# 41 Headaches

## Secondary Causes

![](https://f001.backblazeb2.com/file/wikiFiles/870D751F-CF1A-44E0-AC70-BC5F2F612920.jpg)

* secondary headache causes
* lack of papilledema key finding of secondary headaches

## Primary Causes

![](https://f001.backblazeb2.com/file/wikiFiles/9FF48CBA-02D2-4084-B129-8844D1F9433C.jpg)

### Tension

![](https://f001.backblazeb2.com/file/wikiFiles/094863FB-9D12-4AD9-AD7C-0FF630A2CC16.jpg)

### Migraine

#### Symptoms

![](https://f001.backblazeb2.com/file/wikiFiles/8DC93CD3-99E2-4387-8D2E-AFD39BA83911.jpg)

* lie in quiet dark room

![](https://f001.backblazeb2.com/file/wikiFiles/06E0D43D-76E7-40AB-9F0E-A4E8DEE24F06.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/1900A08E-5263-4E0E-83DD-2C8EB9D207C4.jpg)

* keep diary

#### Pathogenesis

![](https://f001.backblazeb2.com/file/wikiFiles/065AE26D-72B5-44EC-92A8-F00F0A8B5632.jpg)

* used to be believed vasodilation is cause because vasoconstrictors help
* trigeminal nerve involved

#### Treatment

![](https://f001.backblazeb2.com/file/wikiFiles/81222A87-62A1-4A79-85D8-C8771E69685C.jpg)

* abortive: ends migraine

**Abortive**

![](https://f001.backblazeb2.com/file/wikiFiles/ADAFB1F2-8B9A-4770-A860-F5C850DC8565.jpg)

* vasoconstrictors, thus CI in CAD, angina

![](https://f001.backblazeb2.com/file/wikiFiles/049466E8-5ABA-459E-BA22-86C7F8C6F873.jpg)

* ischemia to digits
* if used too much can have overuse headaches

**Preventive**

![](https://f001.backblazeb2.com/file/wikiFiles/04DB19A0-8B21-473E-BA28-5E59DDA2BA95.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/BC2C7549-B685-4A59-B63C-7E575A0C6151.jpg)

* either blocking NA in nerves or increase GABA

![](https://f001.backblazeb2.com/file/wikiFiles/3D1F5EB5-3032-4B7C-90DD-A02CCD463D1A.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/27F607D9-A064-437A-9AE9-01E618E81E17.jpg)

* diabetics: if hypoglycemic, can be masked

#### Pregnancy and Migraines

![](https://f001.backblazeb2.com/file/wikiFiles/F631E4D3-EA7B-40F6-A630-EFEDDBC0954D.jpg)

* usually stop preventative therapies

### Cluster

![](https://f001.backblazeb2.com/file/wikiFiles/B799049E-A064-4317-AD2C-C57CB35A34BA.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/70495497-D35A-4101-88B1-4F116B10A10F.jpg)
