Red Flags






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Medication Overuse Headache
Occurs on 15 or more days per month for more than three months which has developed as a consequence of overuse of acute headache medications
NSAIDs
This class of medications is the first line treatment of tension-type headaches
Topiramate
This first line treatment for prevention of migraine headaches has been known to cause paresthesias, weight loss and somnolence
Caffeine
This common "drug" can treat and trigger a migraine headache.
RED FLAG
A new headache after the age of 50 would be consider this type of flag
Migraine
This type is the most common headache patients will seek medical care for and is often debilitating
Stop the Offending Agent
This is the main "treatment" for medication overuse headaches
6 months
After this many months of treatment for migraine prophylaxis, you will expect up to a 90% reduction of migraines
Women
This gender is more likely to have migraines
Idiopathic Intracranial Hypertension
Most commonly seen in obese women aged 20-40 and associated with OCPs, tetracyclines, Vitamin A and accutane usage
Tension - Type Headaches
Being the most common type of headache in the general population, it is generally not seen in the clinic due to its mild nature
Subcutaneous Sumatriptan
In addition to high-flow oxygen at 100% concentration delivered at 6-12L/min, this medication should also be administered to abort a cluster headache (must include the route)
Frovatriptan
Menstrual migraines can be treated with this triptan for intermittent prophylaxis of migraines.
Two
If migraines occur more than this number of times per week, you should consider giving the patient a prophylactic medicine for their migraines
Temporal or Giant Cell Arteritis
You would be concerned for this in a patient who is older than 50 years of age with jaw claudication, temporal pain, and vertical diplopia
Cluster Headache
Also known as "suicide headaches", patients may be hyperactive due to the pain of these headaches
Estrogen
Women who have auras with their migraines should avoid contraceptives that contain this hormone
Verapamil
This calcium channel blocker is first line for prophylaxis of cluster headaches
Allodynia
This is the term that describes normal non-painful stimuli causing pain that can happen with migraines
Brudzinzki's Sign
When a patient has meningitis, they sometimes present with this sign where the patient will have spontaneous flexion of the hips when the neck is flexed
SUNA and SUNCT
These 2 rare headache syndromes are short-lasting unilateral neuralgia-form headaches both with autonomic symptoms but one has conjunctival tearing (abbreviation is good for the two)
Prednisone
You can use this medication to help with withdrawal symptoms of medication overuse headache
Rimegepant also known as Nurtec
This is the only calcitonin gene related peptide (CGRP) agent that has an indication for both treatment and prevention of migraines
PIN
Photophobia
Incapacitation
Nausea
This acronym is a 3 question screening for migraines that can have a positive predictive value of up to 93% if the answer to all three questions is yes.
25%
This is the percentage of patients who have an acute ischemic stroke that have headaches as part of their presentation
List 3 of the Red Flag Signs that are listed in the module that would prompt you to get neuroimaging

My Head Hurts

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