Neurology Review: Primary and Secondary Headaches

This set of flashcards covers the classification, diagnostic criteria, red flags, and treatment protocols for various primary and secondary headaches as discussed in the Neurology Batch 2 2026 lecture.

Primary Headache

Headaches that are not caused by an underlying disease, accounting for approximately $90\,$ of all headache cases.

Secondary Headache

Headaches caused by an underlying condition such as tumors, infections, vascular issues, or trauma, accounting for approximately $10\,$ of cases.

ICHD

Acronym for the International Classification of Headache Disorders, used to categorize primary and secondary headaches.

HASSOCRATES

A mnemonic used for taking a complete history of headache complaints (History, Associated symptoms, Site, Onset, Characteristics, Radiation, Associations, Timing, Exacerbating/Relieving factors, Severity).

SNOOP (SNUP)

A mnemonic for identifying red flags in headache diagnosis, representing Systemic symptoms, Neurologic signs, Onset (sudden), Older age ($> 50$ years), and Previous history/Progressive pattern.

Migraine

A primary headache characterized by unilateral, pulsating pain of moderate to severe intensity, often lasting $4$ to $72$ hours and aggravated by routine physical activity.

Tension-Type Headache (TTH)

A primary headache characterized by bilateral, pressing, or tightening pain (non-pulsating) of mild to moderate intensity that does not prohibit activity.

Cluster Headache

A primary headache involving severe, excruciating unilateral pain in the orbital, supraorbital, or temporal regions, lasting $15$ to $180$ minutes, often accompanied by autonomic symptoms.

Subarachnoid Hemorrhage (SAH)

A life-threatening secondary headache often caused by vascular anomalies like aneurysms or Arteriovenous Malformations (AVM).

Photophobia

A symptom where light increases headache pain or discomfort, prompting patients to seek dark rooms.

Phonophobia

Sensitivity to sound where loud noises exacerbate headache symptoms.

Chronic Migraine

Headache occurring for $15$ or more days per month for more than $3$ months, with at least $8$ of those days meeting migraine criteria.

Abortive Therapy

Acute treatment intended to stop a headache attack after it has started, categorized into non-specific (NSAIDs, Paracetamol) and specific (Triptans, Ergotamine, Gepants).

Prophylactic Therapy

Preventative treatment aimed at reducing the frequency, severity, and duration of headache attacks, often used if attacks occur $> 2$ times per week.

Medication Overuse Headache (MOH)

A condition where headaches occur $> 15$ days per month due to the regular overuse of acute headache medications for more than $3$ months.

Hemicrania Paroxysmala

A headache disorder characterized by frequent, short-lasting attacks ($2$ to $30$ minutes) that respond absolutely to Indomethacin.

SUNCT

Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing, typically lasting $1$ to $600$ seconds.

Giant Cell Arteritis (GCA)

A vasculitis causing headache in patients over $50$, characterized by jaw claudication, visual loss, and an Elevated Erythrocyte Sedimentation Rate (ESR) of over $100\,mm/h$.

Trigeminal Neuralgia

A condition involving sudden, brief, electric shock-like stabs of pain in the distribution of the trigeminal nerve branches, often triggered by light touch (allodynia).

Tik de Luruts

Another name for Trigeminal Neuralgia mentioned in the text.

Microvascular Decompression (MVD)

A surgical procedure for Trigeminal Neuralgia that involves placing a Teflon sponge between a blood vessel and the trigeminal nerve to relieve pressure.

Tolosa-Hunt Syndrome

A rare condition characterized by unilateral orbital pain associated with paralysis of the third, fourth, or sixth cranial nerves, typically responding to steroid treatment.

Indomethacin

The specific medication used to differentiate and treat Hemicrania Paroxysmala and Hemicrania Continua from other headache types.