PHR 954: Headache Exam
Study Guide
what is the only type of headache that can present as *bilateral* pain? - ANSWER
tension-type
what is the onset of tension-type HA? - ANSWER sudden
which HA presents as mild to moderate pain with dull, squeezing ache and feels like a
band is wrapped around the forehead? - ANSWER tension type
what is the main cause of tension type HA? - ANSWER stress or mental tension
what other symptoms can be associated with tension type HA? - ANSWER stiff/ painful
neck
do tension type HA present with N/V, photophobia or phonophobia? - ANSWER no
what can help treat tension type HA? - ANSWER analgesics (probably NSAIDs)
is a migraine unilateral or bilateral? - ANSWER unilateral
what is the onset of migraines? - ANSWER builds quickly over an hour and lasts 4-72
hours
what HA presents with severe and incapacitating pulsating and throbbing pain
associated with N/V, photophobia, and phonophobia *without* aura? - ANSWER classic
migraine
does exercise help a migraine (with or without aura)? - ANSWER no
what relieves migraines (with or without aura)? - ANSWER laying down in a dark and
quiet room
what HA presents with severe and incapacitating pulsating and throbbing pain
associated with N/V, photophobia, and phonophobia *AND* aura? - ANSWER migraine
with aura
what is aura? - ANSWER flashing lights, scotoma, visual disturbances, paresthesia
prodrome of tiredness, fatigue, mood changes, or GI symptoms
some patients can smell cigarettes or bananas
how does a complex migraine present? - ANSWER focal-neurologic deficits, stroke-like
, symptoms
what is a complex migraine? - ANSWER easily localized ischemia area with presentation
of specific symptoms associated with that area
-> normal CT
what is the 1st step in complex migraines? - ANSWER rule out stroke
what is the onset/ duration of a cluster HA? - ANSWER acute onset over minute, lasts
30-180 minutes
is a cluster HA unilateral or bilateral? - ANSWER unilateral starting around the eye or
the temple
what HA presents with piercing, deep, throbbing pain around eye or temple? - ANSWER
cluster HA
what other symptoms can be associated with a cluster HA? - ANSWER ipsilateral (same
side as pain) nasal congestion or rhinorrhea, conjunctival injection or lacrimation, eyelid
edema, facial sweating, and autonomic signs
what helps relieve a cluster HA? - ANSWER physical activity
are cluster HA more common in men or women? - ANSWER men
are migraines more common in men or women? - ANSWER women
what treatments can be considered in cluster HA? - ANSWER chloropromazine,
procholorperazine, promethazine
droperidol, haloperidol
metoclopramide
sumatriptan
NSAIDs, APAP
VPA
which type of HA is the most common? - ANSWER primary- tension type
which type of HA is most worrisome? - ANSWER acute onset of HA or new character of
HA not experienced before
what BP is a person at high-risk of a head bleed (ICH or SAH) or hypertensive
encephalopathy? - ANSWER BP > 220/120
what is papilledema? - ANSWER swelling of the optic nerve
what does papilledema signify? - ANSWER hypertensive emergency, increased
Study Guide
what is the only type of headache that can present as *bilateral* pain? - ANSWER
tension-type
what is the onset of tension-type HA? - ANSWER sudden
which HA presents as mild to moderate pain with dull, squeezing ache and feels like a
band is wrapped around the forehead? - ANSWER tension type
what is the main cause of tension type HA? - ANSWER stress or mental tension
what other symptoms can be associated with tension type HA? - ANSWER stiff/ painful
neck
do tension type HA present with N/V, photophobia or phonophobia? - ANSWER no
what can help treat tension type HA? - ANSWER analgesics (probably NSAIDs)
is a migraine unilateral or bilateral? - ANSWER unilateral
what is the onset of migraines? - ANSWER builds quickly over an hour and lasts 4-72
hours
what HA presents with severe and incapacitating pulsating and throbbing pain
associated with N/V, photophobia, and phonophobia *without* aura? - ANSWER classic
migraine
does exercise help a migraine (with or without aura)? - ANSWER no
what relieves migraines (with or without aura)? - ANSWER laying down in a dark and
quiet room
what HA presents with severe and incapacitating pulsating and throbbing pain
associated with N/V, photophobia, and phonophobia *AND* aura? - ANSWER migraine
with aura
what is aura? - ANSWER flashing lights, scotoma, visual disturbances, paresthesia
prodrome of tiredness, fatigue, mood changes, or GI symptoms
some patients can smell cigarettes or bananas
how does a complex migraine present? - ANSWER focal-neurologic deficits, stroke-like
, symptoms
what is a complex migraine? - ANSWER easily localized ischemia area with presentation
of specific symptoms associated with that area
-> normal CT
what is the 1st step in complex migraines? - ANSWER rule out stroke
what is the onset/ duration of a cluster HA? - ANSWER acute onset over minute, lasts
30-180 minutes
is a cluster HA unilateral or bilateral? - ANSWER unilateral starting around the eye or
the temple
what HA presents with piercing, deep, throbbing pain around eye or temple? - ANSWER
cluster HA
what other symptoms can be associated with a cluster HA? - ANSWER ipsilateral (same
side as pain) nasal congestion or rhinorrhea, conjunctival injection or lacrimation, eyelid
edema, facial sweating, and autonomic signs
what helps relieve a cluster HA? - ANSWER physical activity
are cluster HA more common in men or women? - ANSWER men
are migraines more common in men or women? - ANSWER women
what treatments can be considered in cluster HA? - ANSWER chloropromazine,
procholorperazine, promethazine
droperidol, haloperidol
metoclopramide
sumatriptan
NSAIDs, APAP
VPA
which type of HA is the most common? - ANSWER primary- tension type
which type of HA is most worrisome? - ANSWER acute onset of HA or new character of
HA not experienced before
what BP is a person at high-risk of a head bleed (ICH or SAH) or hypertensive
encephalopathy? - ANSWER BP > 220/120
what is papilledema? - ANSWER swelling of the optic nerve
what does papilledema signify? - ANSWER hypertensive emergency, increased
