topic 8 - headache

Question 1

hwo common are headaches after concussion

Answer 1

very - often #1
25-90%

Question 2

what is the lifetime prevalence of post traumatic headache

Answer 2

4.7% in men
2.4% in women

persisting PTH has been shown to occur in 15-75% of people (up to 20% have headaches 4 years post injury)

Question 3

what are cervicogenic headaches

Answer 3

• often associated with neck tension, neck pain, and paulling/whiplash feeling
• most often felt in posterior portion of head
• sometimes associated with a positive MRI of the neck

Question 4

what is an ANS/tension headache

Answer 4

• often felts as a band around the head and can be linked with challenges in NV coupling
• have to do with blood flow in the brain/head
• exacerbated by vigorous cognitive/physical activity
• can be associated with imbalance of sympathetic and parasympathetic innervations

Question 5

what is a migraine

Answer 5

• present as an extreme, stabbing pain on one side of the head or the other generally near the top of the head
• often seen in individuals who have a predisposition to / family history of migraines
• can occur with and without “aura” (warning sign - seeing flashing lights/spots)

Question 6

what is occipital neuralgia

Answer 6

• often an undiagnosed cause of head and neck pain that can occur from whiplash and/or concussion
• can have severe stabbing pain in the greater occipital nerve region (back of head)
• can be diagnosed and treated with an occipital nerve block

Question 7

what is an ocular headache

Answer 7

• often felt as a pounding, pulsing or throbbing pain behind the eye
• can be associated with sensitivity to light, noise and/or odours

Question 8

what is a medication overdose / rebound headache

Answer 8

• typically caused by patients taking too many analgesic meds
• as meds wear off, the headache pain increases and may be unrelated to the concussion
• if suspected, med detoxification should occur

Question 9

what are cluster headaches

Answer 9

• similar to migraine
• occur around the eyes without the sensitivities involved in migraines

Question 10

how to help headaches

Answer 10

reduce stress
exercise
look at sleep, breathing, and nutrition

Question 11

how to determine cervical spine involvement

Answer 11

type of symptom
- neck pain, cervicogenic headaches, dizziness

source of pain
- joint, myofascial, nerve, sensorimotor, NM control, psych distress

ton of proprioceptive info that comes from the cervical spine

Question 12

does cervical spine involvement always happen at the same time as the concussion

Answer 12

no - can be separate

Question 13

what is the assessment for cervical spine involvement

Answer 13

ROM
screening
tests for NM control and sensorimotor control

Question 14

how to assess sensorimotor control

Answer 14

cervical proprioception
postural control
eye mvmt control

rehab informed by functional impairment

Question 15

what is the positive prediction rule

Answer 15

facet joint mediated pain

Question 16

what is a post traumatic headache

Answer 16

attributed to injury when new headache occurs following trauma
must occur within 7 days