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Clinical Quiz

Clinical Quiz. Headache Week. Describe the main features of the following headaches:. Migraine. Unilateral Throbbing or pulsating Associated with N + V Exacerbated by movement Photophobia + Phonophobia Lasts approx 72 hours Aura (classic) or no aura (common). Tension-Type Headache.

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Clinical Quiz

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  1. Clinical Quiz Headache Week

  2. Describe the main features of the following headaches:

  3. Migraine • Unilateral • Throbbing or pulsating • Associated with N + V • Exacerbated by movement • Photophobia + Phonophobia • Lasts approx 72 hours • Aura (classic) or no aura (common)

  4. Tension-Type Headache • Bilateral or holocranial headache • Pressing, squeezing or tightening sensation – “like a band or vice around the head” • Occ muscle tenderness in cervical/paracervical muscles

  5. Cluster Headache • Unilateral • Orbital or temporal region • Excruciating • High frequency of headaches lasting days to months • Autonomic symptoms • Patients restless, unable to keep still

  6. SAH • “worst headache of my life” • Sudden onset • Peaks in intensity seconds after onset • Inv: blood in CSF

  7. Raised ICP • Worse in the morning • Some relief when upright, worse when recumbent, walking, bending, coughing • young, overweight women • Occpulsitiletinnitis, transient visual obscurations • Papilloedema, CN 6 palsies, vomiting, fits,

  8. GCA • Usually in pts over 50 • Long lasting • Tenderness of scalp over temporal arteries • Thickening, nodulation, pulselessness and tenderness of arteries on palpation • Fever, fatigue, weight loss • May lead to visual loss

  9. Red Flags for headache • Systemic symptoms or illness (including fever, persistent or progressive vomiting, stiff neck, pregnancy, cancer, immunocompromised state, anticoagulated); • Neurologic signs or symptoms (including altered mental status, focal neurologic symptoms or signs, seizures, or papilledema); • Onset is new (especially in those age 40 years or older) or sudden; • Other associated conditions (eg, headache is subsequent to head trauma, awakens patient from sleep, or is worsened by Valsalvamaneuvers); • Prior headache history that is different (eg, headaches now are of different pattern or are rapidly progressive in severity or frequency).

  10. Stroke in Anterior Cerebral Artery • Personality changes • Contralateralhemiplegia and hemisensory loss

  11. Stroke in Middle Cerebral Artery • Homonymous hemianopia • Contralateralhemiplegia and hemisensory loss in upper limb and face • Language problems • Decorticate spasticity

  12. Stroke in Posterior Cerebral Artery • Contralateralhemiparesis • Eye movement paresis/paralysis

  13. Stroke in Parietal Lobe • Homonimousquadrantanopsia • Spatial Dysperception • Hand-Eye Incoordination • Inability to visually scan one’s surroundings, in spite of having full eye movements • Sensory loss • Astereognosis(the inability to identify an object by the sense of touch) • Hemineglect • Finger agnosia • Right-left confusion • Difficulty with reading, writing, and math

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