of speech as a warning of an oncoming attack |
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Definition
| bilateral and might be described as a sensation of a tight band around the head. The pain is steady and usually lasts longer than 30 minutes |
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Definition
| This type of headache is most common in young males that present with severe unilateral headache, periorbital in location, and are recurrent over a short period of time. Alcohol and vasodilators have been attributed as precipitating factors for these types of headaches. The can also be associated with ipsilateral Horner’s syndrome, lacrimation, and nasal rhinorrhea. These headaches will last for approximately 30 minutes to 3 hours. |
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Definition
| Treatments for these headaches are 100% oxygen, ergot derivatives as well as sumatriptan |
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Definition
| a tricyclic antidepressant which can be used as prophylaxis for migraines as well as cluster headaches |
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Definition
| a powerful NSAID and is commonly prescribed to patients with musculoskeletal pain and can be used to treat severe tension headaches |
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Definition
| most common in middle aged obese females. This condition causes a chronic sustained daily headache secondary to increased intracranial pressure |
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| What is the most common type of headache? |
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Definition
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30 year old male presents with unilateral, stabbing peri/retro-orbital pain, lasting 15 min to 3 hrs, what is the diagnosis?
What other symptoms is it a/w? |
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Definition
Cluster HA
ipsilateral lacrimation, ptosis, nasal congestion, and rhinorrhea |
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Term
| What type of headache often occurs within 90 min of the onset of sleep? |
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Definition
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| Female pt presents with a unilateral headache, with aura, nausea, and photophobia which was triggered by perfume, what is the diagnosis? |
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Definition
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Term
What is Scotoma?
Teichopsia?
Photopsias?
Rhodopsias? |
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Definition
1. Blind spots
2. jagged zigzag lines
3. shimmering lights
4. colors |
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Term
51 year old female presents with unilateral temporal headache and ipsilateral jaw pain. What is the diagnosis?
What other dz is it commonly a/w? |
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Definition
Temporal (Giant cell) arteritis
Polymyalgia Rheumatica |
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| 60 year old pt presents with episodic, severe pain shooting from side of mouth to ipsilateral ear, eye, or nose. What is the dx? |
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Definition
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Term
| Pt with hx of osteoarthritis presents with chronic ear pain, headache, jaw stiffness, and Bruxism. What is the dx? |
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Definition
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Term
How is Temporal arteritis screened for?
How is it diagnosed?
What is the treatment and why is it important? |
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Definition
ESR > 50
Temporal artery biopsy
Corticosteroids ASAP to avoid blindness |
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Term
| How is Trigeminal Neuralgia dx? |
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Definition
| CT or MRI to R/O sinusitis, cerebellopontine angle neoplasm, multiple sclerosis, or Herpes zoster |
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| Pts with HA who are > 50 yrs old or pts with headaches immediately upon waking, what should you suspect? |
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Definition
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Suspect what in pts awakened in middle of the night by HA, who have projectile vomiting, or focal neurologic deficits?
What test should you obtain? |
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Definition
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Term
What is the treatment for Tension HAs?
What is the prophylaxis? |
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Definition
NSAIDs or acetominophen
antidepressants or beta-blockers |
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Term
What is the acute tx for Cluster HAs (first line and second line)?
What is the prophylaxis? |
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Definition
1st - 100% O2 or a triptan
2nd - dihydroergotamine
Verapamil, Lithium, Methysergide, or Ergotamine |
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Term
What is the acute tx for Migraines (1st and 2nd line)?
What is the prophylaxis tx? |
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Definition
1st - triptan, NSAIDs
2nd - dihydroergotamine and/or antiemetics
1st - Beta-blockers
2nd - Calcium blockers |
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Term
| What is the tx for Trigeminal Neuralgia (1st line)? |
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Definition
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Term
| What is the tx for Subarachnoid hemorrhage to reduce incidence of post-rupture vasospasm and ischemia? |
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Definition
| Immediate neurosurgical eval and NIMODIPINE |
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