Headache general
What is Sensory,vestibular, and cerebellar
The ability to recognize familiar objects by sense of touch
What is stereognosis
Cervicogenic vertigo(3)
What is nystagmus, pain with palpation of lateral mass of atlas and suboccipitals, and vertigo induced by neck rotation
Helen is a 65 year old female, she comes into your office with scalp tenderness,jaw claudication near TMJ, vision complaints. On examination you notice pale or swollen disc,visible embolism/occlusion in a vessel on opthalmoscopic exam.
What is temporal arteritis
Dizziness, neck pain,tinnitus,hearing loss,and feeling of unsteadiness
What is cervicogenic vertigo
Serious headaches (3)
What is subarachnoid hemorrhage, subdural or epidural hematoma, and post traumatic HA or post concussive syndrome
Ability to recognize letters or numbers being traced on the skin
What is graphesthesia
Cervigogenic headache (4)
Henrietta is a 30 year old female who has a history of smoking tobacco and uses the birth control pill. She comes into your office with an unrelenting headache on both sides of her head which she has had for the past 3 days. She says the headache came on suddenly.
Subarachnoid hemorrhage
Acute recurrent attacks of vertigo,hearing loss,and tinnitus with no pain
What is meniere’s syndrome
Sensory ataxic deficits seen think injury to?(3)
What is cord damage,multiple nerve root damage, and polyneuropathy
____tend to weaken or paralyze gross movements/positions while _____tend to weaken or paralyze specific muscles or muscle groups
What is UMNLs,LMNLS
Positive Jull test,cervical flexion movement pattern, or craniotomy-cervical flexion test
Cervicogenic headache
Gary comes into your office with photophobia, nausea, and a severe headache. He said the symptoms started after he did a HIIT class 1 day ago, the headache has not gotten better or worse. You perform a neurological exam on him and find no prominent neurological findings, he has a positive babinski bilaterally, hemiparesis, and occulomotor paralysis
What is subarachnoid hemorrhage
Polymyalgia rheumatica symptoms, unexplained weight loss,fever, and fatigue in about 50% of patients
What is temporal arteritis
Quick screening questions for serious pathology (5)
What is the headache of recent onset (less than 6 months
Is there’s any progression in the frequency or severity of the headaches
Was the onset sudden and severe
Are there any clues suggesting focal neurological signs
Are there any cognitive changes associated with the headaches
Subtle weakness, holdpalms up for 2 minutes, patient unable to maintain the posture, one or both of the arms drop,internally rotate and flex at the elbow,while wrist flexes & hand pronates. Important early indicator of UMN disease
What is pronation drift test
Subarachnoid hemorrhage (6)
What is no prominent neurological findings, meningeal signs, visual defects or double vision, occulomotor paralysis,bilateral babinski sign, hemiparesis
Mrs.Lefebvre comes into your office with dizziness,neck pain in the suboccipitals region after she rotates her head,acute hoarseness in her voice, and unilateral facial “eye” pain.
What is Barre-Lieou syndrome
Dull,dragging,boring,background pain, and non-throbbing headache. Frequently onset involves a history of trauma. The location of the headache is often fixed an doesn’t move during the episode
What is cervicogenic headache
Cerebellar ataxia physical exam findings (7)
What is ataxic gait, station,limb ataxia,truncates ataxia,slurred speech, possible vertigo, and nystagmus possible.
Cranial nerve deficit is considered a _____and suggests that a patient’s headache is due to ________
What is Focal deficit, serious cause
Upon fundoscopic exam a subhyaloid hemorrhage
Subarachnoid hemorrhage
Peter Rabbit is a 39 year old male, he comes into your office complaining of excruciating smarts of brief headaches, which last 15 minutes to 3 hours. You ask him more about these headaches and he says he has unilateral eye,temple, and forehead pain. He also says it feels like a stabbing,burning, or pulsating sensation
What is cluster headache
Severe headache,worse in the morning upon rising, and associated with vomiting, valsalva may increase the pain, the headache does not respond to analgesics
What is tumor