T1 SYMPOSIUM. Headaches and migraines (JG)(1)
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Questions and Answers

Which cranial structures are pain insensitive?

  • Dura near the base of the brain and large arteries
  • Arteries at the base of the brain and their major branches (correct)
  • Dural Cranial and Extracranial nerves
  • Arteries of the dura

    • Which neurotransmitter is NOT mentioned in the text?

  • Oxytocin (correct)
  • Dopamine
  • Glutamate
  • Serotonin

    • Which brainstem nucleus is involved in processing pain?

  • Dorsal Raphe nucleus (serotonergic)
  • Superior salivatory nucleus (autonomic)
  • Trigeminocervical complex
  • Locus Coeruleus (Noradrenalin) (correct)

    • What is the most common type of primary headache?

    <p>Migraine</p> Signup and view all the answers

    What are the red flags in clinical assessment for headaches?

    <p>All of the above</p> Signup and view all the answers

    What are the diagnostic criteria for migraines?

    <p>At least five attacks fulfilling criteria B-D</p> Signup and view all the answers

    What is the duration of a migraine headache attack?

    <p>4-72 hours</p> Signup and view all the answers

    What is the third most common disease in the world?

    <p>Migraine</p> Signup and view all the answers

    What are the phases of a migraine?

    <p>Prodrome, Aura, Attack, Postdrome</p> Signup and view all the answers

    How many people in the UK have migraines?

    <p>Over 10 million</p> Signup and view all the answers

    Which of the following is NOT a common symptom of migraines?

    <p>Tingling or numbness in the face</p> Signup and view all the answers

    What percentage of the adult population has had at least one headache over the past year?

    <p>50%</p> Signup and view all the answers

    Which of the following is NOT a pain sensitive structure within the brain?

    <p>Cerebrospinal fluid</p> Signup and view all the answers

    What is the lifetime prevalence of headaches?

    <p>96%</p> Signup and view all the answers

    Which type of headache is NOT classified as a primary headache?

    <p>Sinus headache</p> Signup and view all the answers

    What percentage of the UK population experiences migraines?

    <p>15%</p> Signup and view all the answers

    What is the third highest cause of disability?

    <p>Headaches</p> Signup and view all the answers

    What percentage of all outpatient department (OPD) referrals are related to neurology?

    <p>25%</p> Signup and view all the answers

    What percentage of all admissions to the emergency department (ED) are related to neurology?

    <p>2%</p> Signup and view all the answers

    Why is it important to know about headaches?

    <p>To understand the underlying pathophysiology</p> Signup and view all the answers

    Which of the following is NOT a recommended lifestyle change for treating migraines?

    <p>Exercising</p> Signup and view all the answers

    Which of the following is an abortive treatment for migraines?

    <p>Triptans</p> Signup and view all the answers

    Which of the following is NOT a preventative treatment for migraines?

    <p>NSAIDs</p> Signup and view all the answers

    What is the role of Botox in treating migraines?

    <p>It blocks the release of neurotransmitters</p> Signup and view all the answers

    Which of the following is a common co-morbidity associated with migraines?

    <p>Anxiety</p> Signup and view all the answers

    What are the typical characteristics of tension headaches?

    <p>Severe and bilateral</p> Signup and view all the answers

    What is the imaging of choice for evaluating primary headaches?

    <p>MRI Brain</p> Signup and view all the answers

    What is the recommended investigation for detecting viral infections in the cerebrospinal fluid?

    <p>Lumbar puncture</p> Signup and view all the answers

    What is the treatment for idiopathic intracranial hypertension?

    <p>Acetazolamide</p> Signup and view all the answers

    Which condition is characterized by paroxysmal pain in the V2 and V3 dermatomes triggered by touch, wind, or talking?

    <p>Trigeminal neuralgia</p> Signup and view all the answers

    What is the estimated lifetime prevalence of migraines in the UK?

    <p>100%</p> Signup and view all the answers

    What is the percentage of the UK population that experiences migraines?

    <p>15%</p> Signup and view all the answers

    What is the percentage of outpatient referrals related to headaches?

    <p>25%</p> Signup and view all the answers

    What is the percentage of emergency department presentations related to headaches?

    <p>1%</p> Signup and view all the answers

    What is the first step in the process of diagnosing headaches?

    <p>Determining if there are any red flags present</p> Signup and view all the answers

    Which of the following is NOT considered a red flag in headache assessment?

    <p>Sudden onset of headache within 15 minutes</p> Signup and view all the answers

    What percentage of primary headaches are classified as migraine?

    <p>99%</p> Signup and view all the answers

    What is the main difference between primary and secondary headaches?

    <p>Primary headaches have no identifiable cause, while secondary headaches are caused by an underlying condition</p> Signup and view all the answers

    What are the three main areas involved in the pain pathway of migraines?

