Headache Lecture Notes

Overview

• Headaches (Stalgia): One of the most common physical complaints.
• Types:
  • Primary Headaches: Migraine, tension, cluster headaches.
  • Secondary Headaches: Caused by another condition (e.g., brain tumor, aneurysm).

Assessment and Diagnosis

• Patient History: Stress level, family history, exposure to toxins, medication history (e.g., antihypertensives, diuretics).
• Physical Examination: Head, neck abnormalities, and a neurological exam.
• Diagnostics: CT or MRI for neurological abnormalities.
• Detailed Headache Description: Type of pain, triggers, medication use.

Types of Headaches

Migraine

• Phases:
  • Premonitory Phase: Depression, irritability, food cravings.
  • Aura Phase: Visual disturbances, tingling, dizziness.
  • Headache Phase: Severe pain, photophobia, phonophobia, nausea.
  • Postdrome Phase: Fatigue, mood changes, muscle soreness.
• Treatment:
  • Abortive/Symptomatic: Triptans (e.g., Sumatriptan) - cause vasoconstriction.
    • Contraindications: Ischemic heart disease.
  • Preventive: Avoid triggers, medications (beta blockers, anti-epileptics).

Cluster Headaches

• Characteristics: Unilateral, excruciating pain around eye, nasal congestion.
• Treatment: 100% oxygen, Sumatriptan.

Tension-Type Headaches

• Characteristics: Related to stress, described as band-like, pressure.
• Treatment: Pain relievers, muscle relaxants, stress reduction techniques.

Nursing Management

• Care and Treatment: Individualized based on headache type.
• Medications: Prophylactic for recurrent headaches.
• Comfort Measures: Quiet dark room, massage, and local heat for tension headaches.

Patient Education

• Identify Triggers: Hormone changes, specific foods (e.g., aged cheese, red wine), stress.
• Medication Use: Importance of taking medications as prescribed.
• Stress Reduction: Helpful especially for tension headaches.
• Non-Pharmacologic Therapies: Quiet dark room, massage.
• Follow-Up Care: Regular check-ins with healthcare provider.

Conclusion

• Focus on migraines, tension headaches, and cluster headaches.
• Importance of identifying triggers and appropriate treatment.