Migraine and Cluster Headaches

Presenter: Cathy from Level Up RN

Discussion on migraine and cluster headaches.
Includes a quiz to test knowledge on key facts.
Reference to Level Up RN Medical-Surgical Nursing flashcards for additional learning.

Definition: Neurovascular disorder causing unilateral throbbing head pain.
- Duration: 4-72 hours.
- Aura (visual/sensory disturbance) precedes headaches in 15-30% of cases.
Pathophysiology:
- Poorly understood, linked to activation of cranial nerve 5 and cerebral arterial vasodilation.
Risk Factors:
- Family history.
- More common in women.
Triggers:
- Bright/flashing lights.
- Stress, anxiety, menstrual cycles.
- Sleep deprivation.
- Foods containing MSG or tyramines.
Symptoms:
- Unilateral, throbbing head pain.
- Nausea, vomiting.
- Photophobia (light sensitivity), phonophobia (noise sensitivity).
Treatment:
- Mild cases: NSAIDs (e.g., ibuprofen).
- Severe cases: Ergotamine, sumatriptan (cause vasoconstriction).
- Caffeine for vasoconstriction.
- Antiemetics for nausea/vomiting.
- Prophylactic medications for recurrent migraines (antihypertensives, anticonvulsants).
Patient Teaching:
- Rest in a dark, quiet environment.
- Avoid triggers: stress reduction, avoid certain foods.

Definition: Neurovascular disorder causing unilateral, non-throbbing head pain.
- Duration: 30 minutes to 2 hours.
- Occurs at the same time daily for months, more common in spring/fall.
Pathophysiology:
- Poorly understood.
- Linked to sudden release of histamine or serotonin at cranial nerve 5.
Symptoms:
- Severe, unilateral, non-throbbing head pain around the orbital region.
- Nasal congestion, facial sweating.
- Droopy eyelid, excess tearing from eyes.
- Agitation and pacing.
Treatment:
- Ergotamine and sumatriptan (also used for migraines).
- Oxygen therapy, corticosteroids, verapamil (calcium channel blocker).