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26 Cards in this Set
- Front
- Back
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"Worst HA of life" like being "struck accross head w/ a baseball bat" suggests.... |
subarachnoid hemorrhage! |
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T/F Majority of pts w/ HA have normal physical & neurological exam |
TRUE |
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If an elderly pt w/ a worsening headache, located over left jaw & temporal region & blurry vision, presents w/ palpable, nonpulsatile, tender temporal arteries, what do you suspect? Tx? |
Temporal (Giant Cell) arteritis Tx: IV prednisone given promptly! (dx w elevated ESR & confirmed w. temporal artery biopsy) |
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Headache w/ papilledema suggests.... |
Increased intracranial pressure |
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_________ are recurring HAs that involve the blood vessels, nerves (Trigeminal nerve), & brain chemicals. MC in females, onset usually in young adulthood |
Migraines (spasm of cerebral vessels---> dilation of extracranial arteries--> pain) |
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______ are episodic UNILATERAL HA's, often associated w/ neurologic (photophobia), GI (anorexia, N/V), &/or autonomic changes & auras *frontotemporal location, dull (mild) or throbbing pain (severe) *sx are DISABLING |
Migraines |
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T/F Migraines occur MC (80%) W/O an aura (common migraine) |
TRUE (migraine w/ aura = classic migraine, less common) |
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Auras last < 60 mins, what is the Mc type?
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Scotoma = visual phenomena that precedes the HA (resembles being too close to a camera flash) |
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Migraine attack + major neurologic dysfunction (hemiplegia, coma, etc) that last longer than the migraine |
Complicated migraine |
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Migraines do not require CT &/or spinal tap for dx UNLESS.... |
New symptoms (rule out emergent condition) |
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Migraine: treatment (tx when feel onset, can stop from progressing*) |
Drugs: NSAIDs/ tylenol, caffeine - mild Dihydroergotamines, Tryptans, Anti-emetics, TCAs - moderate Opioids - severe/resistant Avoid triggers (glaring, flashing lights) Regular meals & sleep Minimize environmental stress (relaxation training, meditation, etc) |
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T/F Cluster HAs are common & associated w/ auras |
FALSE Cluster HAs are uncommon & not assoc w/ auras *One of many Trigeminal Autonomic Cephalgias |
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____________ sudden onset, extremely intense constant HA assoc w/ Horner's like sxs (ptosis, miosis), nasal congestion, conjunctival injection, & increased sweating on ipsilateral side. *UNILATERAL Retroorbital location (behind eye) *Reoccurs frequently over several days/ weeks (interspersed w pain free periods) |
Cluster Headache |
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Cluster HA: tx |
preventative- beta blockers abortive- oxygen, DHE, Ergotamines, triptans (not relieved by sitting in dark) |
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MOST common type of headache (& least severe) |
Tension Headache |
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"Vicelike" (pressure-like) BILATERAL headache w/ pain in the neck & upper shoulders, lasts long periods (days) Dx? Tx? |
Dx: Tension Headache Tx: Anxiety/Depression Evaluation, TCAs (prevention), Massage, acupuncture, IM botulin injection, omm |
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T/F Stress can cause tension headaches |
TRUE (craniocervical muscle tension can also cause) |
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HA + Fever + Neck stiffness + Brudzinski's + Kernigs what do you suspecT? |
Meningitis |
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Headache & facial pain that is worse w/ movement What do you suspect? Tx? |
Acute Sinusitis (chronic sinusitis usually NOT accompanied by HA**) Tx: nasal decongestant |
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Obese female of childbearing age, experiences HA's & visual disturbances w/ exertion. PE shows papilledema Dx? Tx? |
Dx: Idiopathic Intracranial HTN (benign intracranial HTN, "pseudotumor cerebri" Tx: Weight loss*, Acetazolamide, CSF shunting (for refractory cases) |
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_________ mc occurs as a result of CSF leakage through the dural sac following a spina tap *Pt presents w/ HA that is relieved in the recumbent position tx? |
Idiopathic Intracranial HYPOtension tx: blood patch (stops leakage) |
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T/F Cranial Neuralgias are long lasting |
FALSE Neuralgias are very brief (1-2 seconds or less) |
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________ Neuralgia; -women, middle age or older -paroxysmal, excruciation episodes of ipsilateral facial pain (very brief) -pain exacerbated or triggered by any slight touch to face (touch, movement, drafts, eating) Tx? |
Trigeminal neuralgia --> (aka Tic Douloureux) caused by vascular compression of the trigeminal nerve root, usually the unilateral 2nd or 3rd division tx: carbamazepine, anticonvulsants, antidepressants, surgery (if refractory) |
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________ Neuralgia; -follows an outbreak of Herpes Zoster -Intense burning pain, localized to affected nerve (same place as the zoster) tx? |
Postherpetic Neuralgia Tx: antidepressants, anticonvulsants, opioids, & topical lidocaine patches |
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__________is a degenerative disorder of the cervical intervertebral discs -osteophyte formation -hypertrophy of adjacent facet joints & ligaments -Sx: painful, stiff neck, shoulder pain, HA, paresthesias radiating down the arm, + Spurling maneuver Tx? |
Cervical Spondylosis Tx: NSAIDs, Cervical Immobilization, OMM, Muscle relaxers, Steroid injections, Surgery (if necessary) |
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_________a burning or aching pain of greater severity & duration (hyperpathia) than expected following trauma to an extremity PE: muscle wasting, decreased ROM, cool & clammy extremity, temperature intolerance Tx? |
Complex Regional Pain syndrome (reflex sympathetic dystrophy (RSD)) Tx: Physical therapy (early stages), Gabapentin |
