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PC2-Headaches

Terms in this set (30)

What are the red flags of HA?
-rapid onset
-new HA after age 50
-papilledema
-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?
tension HA
SXS of tension HA
-band like sensation
-pain in the back of the head and neck
-pericranial tenderness
-anorexia
What can exacerbate tension HA?
noise, fatigue, emotional stress and glare
TX of tension HA
-OTC medications
-relaxation
Are males or females at greater risk of migraine?
females
SXS of migraine
-pulsatile HA that is typically unilateral lasting 4-72 hrs
-n/v
-photophobia
-may have aura (classic migraine)
What are some possible triggers for migraines?
-stress
-sleep patterns
-food
-hormones
-medications
-weather
Behavioral modifications that can help migraines
-avoid triggers
-biofeedback
-acupuncture
-relaxation
-stress reduction
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
-zolmitriptan
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
tylenol
Pt > 50 yrs w/ a HA and pain in the temple should make you consider what dx?
temporal arteritis
What arteries are affected in temporal arteritis?
medium to large arteries
SXS of temporal arteritis
-HA
-jaw pain
-scalp tenderness
-hip pain
Diagnostics for temporal arteritis
-ESR: highly elevated
-temporal artery biopsy: GOLD STANDARD
TX for temporal arteritis
prednisone
Complications of temporal arteritis
-stroke
-blindness
How do you treat a rebound HA?
migraine prophylaxis
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