20% of people
What percentage of people suffer from headaches?
More common in women
Decrease with age
Headaches are more common in ________ (men/women) and ______ (increase/decrease) incidence with aging
Post-trauma: related to concussion and mild head injury.
Caused by injury causing percussive force of brain in cranial activity.
When is an acute headache likely to occur?
TRUE!
Can be a red flag indicator for any of the following:
Subarachnoid hemorrhage
Brain tumor
Meningitis
CVA
T/F: Sudden onset of a severe headache with neurological signs is a red flag
Throbbing in the occipital region, increased in the head down position
Someone who has a headache and hypertension is going to experience what associated symptoms?
Tenderness over the frontal and maxillary sinuses, increased in head down position
Someone with a headache and sinusitis is likely to experience which associated symptoms?
Where
What
Quantity
When
Setting
Better/worse
Associations
What are the 7 attributes of a symptom
Resolves with illness
Someone with a headache due to systemic illness would likely experience what associated symptoms
Refer to PP
Patient is a 35 year old male referred by PCP for evaluation and treatment of cervical pain. His chief complaint is of daily headaches, no pattern apparent, for last four weeks. Headaches are 6/10, and he has to stop activity due to pain. He also reports
Refer to personal PP
Patient is a 4 year old boy referred to you by pediatrician to rule out developmental delay. The parents report that the child complains of headache, and has episodes of extreme fatigue/ lethargy. They also report that he falls frequently. You find some l
Refer to personal PP for diagnosis
Your patient is a 45 year old woman who is being seen post meniscal repair. She presents to clinic with reports of extreme headache, since 20 minutes ago. Her BP is 140/100, HR 80. She is becoming increasingly lethargic.
Mild to severe intermittent headaches
Neurological symptoms include fluctuating consciousness
Describe a subdural hematoma: severity and symptoms
Sudden onset
Severe and constant headache
Elevated BP
Can cause change in consciousness
Describe a sub-arachnoid hemorrhage (onset, severity, symptoms)
Mild to severe headache
Neurologic symptoms include hemiparesis (paralysis to one side of the body)
Visual changes
Brain stem symptoms including vomiting
Altered consciousness
Describe increased intracranial pressure (severity, symptoms)
Mild to severe headache
Local or distant infection
May be afebrile (no fever)
Neurologic symptoms consistent with local site of infection
Describe a tumor with increased cranial pressure (severity and symptoms)
Symptoms: Fever, HA, stiff neck, photophobia, drowsiness, confusion
Effects: flu-like symptoms
Severity: Self-limiting 3-10 days, less contagious
Treatment: Rest and tylenol
Describe viral meningitis (symptoms, effects, severity, and treatment)
Symptoms: High fever, severe HA, stiff neck, photophobia, drowsiness, confusion, ALSO: skin rash, N/V (nausea/vomiting), sore throat
Effects: Brain damage, hearing loss, mental retardation, can be fatal, if not treated aggressively
Severity: life-threaten
Describe bacterial meningitis (symptoms, effects, severity, and treatment)
Post-lumbar puncture or epidural anesthesia
Leaking of the CSF causes changes in pressure
Lying still is necessary, valsalva (closing nostrils and blowing out) increases the pain
Describe a post-dural puncture headache (cause, better/worse)
Frontal or dull headache
Usually worse in mornings, and increased pain in cold damp air
Nasal discharge
Describe sinusitis (better/worse, symptoms)
Generalized headache, pulsating, may show other signs of toxicity
Describe toxicity
Feeling of fullness in the ear, stabbing pains in head, vertigo, and tinnitus
Describe symptoms brought on by otitis media and/or mastoiditis
Migraine
Cluster
Tension
What are the 3 types of chronic headache?
40
Half of migraines develop in childhood or adolescence, but almost always before what age?
Estrogen levels
Patterns change during pregnancy, associated with menses
In women, migraines are related to _______ levels.
Confined to one side of the head
In migraines, pain is usually presented where?
TRUE
T/F: Migraines are exacerbated by physical and/or emotional stress
Long-duration, more common in young women, could have an aura, usually one-sided
Describe a migraine
Episodic unilateral severe pain
Daily or several times per day for a period of several weeks
Associated with sleep apnea and hypoxemia (low blood-oxygen)
Sudden onset
Boring and non-throbbing
Associated with ANS symptoms usually contralateral (nasal conge
Describe a cluster headache
Young men (late 20s)
What populations are cluster headaches most prevalent in?
FALSE, they will feel worse
T/F: Cluster headaches usually feel better after awakening from an afternoon nap
symptoms are alleviated in an upright posture
Do symptoms of cluster headaches get worse or better in an upright posture?
TRUE
T/F: Men with cluster headaches typically have common features such as: hypermasculinity, tall, anxiety, hypochondria, compulsivity, smokers, alcohol