Term
| Name 6 findngs that are considered red flag HA. |
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Definition
| 1)"worst HA of my life" 2)Papilledema 3)AMS 4)Focal neurological findings 5)Meningeal signs 6)AIDS pt |
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Term
| What can secondary HA be associated with? |
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Definition
| Trauma, vascular d/o, CNS infections, HIV, or metabolic d/o |
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Term
| Name 7 diagnostic tests for secondary HA. |
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Definition
| 1)EEG 2)CT/MRI 3)EMG 4)TMJ x-ray 5)Cervical spine films 6)Labs 7)LP |
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Term
| Describe sx of tension-type HA (TTH). |
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Definition
| Mild to mod pain, variable location, often bilat, described as "vice-like" |
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Term
| Do TTH typically have associated nause, photophobia, or a prodrome? Can they be aggravated by stress? |
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Definition
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Term
| What meds are used to tx TTH? |
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Definition
| NSAIDs, tylenol, or Fioricet. Avoid narcotics. |
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Term
| Greater then 50% of pts w/ chronic TTH hvae what? |
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Definition
| Sleep disturbances and mood d/o |
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Term
| What are preventative meds for chronic TTH? |
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Definition
| Amytriptyline (DOC), AD, muscle relaxants, or NSAIDS |
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Term
| What med may be considered to break the cycle of chronic TTH and stop overuse of analgesics? |
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Definition
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Term
| Describe the type of pt that MC suffers from cluster HA. |
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Definition
|
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Term
| When do cluster HA typically occur? |
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Definition
|
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Term
| Describe the sx of cluster HA. |
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Definition
| Unilateral, behind the eye, lasts <3hrs, intense pain |
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Term
| What sx occur during cluster HA d/t autonomic hyperactivity? No they usually have N/V or an aura? |
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Definition
| Conjunctival injection, lacrimation, nasal congestion, and ptosis. No. |
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Term
| Name 5 things that may be precipitating factors for cluster HA. |
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Definition
| Etoh, naps, stress, missed meals, and vasodilating drugs. |
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Term
| Name 4 meds used to prevent cluster HA. |
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Definition
| CCB, lithium, steroids, and valproate |
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Term
| Name 3 meds used to abort cluster HA. |
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Definition
| O2, 5HT receptor agonists (triptans), and intranasal lidocaine |
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Term
| Name 3 preventive meds for medication overuse/withdrawal HA. |
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Definition
| low dose tricyclic AD, Gabapentin, and low-dose Topiramate |
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Term
| What gender and age are Migraines MC in? |
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Definition
| Women, children and elderly |
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Term
| What are differences b/t classic and typical migraines? |
|
Definition
| Classic - unilateral, pulsating, aura. Typical - uni- or bilateral, pulsating or steady, no aura |
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Term
|
Definition
| An isolated area w/i the visual field where vision is absent (30% of migraines) |
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Term
| What is scintillating scotoma? |
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Definition
| Looks like silvery kaleidoscope (occurs in migraines) |
|
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Term
| Name 7 potential triggers of migraines. |
|
Definition
| 1)Stress 2)Menses 3)OCP 4)Infection 5)Trauma 6)Vasodilators 7)Wine/aged cheese |
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Term
| What neurotransmitter plays a role in migraine pathophysiology? |
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Definition
|
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Term
| What meds are used for acute tx of migraines? |
|
Definition
| NSAIDs, Midrin, Triptans, or Ergotamine |
|
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Term
| Who are triptans contraindicated in? |
|
Definition
| h/o CAD or uncontrolled HTN (SE in cardiac ischemia) |
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Term
| Name 2 first line prophylactic drugs for migraines. |
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Definition
|
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Term
| When is amytriptyline used as a first-line prophylaxis for migraines? |
|
Definition
| When the migraine co-exists w/ TTH, another chronic pain condition, disturbed sleep, or depression. |
|
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Term
| Name 4 second-line prophylactic drugs for migraines. |
|
Definition
| 1)Topiramate 2)Sodium valproate 3)CCB 4)Botox |
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|
Term
| Describe pain in trigeminal neuralgia? |
|
Definition
| Paroxysmal lasting seconds to < 2min |
|
|
Term
| What can stimulate pain from trigeminal neuralgia? |
|
Definition
| Wind, chewing, or light skin touch. |
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Term
| 90% of pts w/ trigeminal neuralgia are what age? |
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Definition
|
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Term
| What diagnostic test is rec. for all pts w/ trigeminal neuralgia? Why? |
|
Definition
| MRI - 10% have an intracranial lesion |
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|
Term
| Name 5 meds used to tx trigeminal neuralgia. |
|
Definition
| Carbamazepine, Phenytoin, Valproate, Gabapentin, or muscle relaxers |
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Term
| Describe sx of temporal arteritis. |
|
Definition
| Unilateral HA, dull onset, mod. to severe jabbing pain localized over temporal art., jaw claudication |
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Term
| What is the most common sequela in untreated temporal arteritis? |
|
Definition
|
|
Term
| What age and sex is temporal arteritis MC? |
|
Definition
|
|
Term
| What meds are used to tx temporal arteritis? |
|
Definition
|
|
Term
|
Definition
| Sudden onset, "worst HA of my life", stiff neck progressing to back pain, N/V prominent |
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Term
| What is the most common finding in SAH? |
|
Definition
| Nuchal rigidity present 1-3 hrs /p bleed |
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Term
| AMS or coma occurs in what % of SAH pts? What is the SBP? |
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Definition
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Term
| Descrive sx of intracranial tumor. |
|
Definition
| Lateralized, steady, dull or aching, intensity inc. overtime, N/V |
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Term
| Pain of intracranial tumors is increased with what positions? |
|
Definition
| Valsalva and bending over |
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Term
| Intracranial tumor in 75% of children is located where? 75% of adults? |
|
Definition
| Infratentorial (below cerebrum). Supratentorial (above cerebellum). |
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