Headache Study Guide - PDF

Headache Study Guide 1. Headache Classification Classification Definition Examples Primary Headaches not associated Tension-type headache, migraine (with or without with an underlying illness aura), cluster headache Secondary He...

Headache Study Guide 1. Headache Classification Classification Definition Examples Primary Headaches not associated Tension-type headache, migraine (with or without with an underlying illness aura), cluster headache Secondary Headaches caused by an Headache due to head trauma, stroke, infection underlying condition (bacterial/viral), substance withdrawal, sinus congestion 2. Difference Between Chronic and Episodic Tension Headaches ​ Chronic: Occurs 15 or more days per month for at least 3 months ​ Episodic: Occurs less than 15 days per month 3. Medication-Overuse Headache A patient may be experiencing medication-overuse headache if: ​ They use headache medications more than twice per week for 3 months or longer ​ The headache occurs within hours of stopping the medication ​ They find relief when taking the same medication again 4. Symptoms of Acute Sinusitis ​ Facial tenderness/pain ​ Nasal congestion ​ Nasal discharge (purulent) ​ Pressure-like headache ​ Symptoms worsen when bending forward or blowing nose 5. Headache Characteristics Table Feature Tension-Type Headache Sinus Headache Location Bilateral (both sides of the head) Face, forehead, periorbital area Nature Dull, tightening, pressing pain Pressure behind the eyes/face Onset Gradual Simultaneous with sinus symptoms Duration 30 minutes to 7 days Days (resolves with sinus symptoms) Non-Headache Scalp tenderness, neck pain, Nasal congestion, facial pressure, Symptoms muscle tightness postnasal drip 6. True or False: Aura is always followed by migraine headaches. False – Aura may occur without a subsequent migraine headache. 7. Caffeine Use in Headache Treatment ​ Useful when: Combined with analgesics (e.g., aspirin or acetaminophen) to enhance pain relief, especially for tension-type headaches and migraines. ​ Harmful when: Overused, as it can lead to withdrawal headaches or contribute to medication-overuse headaches. ​ Specifics: Caffeine withdrawal after regular use (>200 mg/day) can trigger rebound headaches. Limit caffeine intake to ≤2 days/week in headache management 8. Medication Effectiveness and Safety Medications Effectiveness Aspirin vs. Equally effective for pain, but aspirin is better for inflammatory Acetaminophen pain. Ibuprofen vs. Aspirin Equally effective, but ibuprofen may be safer (less GI irritation and bleeding risk). Acetaminophen vs. Equally effective, but acetaminophen lacks anti-inflammatory Ibuprofen properties. NSAIDs (like ibuprofen) are less toxic in overdose. Naproxen vs. Both are effective, but naproxen lasts longer (dosed every 8–12 Ibuprofen hours vs. ibuprofen every 4–6 hours). 9. Complete the Statements ​ Children 12 years and older may use naproxen for self-treatment of headache. ​ To decrease the risk of Reye’s syndrome, parents should not use aspirin or other salicylates in children and teenagers who have or are recovering from chickenpox or influenza-like symptoms, unless directed by a PCP. ​ Acetaminophen is generally recognized as the agent of choice to manage mild-to-moderate pain in the geriatric population. 10. Follow-Up Recommendations ​ Episodic headaches: Follow up if headache persists for more than 10 days or worsens despite treatment. ​ Chronic headaches: Follow up if headaches increase in frequency or do not improve with self-treatment. 11. When Should a Patient Seek Medical Attention? ​ Severe head pain ​ "First" or "worst" headache ever ​ Headache lasting >10 days ​ High fever or signs of infection ​ Neck stiffness ​ Neurological symptoms (visual disturbance, seizure, confusion) ​ Headache in a patient with cancer, HIV, or pregnancy ​ Symptoms of migraine but no formal diagnosis ​ History of liver disease or heavy alcohol use ​ Visual changes/scotoma without headache (possible retinal migraine) ​ Positional exacerbation (worse lying down)