Duke PA Headache
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| dietary triggers for migraines | ETOH, chocolate, aged cheeses, MSG, aspartame, caffeine, nuts, nitrites
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| 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?
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| POUND criteria (Pulsatile, hOurs4-72, unilateral, nausea, disabaling) is used for what condition | migraine headache
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| thunderclap headache "worst headache of my life", onset within seconds | subarachnoid headache, medical emergency
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| 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.
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| 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
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| headache with papilledema | intracranial mass lesion
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| patients with migraine headaches and no neurological deficits don't need __ | imaging
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| patients with sexual activity need __ | imaging
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| indications for lumbar puncture | suspicion of an infectious or inflammatory etiology
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| migraine without aura is __ | most common
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| right to left cardiac shunt is associated with | migrain with aura
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| Calcitonin gene-related peptide | potent vasodilator
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| clinical manifestations of migraine | photophobia, phonophobia, dark, quiet room
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| neurologic deficit, precedes migraine, usually stops before onset of headache | aura
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| scintillating scotoma | loss peripheral vision/tunnel vision preceding migraine
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| numbness/tingling of the lips, face, fingers of one hand | cheio-oral aura
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| hypersensitivity of the skin during the migraine headache. | cutaneous allodynia
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| menstrual migraine usually due to decreased levels of __ | estrogen
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| cluster headache pain symptoms | maximal pain in a few minutes, deep, excruciating, continuous, begins in or around the eye or temple
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| 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
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| tension headache | most common, pressure or tightness, generalized, waxes and wanes, food triggers less common
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| acute sinusitis | uncommon cause of recurrent HA, generally in conjunction with fever and purulent discharge
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| 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
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| sinus HA specific symptoms | bilateral/peri-orbital, pressure-like, dull, nasal obstruction or congestion, lasts days
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| brain tumor headache | pain may follow maneuvers raising intrathoracic pressure (cough, sneeze, Valsalva), abnormal neuro exam, significant change in prior HA pattern
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| most important physical sign of idiopathic intracranial HTN (pseudotumor cerebri) | papilledema
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| chronic vasculitis of large and medium sized vessels. tenderness or decreased pulse of the temporal artery | Giant cell arteritis (temporal arteritis)
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| giant cell arteritis symptoms | fever, fatigue, weight loss, jaw claudication, visual (amaurosis fugax)
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| trigeminal neuralgia symptoms | sudden, unilateral, sever, brief, stabbing, recurrent episodes of pain (electric shock like)
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| cause of trigeminal neuralgia | caused by compression of the trigeminal nerve root
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| Trigeminal neuralgia distribution pattern | V2/V3>V1
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| trigeminal neuralgia-facial muscle spasms with severe pain | tic douloureux
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| trigeminal neuralgia triggers | light touch, chewing, talking, brushing, cold air, smiling, grimacing
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| postherpetic neuralgia | continuum of pain that never resolved following an acute episode of herpes zoster
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| 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
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| __ can have refered pain presenting as Persistent idiopathic (atypical) facial pain | nasopharyngeal cancer, or lung cancer
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| glossopharyngeal neuralgia | numerous analogies with trigeminal neuralgia with a different nerve distribution (radiates from oropharynx towards the ear)
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