Headaches

T or F: Headaches are the most common of all physical human complaints

T

Headaches are a __________ not a ___________

Symptom, disease

Headaches are a ________ response leading to inflammation

Stress

Two Headache Classifications

Primary and Secondary

Two kinds of Primary Headaches

Migraine and Cluster

Three kinds of Secondary Headaches

Tumor, bleeds, trauma

T or F: Primary headaches are less concerning and have no cause, while Secondary headaches are very concerning

T

What question should you ask a patient coming in for a headache? Why?

Is this the worst headache of your life? (because if it is then that is indicating that something more serious can be going on)

What is a Migraine?

Periodic/recurrent attack of severe headaches lasting hours to days, that is primarily caused by vascular disturbance

Migraine Symptoms

Photophobia, N/V, stress, anxiety, inability to perform ADL’s temporarily

T or F: Migraines have familial tendency and are more common in women

T

Thalamus/Hypothalamus Function

Controls sensory sensations that enter the body

4 Phases of a Migraine

Premonitory/Prodromal, Aura, Headache, Postdromal

Premonitory/Prodromal Phase

Occurs hours to days before headache and effects 80% of people

Aura Phase

Vision problems and hemianopia that occur before headache; effect 30% of people

Headache Phase

Severe and incapacitating pain of migraine begins

Postdromal Phase

Migraine pain slowly subsides but fatigue, mood changes, and excess sleep can occur

Why is it important to know the 4 Migraine Phases?

Because it allows you to know and treat a migraine before the headache phase begins

What is Abortive Therapy used for?

To treat a headache during onset or progression while in severe pain

Mild Abortive Therapy Medications

NSAID’s, acetaminophen, antiemetics

Severe Abortive Therapy Medications

Triptans, Ergotamine preparations, IV fluids

Why would you not give Triptans or Ergotamine Preparations to someones with CAD?

Because both are vasoconstrictors and can exacerbate the issue

What is Preventative Therapy used for?

For patients with frequent and predictable attacks (chronic)

Preventative Therapy Medications

NSAID’s, Beta-blockers, Botox

How do Beta-Blockers treat Migraines?

They block epinephrine and adrenaline receptors to reduce the frequency and severity of headaches

How does Botox treat Migraines?

It blocks pain receptors and reduces muscle tension in the forehead, temples, and back of the head

What Medications do we NEVER give for Migraines

Opioids

Nursing Interventions for Symptomatic (Acute) Migraines

Administer meds, reduce noise/light, adjust room temperature, elevated HOB

What is the Priority for Symptomatic (Acute) Migraines?

Pain control

Nursing Interventions for Preventative (Chronic) Migraines

Educate about meds/triggers/symptoms, identify aura, keep journal, consider alternative medicine like yoga/acupuncture/herbs

What Foods trigger Migraines?

Gluten, aged cheese, nitrates, bread, chocolate, alcohol, MSG, some fruits (red skinned apples, bananas, citrus), cold drinks/food, caffeine

Migraine Triggers

Certain meds, stress/anger, lack of sleep, weather changes, light, menstrual cycle, intense odors

T or F: Caffeine helps some people’s migraines and for others make their migraines worse

T

What are Cluster Headaches?

Cluster headaches are severe, recurrent headaches that occur in cyclical patterns or clusters of 15 minutes to 3 hours

Cluster Headache Symptoms

Brief and intense, unilateral (teary eyes, eye drooping, runny nose), no throbbing

What Medication is given specifically for Cluster Headaches?

O₂ at 12 L/min for 15-20 minutes