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DU PA Headache

Duke PA Headache

dietary triggers for migraines ETOH, chocolate, aged cheeses, MSG, aspartame, caffeine, nuts, nitrites
triggers for migraines hormones, sensory stimlui (lights, odors, sounds/noise), stress (intense activity, loss or change, moving, crisis), environment (weather, altitude, schedule), habits (sleeping patterns, dieting), HTN?
POUND criteria (Pulsatile, hOurs4-72, unilateral, nausea, disabaling) is used for what condition migraine headache
thunderclap headache "worst headache of my life", onset within seconds subarachnoid headache, medical emergency
headache associated danger signs, not just an everday headache absence of similar HA previously, worsening pattern, focal neurologic s/s, fever, mental status change, rapid onset with strenuous exercise. Pain spreading to lower neck/shoulders.
Danger signs in patients with new headache <5 yo or >50 yo, in a patient with CA, in a patient with lyme disease, in a patient with HIV
headache with papilledema intracranial mass lesion
patients with migraine headaches and no neurological deficits don't need __ imaging
patients with sexual activity need __ imaging
indications for lumbar puncture suspicion of an infectious or inflammatory etiology
migraine without aura is __ most common
right to left cardiac shunt is associated with migrain with aura
Calcitonin gene-related peptide potent vasodilator
clinical manifestations of migraine photophobia, phonophobia, dark, quiet room
neurologic deficit, precedes migraine, usually stops before onset of headache aura
scintillating scotoma loss peripheral vision/tunnel vision preceding migraine
numbness/tingling of the lips, face, fingers of one hand cheio-oral aura
hypersensitivity of the skin during the migraine headache. cutaneous allodynia
menstrual migraine usually due to decreased levels of __ estrogen
cluster headache pain symptoms maximal pain in a few minutes, deep, excruciating, continuous, begins in or around the eye or temple
Cluster headache clinical presentation remains on the same side of the head during a cluster, can switch sides during the next cluster, restlessness, pacing, ipsilateral lacrimation, eye redness, stuffy nose, rhinorrhea, sweating, pallor, and Horner's syndrome
tension headache most common, pressure or tightness, generalized, waxes and wanes, food triggers less common
acute sinusitis uncommon cause of recurrent HA, generally in conjunction with fever and purulent discharge
autonomic features that are present in both cluster and migraine, often mistaken for Sinus HA nasal congestion, rhinorrhea, tearing, color and temperature change, changes in pupil size
sinus HA specific symptoms bilateral/peri-orbital, pressure-like, dull, nasal obstruction or congestion, lasts days
brain tumor headache pain may follow maneuvers raising intrathoracic pressure (cough, sneeze, Valsalva), abnormal neuro exam, significant change in prior HA pattern
most important physical sign of idiopathic intracranial HTN (pseudotumor cerebri) papilledema
chronic vasculitis of large and medium sized vessels. tenderness or decreased pulse of the temporal artery Giant cell arteritis (temporal arteritis)
giant cell arteritis symptoms fever, fatigue, weight loss, jaw claudication, visual (amaurosis fugax)
trigeminal neuralgia symptoms sudden, unilateral, sever, brief, stabbing, recurrent episodes of pain (electric shock like)
cause of trigeminal neuralgia caused by compression of the trigeminal nerve root
Trigeminal neuralgia distribution pattern V2/V3>V1
trigeminal neuralgia-facial muscle spasms with severe pain tic douloureux
trigeminal neuralgia triggers light touch, chewing, talking, brushing, cold air, smiling, grimacing
postherpetic neuralgia continuum of pain that never resolved following an acute episode of herpes zoster
Persistent idiopathic (atypical) facial pain persistent facial pain that does not have the characteristics of the cranial neuralgias and is not attributed to another disorder
__ can have refered pain presenting as Persistent idiopathic (atypical) facial pain nasopharyngeal cancer, or lung cancer
glossopharyngeal neuralgia numerous analogies with trigeminal neuralgia with a different nerve distribution (radiates from oropharynx towards the ear)
Created by: bwyche