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41 Cards in this Set
- Front
- Back
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typical food and drink migraine triggers?
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ripened cheese
chocolate MSG caffeinated beverage alcohol skipping meals |
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theory for migraine pathogenesis?
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trigeminovascular theory: increased 5-HT and NE stimulation at brain stem leading to vasodilation and stimulation of CN-V
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triptan mechanism?
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activate 5-HT1 receptors to cause vasoconstriction and prevent neuropeptide release
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common migraine?
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migraine without aura
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classic migraine?
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migraine with aura
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aura lasting >60 min most likely indicates?
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stroke
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teichopsia?
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waving lines;
positive symptom |
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scotomata?
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small black dot in visual field that grows progressively larger;
negative symptom |
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hemianopsia?
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loss of half of a field of vision
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metamorphopsia?
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illusions of distorted size, shape, and location of fixed objects
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how many of migraineurs have an aura preceding?
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20%
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what disorders are migraines commonly associated with?
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neurologic
medical psychiatric |
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acute treatment options in migraine?
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triptans
antiemetics/antinauseants NSAIDs ergot alkaloids combination analgesics |
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contraindications for triptans?
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HTN and CAD
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best preventative treatments for migraine?
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amitriptyline
divalproex sodium propranolol timolol |
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epidemiology of cluster headaches?
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more prevalent in men than women (6:1);
20-40; possible genetic predisposition |
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best acute treatment for cluster headaches?
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100% O2 via face mask at 7 L/min
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treatment for cluster headache to induce remission?
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prednisone
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prevention treatment for cluster headaches?
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lithium carbonate
verapamil valproic acid |
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causes of secondary headache?
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mass lesions
eye, ear, nose, throat, or teeth disease arteritis, phlebitis, cranial neuralgias occlusive vascular disease atypical facial pain temporomandibular joint disease |
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warning signs and symptoms of secondary headache?
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a headache (vs recurrent)
sudden onset onset after 50 yo systemic signs systemic disease change in headache pattern neurologic symptoms or abnormal PE |
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red flags in evaluating a headache?
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awakens at night
always occurs in am associated with straining progressive lethargy personality change visual difficulties focal weakness ataxia |
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key signs in chronic progressive headache syndrome?
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papilledema
cranial nerve palsies ataxia focal signs, motor or sensory |
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meningismus?
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blood within the subarachnoid space
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symptoms of dissection of cranial and vertebral arteries?
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headache
tinnitus horner's syndrome monocular blindness bruit |
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etiology of cranial and vertebral artery dissection?
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fibromuscular dysplasia
traumatic |
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epidemiology of temporal arteritis?
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>50 yo
2:1, female to male elevated WSR positive temporal artery biopsy responsive to steroids |
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signs and symptoms of temporal arteritis?
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localized headache
weight loss night sweats fever arthralgias jaw claudication polymyalgia rheumatica |
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polymyalgia rheumatica?
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inflammatory condition of muscles
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temporal arteritis etiology and pathology?
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autoimmune
mononuclear cell infiltrate of intima and media skip lesions elevated WSR 18/100,000 |
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cause of visual loss with temporal arteritis?
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occlusion of posterior choroidal artery
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headache seen with mass above or below the tentorium?
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above = frontal
below = referred to neck/occipital |
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headache due to chiasmal mass?
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pain referred to vertex
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sinus headache?
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pain produced by an inflammatory reaction in the nasal mucosa and sinus ostia leading to occlusion and pressure (secondary to structural abnormalities, polyps, allergy)
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sinusitis complications if untreated or undertreated?
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cavernous sinus thrombosis
meningitis intracerebral abscess retro-orbital abscess cranial nerve palsies |
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causes of acute, generalized headaches?
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systemic infection
CNS infection toxins (lead, CO) postseizure electrolyte imbalance post lumbar puncture head trauma embolism vascular thrombosis hemorrhage collagen vascular disease exertion shunt malfunction |
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causes of acute, localized headaches?
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sinusitis
otitis media ocular abnormalities dental disease head trauma occipital neuralgia temporomandibular joint disorder |
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causes of acute, recurrent headaches?
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vascular disease
intoxication MELAS postseizure hypoglycemia exertion |
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causes of chronic progressive, acute headache?
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tumor
pseudotumor cerebrii brain abscess subdural hematoma hydrocephalus |
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criteria for neuroimaging with headache?
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abnormal neuro findings
worrisome symptoms new headache in elderly failure to meet full migraine criteria |
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common clinical indications for LP in headache?
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unexplained fever
suspected pseudotumor cerebrii suspected subarachnoid hemorrhage fever of undetermined origin in a child |
