Case 18: 24-year-old female with headaches
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1. Types of primary headaches =: Migraine
Tension
Cluster
2. Serious causes of headache you don't want to miss =: Meningitis
Brain tumor
Intracranial hemorrhage
Traumatic brain injury (concussion)
3. This type of headache is associated with rhinorrhea, lacrimation, facial
sweating, miosis, eyelid edema, conjunctival injection, and ptosis: CLUSTER
HEADACHE
4. This type(s) of headache(s) may occur with photophobia or hyperacusis
=: MIGRAINE or TENSION headaches
5. This type of headache worsens with physical activity =: MIGRAINE
6. This type of headache is characterized by pressing, tightening, and bilateral
pain =: TENSION
7. Duration of a migraine headache =: 4-72 hours
8. Duration of a tension headache =: 30 minutes to 7 days
9. # of episodes needed for diagnosis of migraines =: *5* episodes
10. # of episodes needed for diagnosis of tension headaches =: *10* episodes
11. # of episodes needed for diagnosis of cluster headaches =: *5* episodes
12. Sudden onset of headache, severe headache, recent trauma, elevated
blood pressure = concerning for?: ICH
13. Cognitive impairment, weight loss or other systemic symptoms, abnormal
neurologic examination = concerning for?: BRAIN TUMOR
14. Common causes of secondary headaches =: 1. Anxiety/depression
2. Medication overuse
15. Headache due to depression or anxiety is most similar to this type of
headache =: *Tension headache*
- Bilateral, pressing, and/or tight
- Last from 30 minutes to seven days
16. Chronic use of this type of medication can cause medication overuse
headache =: Analgesics
17. Diagnostic criteria for medication overuse headache =: - > 15 headaches
per month
- Regular overuse of an analgesic for > 3 mos (at least 15x in the past 3 months for
simple analgesics)
- Development or worsening of a headache during medication overuse
- Headache resolves or reverts to its previous pattern within 2 months after discon-
tinuation of overused medication
1/4
Study online at https://quizlet.com/_fm553k
1. Types of primary headaches =: Migraine
Tension
Cluster
2. Serious causes of headache you don't want to miss =: Meningitis
Brain tumor
Intracranial hemorrhage
Traumatic brain injury (concussion)
3. This type of headache is associated with rhinorrhea, lacrimation, facial
sweating, miosis, eyelid edema, conjunctival injection, and ptosis: CLUSTER
HEADACHE
4. This type(s) of headache(s) may occur with photophobia or hyperacusis
=: MIGRAINE or TENSION headaches
5. This type of headache worsens with physical activity =: MIGRAINE
6. This type of headache is characterized by pressing, tightening, and bilateral
pain =: TENSION
7. Duration of a migraine headache =: 4-72 hours
8. Duration of a tension headache =: 30 minutes to 7 days
9. # of episodes needed for diagnosis of migraines =: *5* episodes
10. # of episodes needed for diagnosis of tension headaches =: *10* episodes
11. # of episodes needed for diagnosis of cluster headaches =: *5* episodes
12. Sudden onset of headache, severe headache, recent trauma, elevated
blood pressure = concerning for?: ICH
13. Cognitive impairment, weight loss or other systemic symptoms, abnormal
neurologic examination = concerning for?: BRAIN TUMOR
14. Common causes of secondary headaches =: 1. Anxiety/depression
2. Medication overuse
15. Headache due to depression or anxiety is most similar to this type of
headache =: *Tension headache*
- Bilateral, pressing, and/or tight
- Last from 30 minutes to seven days
16. Chronic use of this type of medication can cause medication overuse
headache =: Analgesics
17. Diagnostic criteria for medication overuse headache =: - > 15 headaches
per month
- Regular overuse of an analgesic for > 3 mos (at least 15x in the past 3 months for
simple analgesics)
- Development or worsening of a headache during medication overuse
- Headache resolves or reverts to its previous pattern within 2 months after discon-
tinuation of overused medication
1/4
