Term
| which system (connected with a certain cranial nerve) mediates pain in the head? |
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Definition
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Term
Tension-type headaches: (Yes or No)
- show moderate to severe pain?
- aggravated by routine physical activity?
- Associated with severe nausea and vomiting?
- associated with bilateral pain? |
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Definition
Not moderate to severe pain
not aggravated by routine physical activity
not associated with severe nausea and vomiting
YES bilateral, described as throbbing or aching pain |
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Term
| headaches that are caused by something else such as dental pain or eye pain are called ____ headaches |
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Definition
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Term
| What are 5 main types of primary headaches? |
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Definition
Tension-type
Migraine
Trigeminal neuralgia
Cluster headache
Paroxysmal hemicrania |
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Term
What type of headache:
-Lasts 30 minutes to several hours
-is bilateral
-Pressing/tightening quality
-Intensity is mild or moderate
-Not aggravated by routine physical activity |
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Definition
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Term
| would a person with a tension type headache have photophobia, phono phobia, and mild nausea simultaneously? |
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Definition
| No - this would present in a migraine |
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Term
| is moderate/severe nausea involved in a tension-type headache? |
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Definition
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Term
| the majority of people that come to the clinic for a headache have what type of headache? |
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Definition
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Term
| T or F: To diagnose a migraine, The patient must have all four of these symptoms simultaneously- unilateral pain, throbbing, aggravation on movement, moderate to severe intensity |
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Definition
| False - the patient must show 2 of these 4 symptoms -unilateral pain -throbbing -aggravation on movement -moderate to severe intensity |
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Term
How many episodes do you look for when diagnosing migraine headaches?
How long do these episodes last? |
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Definition
- 5 or more episodes
- 4-72 hours each |
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Term
| When diagnosing a migraine, along with unilateral pain, throbbing, aggravation on movement, and moderate to severe intensity, the patient must also show ______/______ OR _____/_______ |
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Definition
| Nausea/vomiting OR photophobia/phonophobia |
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Term
What is the prevalence of migraine headaches in the general population?
In women?
In men? |
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Definition
general population - 12%
women - 18%
men - 6%
(He says not important to know exact percentages) |
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Term
| Migraines are more prevalent in (older/younger) populations |
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Definition
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Term
| A patient comes in and says that occasionally they experience flashes of excruciating pain that last for only a few seconds. What could the patient have? |
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Definition
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Term
| What are several common triggers of trigeminal neuralgia? |
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Definition
brushing of teeth
shaving
wind on face |
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Term
| what is one important thing to rule out when diagnosing trigeminal neuralgia? |
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Definition
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Term
| What are the two types of trigeminal neuralgia and their differences? |
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Definition
Classical - Idiopathic; Vascular compression of trigeminal ganglion
Symptomatic - can be due to MS, tumors, abnormalities of the skull, dental procedures |
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Term
| What are some medical treatments for trigeminal neuralgia |
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Definition
| anticonvulsants/adjuvants steroids analgesics - not the best because it won't do much good when the pain comes and goes so quickly |
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Term
| What are 3 surgical procedures for trigeminal neuralgia? |
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Definition
Rhizotomy
Janetta procedure
gamma knife? |
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Term
| Surgically killing one branch of the trigeminal nerve either by injections or radiofrequency is called ____ |
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Definition
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Term
| What is the surgical procedure for trigeminal neuralgia in which you first give the patient an MRI with a stereotaxic helmet so you can line up coordinates in 3 dimensions of space, figure out where the coordinates are for the trigeminal ganglia, and then focus three separate beams in three different directions on that one spot in space. |
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Definition
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Term
| What is the surgical procedure for trigeminal neuralgia where they open up their head and go into your skull and they stick a little piece of gel foam between the blood vessel and trigeminal ganglia. |
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Definition
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Term
| Which of the 3 surgical procedures for trigeminal neuralgia do younger patients usually get? Older patients? |
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Definition
younger - Janetta
older - rhizotomy |
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Term
