Term
| How would you describe a thunderclap headache? |
|
Definition
| Like a blow with a baseball bat. Vomiting. |
|
|
Term
| What it is important to look out for in a thunderclap headache? |
|
Definition
1) Subarachnoid haemorrhage
2) Venous sinus thrombosis. |
|
|
Term
| Why do patients sometimes get a headache preceded by a visual disturbance (flashing lights)? |
|
Definition
| A wave of distortion spreadig across the cortex causing a migraine visual aura |
|
|
Term
| What are some of the more obvious differences between tension headache and migraine? |
|
Definition
| Migraine: aura, unilateral, triggers, throbbing, responsive to triptans, disabling. |
|
|
Term
| What are the simplified diagnostic criteria for identifying migraine? |
|
Definition
1) Light sensitivity
2) Nausea
3) Decreased ability to function
-2/3= migraine. |
|
|
Term
| How would you treat tension headache? |
|
Definition
1) Rest
2) Relaxation
3) Simple analgesics
4) Amitryptyline 5-10 mg nocte |
|
|
Term
| How would you treat acute migraine? |
|
Definition
1) NSAIDs
2) Opiates
3) Triptans |
|
|
Term
|
Definition
| 5-HT agonists. Cause cranial vasodilation and neuropeptide relese. |
|
|
Term
| Describe the symptoms of cluster headache? |
|
Definition
1) Clusters of episodes with long periods of remission
2) Unilateral tearing/ nasal discharge
3) Often at the same times
4) Often presents as 'eye pain'. |
|
|
Term
| How do you treat cluster headache? |
|
Definition
|
|
Term
| What is temporal arteritis and how would you diagnose it? |
|
Definition
An inflammation of the blood vessels around the brain.
1) Normally >60 years old
2) Elevated inflammatory markers (ESR)
3) Systemically unwell (sometimes pyrexia). |
|
|
Term
| How would you treat temporal arteritis? |
|
Definition
|
|
Term
| What is trigeminal neuralgia? |
|
Definition
| 1) Paroxysmal attacks of frontal pain that lasts for a few seconds (less than 2 min) |
|
|
Term
| How would you treat trigeminal neuralgia? |
|
Definition
| Carbamezapine (an anti convulsant) or using a Jannetta procedure. |
|
|
Term
| What would you expect to find in a patient with idiopathic intracranial hypertension? |
|
Definition
1) Obesity
2) Increased CSF opening pressure
3) Transient visual loss. |
|
|
Term
| What is the treatment for idiopathic intracranial hypertension? |
|
Definition
|
|
Term
| What is the diagnosis for an obese patient who wakes up with a headache and often falls asleep in the early evenings? |
|
Definition
| Morning headache due to obstructive sleep apnoea. |
|
|
Term
| How do you treat obstructive sleep apnoea? |
|
Definition
1) Reduce alcohol intake
2) Lose weight
3) Nocturnal CPAP. |
|
|
