Info
🌱 來自: Huppert’s Notes
Secondary Headache Disorders🚧 施工中
Secondary Headache Disorders
Medication overuse headache (“rebound headache”)
• Drugs that cause rebound headaches: Abortive medications taken ≥2 times per week, such as acetaminophen-butalbital-caffeine, APAP, NSAIDs, caffeine, ergotamine, opioids, triptans
• Treatment: Taper off medication; reduce 10% every 1–2 wks, can treat with naproxen 500 mg BID to bridge
Post-traumatic headache
• Vascular etiologies:
- Arteriovenous malformation (AVM), subarachnoid hemorrhage (SAH), dissection
- Giant cell arteritis
- Reversible cerebral vasoconstriction syndrome (RCVS)
- Posterior reversible encephalopathy syndrome (PRES, associated with malignant hypertension, pre-eclampsia, certain medications)
- Pituitary apoplexy
- Cerebral venous sinus thrombosis
• Intracranial hypotension/low CSF volume:
- Symptoms: Positional headaches
- Etiologies: Post-LP, postural orthostatic tachycardia syndrome (POTS), spontaneous
- Treatment: Epidural blood patch if CSF leak
• Intracranial hypertension:
- Etiology: Idiopathic intracranial hypertension (pseudotumor cerebri) vs. secondary
- Risk factors: Obesity, vitamin A excess, tretinoin use
- Diagnosis: Test visual fields and acuity, evaluate optic discs for papilledema
- Treatment: Acetazolamide or topiramate, VP shunt, optic nerve fenestration if vision loss