| A patient comes in with a bad headache that’s on one side. One eye is red, one side of his nose is running, it is obviously a very excruciating headache, and he is agitated. He’s walking around, he looks like he wants to beat his head on something.---What type of headache is this? |
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Definition
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Term
| cluster headaches often occur right after what? |
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Definition
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Term
| are cluster headaches more common in females or in males? |
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Definition
|
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Term
| cluster headaches usually occur how many times per year? |
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Definition
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Term
| headaches that occur at least 15 times per day and last 5-20 minutes each are called? |
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Definition
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Term
| What medicine does paroxysmal hemicrania respond to? |
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Definition
|
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Term
| paroxysmal hemicrania more common in females or males? |
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Definition
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Term
| What type of headache can cause autonomic features such as Horner's syndrome? |
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Definition
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Term
| headaches caused by sinus disease, needing new glasses, cervicogenic, dental pain, medication overuse, and post LP/CSF leak are called |
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Definition
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Term
| headaches emanating from neck pain are called |
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Definition
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Term
| individuals who have had trigeminal neuralgia, and they've had all these treatments-medical and surgical-and they still have terrible pain may have what? |
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Definition
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Term
| what is atypical face pain usually treated with? |
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Definition
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Term
| Increased intracranial pressure in the absence of an intracranial mass or hydrocephalus |
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Definition
| Pseudotumor cerebri (Idiopathic intracranial Hypertension) |
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Term
| What are some signs of pseudotumor cerebri? |
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Definition
Papilledema
transient obscurations of vision
Often obese women of childbearing age |
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Term
What type of primary headache do these describe?
Increased rate of CSF formation
decreased rate of CSF absorption
Increased brain volume caused by increased water content
increased blood volume
increased intracranial pressure caused by elevated intra-abdominal pressure |
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Definition
| Idiopathic Intracranial Hypertension (pseudotumor cerebri) |
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Term
T or F
Obesity, endocrine issues (thyroid, parathyroid), Vitamin A deficiency, hematological disorders, HIV, and Turner Syndrome are etiological factors for IIH (pseudotumor cerebri ) |
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Definition
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Term
| In Idiopathic Intracranial Hypertension, intracranial pressure will be greater than what when measured in a lumbar puncture |
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Definition
| greater than 250 mm (25 cm) of H20 |
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Term
| Enlarged blind spot and papilledema are symptoms of ______ |
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Definition
| Idiopathic Intracranial Hypertension |
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Term
| Should you do a spinal tap with the patient sitting up? |
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Definition
| No - the head should be level with the entering needle |
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Term
| carbonic anhydrase inhibitors are used to treat _____ |
|
Definition
| Idiopathic Intracranial Hypertension |
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Term
| What are 3 examples of Carbonic Anhydrase Inhibitors? |
|
Definition
acetazolamide
topiramate
zonisamide |
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Term
| Indications for IIH surgical treatment? |
|
Definition
Rapid deterioration
Impending visual loss
Failure to improve with medical treatment |
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Term
| What are 2 surgical treatments for IIH? |
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Definition
CSF shunts
Optic nerve sheath fenestration |
|
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Term
| what is optic nerve sheath fenestration? |
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Definition
| The lateral rectus of the eye is cut, the eye is enucleated, and they get a little tool and make several little slits in the optic nerve back there so spinal fluid can leak out into the retro-orbital space. They put the eye back in, sew the lateral rectus back up. |
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Term
| Evidence that pain can be attributed to the TMJ disorder based on at least one of the following: |
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Definition
- Pain is precipitated by jaw movements and/or chewing hard of tough food
- Reduced range of or irregular jaw opening
- Noise from one or both TMJs during jaw movements
- Tenderness of the TMJ capsule |
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Term
| In successful treatment of TMJ disorder, the headache will resolve in ____ months |
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Definition
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Term
| What's the most common cause of intraoral pain? |
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Definition
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Term
| The most common headache type in the general population is? |
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Definition
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