What type of headache is associated with a sharp pain?
Neurological
What type of headache is associated with throbbing pain?
More vascular in nature
What type of headache is associated with inside pressure pushing outward?
Throbbing headache (vascular) - could be life threatening
What type of headache is associated with outside inward pressure?
Tension headache - associated with ‘hat band’ distribution of pain
What could a dull headache be indicative of?
Tooth-ache
What is a bilateral headache associated with?
Tension headache
What is a unilateral headache associated with?
A migraine or a vascular/life-threatening
T/F: Tension headaches get worse as the day progresses.
True
What 4 mechanisms are responsible for producing a headache?
- Spasms of cervical musculature
- Traction on veins and/or displacement of dural venous sinus
- Inflammation or pressure by masses upon any of the pain sensitive structures internally or externally to the cranium
- Traction or distention of arteries at the base of the skill (E.G. VBA)
What are specific characteristics of life-threatening headaches (e.g. Meningitis, subdural hematoma, etc)?
- Acute, severe headache
- Short history of onset
- Positive Valsalvas/Triad of Dejerine
- Exacerbated by recumbency (increases intracranial pressure) and more severe upon wakening but becomes more tolerable during the day
What is the most common type of headache?
Tension headache
- *Worsen throughout the day
- *Often accompanied by stress
What are the best management strategies for tension headaches?
- Adjust
- Wet heat
- Hydrate
- Eliminate caffeine
- Rest with neck in normal cervical curve
What is the most common type of tension headache?
Acute Muscle Contraction Headache
- Aching pain
- Begins in neck and generalizes throughout cranium
- Pain may be relieved by stretching/massage
What are characteristics of a Sub-Acute Muscle Contraction Headache?
aka “Sick headache”
Generalized pain throughout cranium
N/V
Prolonged headache that occurs for days
Pain is disabling enough to interrupt daily activities
What are characteristics of a Chronic Muscle Contraction Headache?
Related to physical/emotional trauma
Pain is present at bedtime, may wake patient up
Pain generalized in head, may involve shoulders
Dull ache, outward to inward
What are the basic characteristics of a typical migraine?
- Retro-orbital and/or temporal
- Unilateral
- Vascular throbbing/pounding
- May be familial
- Possible warning (aura)
- N/V
- Onset usually begins in childhood
- Begins upon waking hours
What are characteristics of an atypical migraine?
- Bilateral, with one side more severe
- Dull ache/stabbing pain in or behind eye
- Dull and relentless pain
- Can occur upon waking hours or later in the day
What are characteristics of a cluster migraine?
- Unilateral, orbital area radiating to temple, nose, upper jaw, or neck
- Sudden onset of pain with brief duration
- Stabbing/knife like
- More common in middle aged males
- Occurs frequently during sleep/patient will wake up
- Redness of eye affected, increase in lacrimation, rhinorrhea, stuffiness of nostril
What is another name for a cluster migraine?
Horton’s Histaminic Cephalgia
What are characteristics of temporal arteritis?
- 55+
- Unilateral, temporal pain
- Knife-like, shooting, stabbing pain
- Tenderness in scalp
- Exacerbated by combing hair
S/S: Cachexia, malaise/fatigue, muscle ache around affected area
What are the 2 types of Post Concussion Syndrome?
Type 1: MC
- Dull, aching pain
- Entire scalp is involved
- Patient may be anxious
- Described as ‘weight’ on top of head
Type 2:
- Pain is local to injury site
- Tender zone at point of pain
