Term
|
Definition
- Headache attributed to head and/or neck trauma
• Headinjury
- Headache attributed to cranial or cervical vascular disorder including:
• Intracerebral hemorrhage
• Subarachnoid hemorrhage
• Giant cell arteritis (temporal arteritis)
- Headache attributed to non-vascular intracranial disorder including:
• Idiopathic intracranial hypertension (formerly pseudotumorcerebri)
•Post-dural puncture headaches
• Ictal headache
- Headache attributed to a substance or its withdrawal including:
• Medication over use headaches
• Medication or drug withdrawal headaches
• Hangovers
- Headache attributed to infection including:
• Meningitis
- Headache attributed to disorder of homoeostasis
-Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose,
sinuses, teeth, mouth or other facial or cranial structures
- Headache attributed to psychiatric disorder |
|
|
Term
| Medication Overuse Headache |
|
Definition
• Headache present on > 10 (to 15) days/month fulfilling criteria C and D
• Regular overuse for > 3 months of one or more drugs that can be taken for
acute/symptomatic treatment of headache
• Headache has developed or markedly worsened during medication
overuse
• Headache resolves or reverts to its previous pattern within 2 months after
discontinuation of overused medication
• Applies to
- Ergotamine-overuse headache
- Triptan-overuse headache
- Analgesic-overuse headache
- Opioid-overuse headache
- Combination medication-overuse headache |
|
|
Term
|
Definition
• Headache is present in 90% of patients with SAH
• Sudden, severe headache that is continuous and often with nausea, vomiting, meningismus, focal neurological findings, and loss of consciousness
• Nontraumatic causes are most commonly from a ruptured Berry aneurysm or AVM
• “Sentinel” headache prior to the SAH
• CT scan has >90% sensitivity if done in the 1st 24 hours
- A normal CT does not rule out a SAH
- If the CT is normal and your index of suspicion is high, do an LP and examine for xanthochromia
• Gold standard is cerebral angiography |
|
|
Term
|
Definition
|
|
Term
| Subarachnoid hemorrhage treatment |
|
Definition
• A,B,C
• Neurosurgical consult • Avoid hypotension
• Prevent complications
- Hypertension—both systemic and intracranial
- Vasospasm
- Hydrocephalus
- Hemorrhage—rebleeding
- Hyponatremia (SIADH) |
|
|
Term
|
Definition
• No correlation of severity of trauma with neurological signs
• Headache usually appears within a day of injury
• Usually, constant dull ache with overlying throbbing that may be localized, lateralized, or diffuse
• Nausea, vomiting, scintillating scotomas, disequilibrium, impaired memory, poor concentration, emotional instability, increased irritability
• Treatment is difficult |
|
|
Term
|
Definition
• 50% of patients with temporal arteritis have polymyalgia rheumatica and 15% of people with polymyalgia rheumatica have temporal arteritis
• Headache may be described as throbbing (most often), sharp, dull, burning, lancing
• May be worse at night when lying on a pillow, while combing hair, or washing face
• Location of headache may be unilateral or bilateral
• Intermittent jaw claudication occurs in 38%
• On physical exam, 50% will have temporal artery tenderness
• ESR—normal in 10%- 35%
• Start on corticosteroids |
|
|
Term
|
Definition
• Also termed idiopathic intracranial hypertension
• Unknown etiology
• Papilledema is present 95% of cases
• Headache is usually pulsatile, daily, and continuous
• May be unilateral or bilateral
• Nausea (60%) and vomiting (40%)
• May have visual changes
• Testing includes a brain scan, either CT or MRI (more sensitive) which will help exclude a brain tumor
• Follow the imaging study with LP, which will show increased opening pressure and normal CSF
• Treatment includes weight loss, diuretics to decrease CSF production, therapeutic LPs
• Monitor visual acuity, visual fields, funduscopic exams to prevent visual loss |
|
|
Term
|
Definition
• Suspect in patients with a history of malignancy but may also be primary tumor
• Headaches may be nonspecific in character and may vary in severity from mild to severe
• Suspect with new onset headache or progressive headaches or headaches associated with other problems (seizures, confusion, prolonged nausea and vomiting, hemiparesis) |
|
|
Term
|
Definition
• Consider many causes:
- Infectious: Cryptococcus, tuberculosis, syphilis, meningitis
(bacterial, fungal)
- Focal brain lesions: lymphoma, toxoplasmosis, brain abscess - Diffuse brain lesions: herpes simplex, cytomegalovirus
• MRI with gadolinium or contrast CT
• If imaging is normal, LP should be done even in the absence of meningeal signs |
|
|