    <p>Thalamus, hypothalamus, and cortex</p> Signup and view all the answers

    Which of the following is NOT a potential origin of migraines?

    <p>Cerebellum</p> Signup and view all the answers

    What is the main neurotransmitter associated with the thalamus and hypothalamus in migraines?

    <p>Serotonin</p> Signup and view all the answers

    What is the current understanding of migraines as a brain disorder?

    <p>Migraines are a central disorder</p> Signup and view all the answers

    Which of the following is a key distinguishing feature between migraines and cluster headaches?

    <p>Presence of autonomic features</p> Signup and view all the answers

    What is the duration of a cluster headache attack?

    <p>Between 15 minutes and 4 hours</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with migraines?

    <p>Facial redness</p> Signup and view all the answers

    What is the recommended action for someone experiencing a severe cluster headache?

    <p>Pace up and down</p> Signup and view all the answers

    Which of the following is a red flag symptom for headaches?

    <p>Headache that starts suddenly and never goes away</p> Signup and view all the answers

    Which of the following can provoke certain types of headaches?

    <p>Coughing and sneezing</p> Signup and view all the answers

    What is the imaging modality that is less sensitive than MRI but can be requested by GPs in the local area?

    <p>CT scan</p> Signup and view all the answers

    What is the recommended approach if a primary headache is suspected and no red flag symptoms are present?

    <p>Document the findings and continue with management</p> Signup and view all the answers

    How are tension headaches typically characterized?

    <p>They are often accompanied by a band-like sensation around the head</p> Signup and view all the answers

    What is the relationship between tension headaches and migraines, as mentioned in the text?

    <p>Tension headaches and migraines are part of the same spectrum</p> Signup and view all the answers

    What is a distinguishing feature of tension headaches, as mentioned in the text?

    <p>Preference for a quieter environment</p> Signup and view all the answers

    What is the typical location of a tension headache, as mentioned in the text?

    <p>Bilateral and often with a band around the head</p> Signup and view all the answers

    What is the recommended treatment for tension headaches, as mentioned in the text?

    <p>Lifestyle changes</p> Signup and view all the answers

    Who is likely to have experienced a tension headache?

    <p>Most women in the room</p> Signup and view all the answers

    Which of the following structures within the cranium is NOT pain sensitive?

    <p>The brain itself</p> Signup and view all the answers

    Which neurotransmitter is highlighted as a modulator for migraine headaches?

    <p>Serotonin</p> Signup and view all the answers

    Which part of the brain is believed to be the link between the thalamus and hypothalamus in the pain pathway?

    <p>The brainstem</p> Signup and view all the answers

    Which cranial structure is part of the trigeminal vascular bundle and is pain sensitive?

    <p>The trigeminal nerve</p> Signup and view all the answers

    Study Notes

    Headache Symposium: Diagnosis, Types, and Red Flags

    • Headaches affect a significant portion of the adult population, with an estimated half experiencing at least one headache in the past year.
    • Migraines are prevalent in the UK, affecting about 15% of the population, making it the third most common disease worldwide.
    • Headaches account for 25% of all outpatient referrals to Neurology and 1-2% of all admissions to the Emergency Department.
    • Pain sensitivity varies among cranial structures, with some being pain-sensitive (e.g., cranial venous sinuses) and others pain-insensitive (e.g., brain parenchyma).
    • Several neurotransmitters and neuropeptides, such as serotonin and CGRP, are involved in modulating pain in the central nervous system.
    • Clinical assessment of headaches includes considering the phenotype, site, frequency, severity, and precipitating factors.
    • Headaches can be classified as primary or secondary, with primary headaches being more common (99% of cases) and secondary headaches having underlying causes such as trauma or vascular disorders.
    • Red flag symptoms, such as thunderclap onset, rapid progression, or neurological signs, indicate the need for further investigation to rule out serious underlying conditions.
    • Migraines have specific diagnostic criteria, including the presence of at least five attacks lasting 4-72 hours, unilateral location, pulsating quality, and associated symptoms like nausea and photophobia.
    • Different types of migraines exist, including those with or without migrainous features, and they can be managed with lifestyle changes, abortive treatments (e.g., triptans, NSAIDs), and preventive medications (e.g., antiemetics, antihypertensives).
    • Migraines are often comorbid with depression, and there is a bidirectional relationship between anxiety/depression and migraines.
    • Other primary headaches, such as tension headaches and cluster headaches, have distinct characteristics and may require different treatment approaches.

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    Related Documents

    T1 SYMPOSIUM. Headaches and migraines (JG)(1).pptx

    Description

    Test your knowledge on headache diagnosis and pathophysiology in this quiz! Learn about pain sensitive structures in the brain, differentiate between primary and secondary headaches, and identify common symptoms. Enhance your understanding with this headache symposium module led by Dr. Jeban Ganesalingam, a renowned consultant neurologist from University Hospitals Sussex.

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