Medicine sdl 46-54 (1).pptx.123456789010

Presentation of Head ache

1. Roll no. 46, 47, 48, 49, 50, 51, 52, 53, 54

2. Types of headache Primary headache: cause is unknown 2. Secondary headache: caused by exogenous disorders

3. Primary headache

4. Theory Key Features Limitations Vascular Theory • Vasoconstriction → aura • Vasodilation → throbbing pain Doesn’t fully explain aura or sensory symptoms Muscle Tension Theory • Head/neck muscle contraction • Reduced blood flow → pain Doesn't explain aura; overlaps with tension headache Neurovascular Theory • Involves brainstem, trigeminovascular system • CGRP → inflammation & pain Most accepted; explains pain & sensitivity Cortical Spreading Depression (CSD) • Wave of neuronal activity • Associated with aura Explains aura but not headache Genetic & Environmental • Family history (e.g., hemiplegic migraine) • Triggers: stress, sleep, food, hormones Explains predisposition and attack triggers Etiology: different theories suggest different causes

5. Types of migraine

6. It is associated with - lacrimation aural fullness rhinorrhoea ptosis

7. Acute attack treatment of cluster headache Patients with acute cluster headache respond very well to oxygen inhalation This should be given as 100% oxygen at 10-12 liter /min for 15-20 mins Sumatriptan 20 mg and zolmitriptan 5 mg nasal sprays are both effective in acute cluster headache

8. Approach to patient 1. Headache History

When did your headaches start? __________________________________
How often do you get headaches? ☐ Daily ☐ Weekly ☐ Monthly ☐ Occasionally
How long does each headache usually last? ______________________
Is there a specific time of day headaches tend to occur? ☐ Morning ☐ Afternoon ☐ Night ☐ No pattern

2. Headache Characteristics

Where is the pain located? ☐ One side ☐ Both sides ☐ Front ☐ Back ☐ Around eyes ☐ Neck
Type of pain: ☐ Throbbing ☐ Dull ☐ Sharp ☐ Pressure ☐ Burning ☐ Other: __________

9. 3. Associated Symptoms

Do you experience any of the following with your headache? ☐ Nausea
☐ Vomiting
☐ Light sensitivity (photophobia)
☐ Sound sensitivity ( phonophobia )
☐ Visual disturbances (e.g., aura, blurring)
☐ Dizziness
☐ Numbness or tingling
☐ Weakness
☐ Difficulty speaking 4. Triggers

Do any of the following seem to trigger your headaches? ☐ Stress
☐ Lack of sleep
☐ Certain foods or drinks (e.g., chocolate, caffeine, alcohol)
☐ Menstruation
☐ Bright lights
☐ Strong smells
☐ Physical exertion
☐ Skipping meals

10. 5. Relief Factors

What helps relieve the headache? (check all that apply) ☐ Sleep/rest
☐ Darkness/quiet room
☐ Over-the-counter medication
☐ Prescription medication
☐ Cold or hot compress
☐ Other: _______________________

6. Medication Use

Are you currently taking any medications for your headache? ☐ Yes ☐ No
If yes, list: __________________________________________
How often do you take pain medication for headaches? _______________
Do you feel the medication is effective? ☐ Yes ☐ No ☐ Sometimes

7. Medical History

Do you have any other medical conditions? ☐ Yes ☐ No
If yes, list: ___________________________________________
Any family history of headaches or migraines? ☐ Yes ☐ No

11. 8. Impact on Daily Life

How much do headaches affect your daily life?
☐ Not at all ☐ Mildly ☐ Moderately ☐ Severely
Have you missed work or school due to headaches? ☐ Yes ☐ No
If yes, how often?

12. Treatment