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Terms in this set (30)
What are the red flags of HA?
-new HA after age 50
-HA w/ systemic sxs
-New HA in HIV/CA pt
-worsening of chronic HA
What should you always consider w/ a sudden onset HA?
Vascular problem such as stroke or subarachnoid hemorrhage
A pt presenting w/ the "worst HA of my life" should have what tests done?
CT scan, if neg f/u w/ LP
What are the primary HAs?
migraine, tension, cluster
Who is most at risk for cluster headaches?
Middle aged males
What are cluster HAs?
A HA that occurs at the same time of the day lasting 15 min-3 hrs. There are a number of closely spaced attacks followed by spontaneous remission for weeks to months before another bout begins
SXS of cluster HA
-severe, unilateral periorbital pain
-Pt may also have ipsilateral nasal congestion, Horner's syndrome, rhinorrhea or lacrimation
-redness of the eye
What are the sxs of Horner's Syndrome?
ptosis, meisosis, and anihydrosis
What is the treatment for cluster HAs?
100% oxygen; zolmitriptan
What is the MOST common type of primary HA?
SXS of tension HA
-band like sensation
-pain in the back of the head and neck
What can exacerbate tension HA?
noise, fatigue, emotional stress and glare
TX of tension HA
Are males or females at greater risk of migraine?
SXS of migraine
-pulsatile HA that is typically unilateral lasting 4-72 hrs
-may have aura (classic migraine)
What are some possible triggers for migraines?
Behavioral modifications that can help migraines
Prophylaxis for migraines
topiramate, ß-blocker, botox (only use if pt has ≥2 HA/month or HA are debilitating)
TX of migraine
-dark, quiet room
How long after a head injury does it take a post-traumatic HA to develop?
24 hrs- 1 week
SXS of post-traumatic HA
-constant, dull ache w/ superimposed throbbing
-may have n/v or scintillating scotoma
What will the diagnostics show in a post-traumatic HA?
they will all be negative
TX post-traumatic HA
Pt > 50 yrs w/ a HA and pain in the temple should make you consider what dx?
What arteries are affected in temporal arteritis?
medium to large arteries
SXS of temporal arteritis
Diagnostics for temporal arteritis
-ESR: highly elevated
-temporal artery biopsy: GOLD STANDARD
TX for temporal arteritis
Complications of temporal arteritis
How do you treat a rebound HA?
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