- DAMS
HEADACHE : - marrow
- marwah
Classification :
1° 2°
Where Headache is the DISEASE Due to underlying pathology
Benign, recurrent Causes : Head trauma
Idiopathic stabbing & exertional Hemorrhage (subarachnoid)
Systemic infections - m/c
TYPES : tension type (69%) (Sinusitis , meningitis)
Migraine type Tumor ( brain )
TAC (trigeminal autonomic cephalgia) Opthalmic causes
Trigeminal neuralgia Dental pain
Cluster type
Exertional
• Headache symptoms that suggest a serious underlying disorder:
Sudden - onset headache
1st severe headache
“worst” headache ever
Vomiting that precedes headache
Pain induced by bending, lifting, coughing
Pain that disturbs sleep or presents immediately upon awakening
Abnormal neurological examination
Onset after age 55
Mc type of headache = tension headache
Mc type of 2° headache = infection
TENSION TYPE HEADACHE :
Mc type of 1° headache
Mc occurs in a middle aged females > males
Doesn’t affect activities of daily living
It’s related to stress & depression (1/3rd pts hence it responds well to low dose amitriptyline)
Clinical features: B/L , dull aching “ band like sensation”
Scalp tenderness often ass. W/ paraesthesia
Treatment:
Acute attack - NSAIDs + muscle relaxants
Chronic prophylaxis - SSRI /TCA (w/ amitriptyline)
, Tension headache may Migraine headache Pain often around
be once or few times a is severe, intense eyes & pt. May wake
week or continuous for throbbing pain w/ up often in the
a several days pulsating character middle of the night
mostly localised on
one side of head
MIGRAINE TYPE HEADACHE :
Predominantly affects female aged 20-40 yrs
2 nd mc cause of 1° headache
M
Usually episodic For diagnosis of migraine,
mnemonic :
Precipitation factors : glare
Bright lights P - pulsating headache
Sounds O - one day duration (4-72 hrs)
Hunger U - unilateral
Excess stress N - nausea
Physical exertion D - disabling in character
Lack or excess of sleep
Alcohol
Migraine stressors in India : crowds , busy traffic
Hot arid climate
Mosquito coils
Henna
Hot & spicy food
The important pathogenic cytokine in migraine is CGRP (calcitonin gene related peptide)
HEADACHE : - marrow
- marwah
Classification :
1° 2°
Where Headache is the DISEASE Due to underlying pathology
Benign, recurrent Causes : Head trauma
Idiopathic stabbing & exertional Hemorrhage (subarachnoid)
Systemic infections - m/c
TYPES : tension type (69%) (Sinusitis , meningitis)
Migraine type Tumor ( brain )
TAC (trigeminal autonomic cephalgia) Opthalmic causes
Trigeminal neuralgia Dental pain
Cluster type
Exertional
• Headache symptoms that suggest a serious underlying disorder:
Sudden - onset headache
1st severe headache
“worst” headache ever
Vomiting that precedes headache
Pain induced by bending, lifting, coughing
Pain that disturbs sleep or presents immediately upon awakening
Abnormal neurological examination
Onset after age 55
Mc type of headache = tension headache
Mc type of 2° headache = infection
TENSION TYPE HEADACHE :
Mc type of 1° headache
Mc occurs in a middle aged females > males
Doesn’t affect activities of daily living
It’s related to stress & depression (1/3rd pts hence it responds well to low dose amitriptyline)
Clinical features: B/L , dull aching “ band like sensation”
Scalp tenderness often ass. W/ paraesthesia
Treatment:
Acute attack - NSAIDs + muscle relaxants
Chronic prophylaxis - SSRI /TCA (w/ amitriptyline)
, Tension headache may Migraine headache Pain often around
be once or few times a is severe, intense eyes & pt. May wake
week or continuous for throbbing pain w/ up often in the
a several days pulsating character middle of the night
mostly localised on
one side of head
MIGRAINE TYPE HEADACHE :
Predominantly affects female aged 20-40 yrs
2 nd mc cause of 1° headache
M
Usually episodic For diagnosis of migraine,
mnemonic :
Precipitation factors : glare
Bright lights P - pulsating headache
Sounds O - one day duration (4-72 hrs)
Hunger U - unilateral
Excess stress N - nausea
Physical exertion D - disabling in character
Lack or excess of sleep
Alcohol
Migraine stressors in India : crowds , busy traffic
Hot arid climate
Mosquito coils
Henna
Hot & spicy food
The important pathogenic cytokine in migraine is CGRP (calcitonin gene related peptide)
