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What are the features of Tension-Type Headache?
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What are th features of Migraine?
Number/Duration: 5 headaches of >4 hours
Characteristics: Unilateral (frontal), Pulsating, Moderate to Severe, Aggravated by activity (at least 2)
Associated Features: Nausea / Vomitting, Photo or Phonophobia (at least one)
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What are some contradictions for the use of Triptans?
- Ischemic heart disease
- Ischemic cerebrovascular disease
- Ischemic bowel disease
- Uncontrolled HTN
- Hemiplegic or Basilar Migraine
- Ise wit Ergots / Tryptans / SSRI's
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What is Familial Hemiplegic Migraine?
- Complicated migraine with hemiplegia / paresis
- Maps to Chromosome 19
- Caused by a mutation in Ca Channel
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What is CADASIL?
- Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy
- Autosomal dmoninant disorder
- Presents with migraine and recurrent strokes
- Notch3 gene on Chromosome 19
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What are the features of Cluster Headache?
- M > F
- Recurrent, severe, unilateral, retro/peri-orbital pain
- > 60 minutes
- Clusters often occur seasonally first thing in the morning
- Autonomic features
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Describe the features of Paroxysmal Hemicrania?
- F > M
- Episodes of unilateral retroorbital pain
- Multiple attacks a dayeach attack lasts minutes
- Associated autonomic features
- Diagnosed by Indomethacin responsivits
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What are the features of SUNCT?
- Short-acting Unilateral Neuralgiform headache with Conjunctival Injection and Tearing
- M > F, < 50 years old
- 3-100 attacks a day
- No response to indomethacin
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What are the features of Trigeminal Neuralgia?
- Severe, brief, recurring, lancinating pain in a V2-V3
- Triggered by trigger points
- Treated with Tegretol, PHT, GABApentin, Baclofen, Bz
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What are the features of Pseudotumor Cerebri?
- Headache, Papilledema, Bilateral CN VI Palsies, Visual Loss
- F > M
- DX: LP (>25), MRI - empty sella
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What are the features of Giant Cell Arteritis?
- F > M and W > B
- Systemic disorder with large artery inflammation
- Fevers, Weight Loss, Angina, Jaw Claudication, Transient monocular blindness
- HA (unilateral temporal)
- DX: ESR (>100), CRP, CBC, and Temporal Artery Bx
- TX: High dose steroids
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What are some common medications that can cause headaches?
- Aggrenox
- OTC Agents (rebound)
- NSAIDs (asceptic meningitis)
- Nitroglycerin
- Calcium Channel Blockers
- H2 Blockers
- Methylxanthines
- IVIg
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