Headache and Fever L.O..docx - Headache and Fever Headache Learning Objectives \u2022 Differentiate between the different types of headaches based upon

Headache and Fever L.O..docx - Headache and Fever Headache...

This preview shows page 1 - 4 out of 12 pages.

Headache and Fever Headache Learning Objectives Differentiate between the different types of headaches based upon signs/symptoms and clinical presentation. Primary HA 90% of HA Not associated with underlying illness Examples Chronic tension-type HA Episodic or chronic (chronic = ≥15 days/month for at least 3 months Migraine HA w/wo aura Cluster HA Medication overuse HA Secondary HA Symptoms of underlying illness Examples Head trauma Stroke Substance abuse/withdrawal Bacterial/viral illnesses Disorders of craniofacial structures Describe the pathophysiology for each of the types of headache disorders. Migraine Headaches Complex interaction between neuronal and vascular factors Main locus believed to be activity within trigeminal neurovascular system
Image of page 1
Activation of trigeminal sensory nerves releases vasoactive neuropeptides—substance P, CGRP, Neurokinin A Leads to vasodilation and dural plasma extravastation inflammation Vasodilation causes relay of pain impulses to cortical pain centers Triggers Stress, fatige, irregular sleep, hormonal changes, everything Medications Nitrates, contraceptives, postmenopausal hormones, reserpine Clinical Presentation Premonitory symptoms—12-79% of patients –hours to days before migraine Allodynia (hypersensitive to pain), photophobia, hyperosmia, difficulty concentrating Aura –25% of patients Evolves over 5-20 minutes, lasting <60minutes HA generally occurs w/in 60 min of aura Usually visual May also manifest as parasthesias, numbness, weakness, hemiparesis HA Gradual in onset, peaks in intensity over minutes to hours Duration 4-72 hours Pain usually in frontotemporal region Usually unilateral and described as throbbing or pulsating N/V Other concomitant symptoms Anorexia, food cravings, constipation, diarrhea, cramps, lburred vision, photophobia, phonophobia Resolution phase
Image of page 2
Fatigue, irritability, impaired concentration, malaise Tension Headache Manifest in response to stress, anxiety, depression May be acute or chronic Activation of pain perception structure in brainstem Central modulation pf peripheral stimuli to pain Chronic HA evolves from acute, episodic HA Clinical Presentation Premonitory and aura symptoms are absent Pain usually mild-moderate Dull, nonpulsatile tightness or pressure Bilateral pain is most common “hatband” pattern Associated symptoms generally absent Shivering/cold temps may make them worse Sinus Headache Dull, pressure-like pain in the periorbital, forehead area Usually patient will have other sinus symptoms Treated much the same as tension HA May recommend decongestant products as well Cluster Headaches The most severe of the primary HA disorders Relatively uncommon males 3:1
Image of page 3
Image of page 4

You've reached the end of your free preview.

Want to read all 12 pages?

  • Spring '17
  • Headaches, migraine, Headache

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture