by ahmed jabbar

1. HEADACHE
Neurology session.
Done by ahmed jabbar

2. Caused by traction,displacement
inflammation and vascular spasm or
distention of pain sensitive structures in
the head or neck.
Pain sensitive structures include: venous
sinus,arteries,dura,v,ix,x cranial nerves and
periostium

3. 1.Types
A.Primary.
headache.migraine,tension,trigeminal
autonomic cephalagia(TACs),primary
thunderclap,hemicraine and continua
B.Secondary.
Meningitis,intracranial hemorrhage,brain
tumor and temporal arteritis

4. 1. location of pain: unilateral (migraine)
, bilateral(tension)and paranasal(sinusitis)
2.characteristics:
pulsating(migraine),tight or
pressure(tension),dull(mass) and
sharp(trigeminal neuralgia)
3.presipitating factors:
stressmfatigue,menses,hunger,choclate
and tyramine

5. 4.relieving factors: darkness,sleep and
vomiting
5.associated symptoms :wt.loss fever
nausea, photophobia, phonophobia
etc…
6.time
7.aura.

7. is a chronic neurological disease
characterized by recurrent moderate to
severe headaches often in association
with a number of autonomic nervous
system symptoms
*migraine is sensitive to sound,light and
movement

8. 1.common migraine(without
aura):recurrent lasting 4-72 hours
2.classic migraine (with aura)
aura is a transient focal neurological
phenomenon that occurs before or
during the headache
Consist of visual,sensory and speech

9. 1.The diagnosis of migraine without aura
#Five or more attacks—for migraine with aura, two attacks
are sufficient for diagnosis
#Four hours to three days in duratio
#Two or more of the following:
Unilateral (affecting half the head);
Pulsating;
Moderate or severe pain intensity
#One or more of the following:
Nausea and/or vomiting;
Sensitivity to both light (photophobia) and sound
(phonophobia)
.

10. 2. The diagnosis of migraine with aura
#at least 2 attcks
#aura.reversible
#2 of the following
Visual symptoms and or unilateral sensory
symptoms.
At least one aura

11. 1.Nonpharmalogical: lifestyle change
2.pharmalogical:
Analgesics
Triptans
Ergotamines
NSAIDs
Dopamine antagonist
3.Prevention
Antiepileptic drug
Antidepressant
Beta blockers
CCB
antiserotonine

12. is the most common type of
primary headache. The pain can radiate
from the lower back of the head, the
neck, eyes, or other muscle groups in the
body. Tension-type headaches account
for nearly 90% of all headaches.

13. Diffuse
Not aggravated by activity
Not severe
No nausea and vomiting
Photophobia or phonophobia

14. Lifestyle
Physical
Pharmacological:
Acetaminophen
Aspirin
Ibuprofen
Preventive:
Amitriptyline(antidepressant)

15. neurological disorder characterized by
recurrent, severe headaches on one side
of the head, typically around the eye.
There are often accompanying
autonomic symptoms during the
headache such as eye watering, nasal
congestion and swelling around the eye,
typically confined to the side of the
head with the pain.
Lasting 15 min to 2 hours

16. Sumatriptan nasal spray
Prevention:
Short term: prednisone
Long term: verapamil

17. Temporal arteritis
Idiopathic intracranial hypertension
Trigeminal neuralgia

18. is an inflammatory disease of blood
vessels most commonly involving large
and medium arteries of the head,
predominantly the branches of the
external carotid artery.
Associated with malaise,myalgia,wt
loss,arthralgia and fever
Pain during chewing(jaw claudication)
Involvement of ophthalmic artery lead to
visual loss

19. Dilated and tender
Biopsy: thick wall
High ESR
Rx:
High dose of prednisone

20. sometimes called by the older names
benign intracranial hypertension
is a neurological disorder that is
characterized by increased intracranial
pressure in the absence of a tumor or other
diseases.
double vision and other visual symptoms. If
untreated, it may lead to swelling of
the optic disc(papilledema) in the eye,
which can progress to vision loss.

21. Dandy criteria
1.Increased i.c pressure(headache
and papillidema)
2. 6th nerve palsy
3.Normal neuroimage
4.Elevated opening pressure more
than 250 mmH2O

22. Removal of 20-40 ml of csf
Diuretics:
Acetazolamide
furesamide

23. is a neuropathic disorder characterized
by episodes of intense pain in the face,
originating from the trigeminal nerve. The
clinical association between TN and
hemifacial spasm is the so-called tic
douloureux.
No more than few seconds or minutes
Sensory loss can not be demonstrated
on examination.
Common.

24. Carbamazepine.
Baclofen.
Gasserian ganglian ablation.
Radio-surgery .

25. Causes
1.Subarachnoid or intracerebral hg
2.cervico-cephalic arterial dissection
3.Cerebral venous thrombosis
4.Acute hypertension
5.Acute low csf pressure