Headache

Question 1

Migraine with aura- Eti

Answer 1

• Triggered by emotional/ phys stress
• Foods & alcohol
• Bright lights, noise
• Menstruation
• Family hx
• Neurovascular dysfunction

Question 2

Migraine with aura- Sx

Answer 2

• Transient visual sx precede pain
• Photo, phono & osmophobia
• Builds gradually, lasts hours
• Visual field defects, hallucinations

Question 3

Migraine with aura- Dx

Answer 3

• HA lasts 4-72 hrs
• Has defining characterisits
• Reversible aura sx

Question 4

Migraine with aura- Tx

Answer 4

• Analgesics
• Sumatriptan
• Avoid precipitating factors

Question 5

Migraine without aura- Eti

Answer 5

• Triggered by emotional/ phys stress
• Foods & alcohol
• Bright lights, noise
• Menstruation
• Family hx
• Neurovascular dysfunction

Question 6

Migraine without aura- Sx

Answer 6

• Bilateral and perioribital pain
• No visual disturbances
• No focal neuro deficits

Question 7

Migraine without aura- Dx

Answer 7

• 5+ attacks lasting 4-72 hrs
• Pulsating, moderate to severe pain, aggravated by phys activity
• Nausea, vomiting

Question 8

Migraine without aura- Tx

Answer 8

• Analgesics
• Sumatriptan
• Avoid precipitating factors

Question 9

Cluster HA- Eti

Answer 9

• Middle aged men
• No fam hx
• Activation of autonomic vascular sx
• Few days to weeks then ends

Question 10

Cluster HA- Sx

Answer 10

• Severe unilateral periorbital pain
• Occurs daily for weeks
• Ipsilateral congestion, rhinorrhea, redness of eye, lacrimation, Horner syndrome
• Occur at night, 15min - 3 hrs
• Restlessness and agitation
• Precipitated by alcohol, stress, glare, food

Question 11

Cluster HA- Tx

Answer 11

• Sumatriptan
• Lidocaine- intranasal
• High dose steroids 2 weeks
• High dose O2

Question 12

Tension HA- Eti

Answer 12

• Exacerbated by stress, fatigue, glare

Question 13

Tension HA- Sx

Answer 13

• Generalized HA, most intense at neck, back of head
• Mild to moderate intensity
• Constant, daily HA
• Viselike, tight
• No focal neuro sx

Question 14

Tension HA- Dx

Answer 14

• Exclude other HA causes

Question 15

Tension HA- Tx

Answer 15

• Analgesics

- Massage, relaxation, biofeedback

Question 16

Postconcussive HA- Eti

Answer 16

• Within a day of injury

- Worsens over weeks

Question 17

Postconcussive HA- Sx

Answer 17

• Constant, dull ache
• Nausea, vomiting, scotomas
• Dysequilibrium, rotary component
• Impaired memory, poor concentration
• Irritability

Question 18

Postconcussive HA- Tx

Answer 18

• Analgesics
• Should resolve in own
• Sumatriptan if severe

Question 19

Mass lesion HA- Eti

Answer 19

• Due to all types of intracranial masses

- Displacement of vascular structures

Question 20

Mass lesion HA- Sx

Answer 20

• Nonspecific HA- vary

- Worsen with exertion, postural change

Question 21

Mass lesion HA- Dx

Answer 21

CT or MRI

Question 22

MOH HA- Eti

Answer 22

• Rebound HA due to acetaminophen, opioids, aspirin, triptans etc

Question 23

MOH HA- Sx

Answer 23

• HA upon wakening
• Proceeded by migraine or tension HA
• Dull, mild to moderate

Question 24

MOH HA- Dx

Answer 24

HA > 15 days per month with HA disorder

Question 25

MOH HA- Tx

Answer 25

- Withdrawal offending med, Bridge therapy

Question 26

Chronic HA Tx

Answer 26

- Prevention, avoid triggers | - Analgesics

Question 27

Chronic HA- definition

Answer 27

- 15 days per month - 3 + months - 4 hrs per day