Headaches

Extracranial/ Intracranial 

Extracranial: Asthenopia, Sinus Pressure, Migraines, Tension Headache and Psychotics/Milingering 

Intracranial: Raised Intracranial Pressure, Giant Cell Arteritis, Meningitis 

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  • Created by: Emma
  • Created on: 25-11-12 16:02

Asthernopia

Extracranial

  • Associated with reading and eye problems
  • Dull and achey pain
  • Gets worse towards the end of the day- accomodating for 8 hours- tired muscles.

MANAGEMENT: Try glasses for a couple of weeks to try to elevate the problem 



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Sinus Pain

Extracranial

  • Usually up to a week after a respiratory tract infection
  • Worse with increasing pressure (eg bending over) 
  • Usually a dull ache

MANAGEMENT: I cant find anything wrong with your eyes which are causing these symptoms however since youve said you recently had a cold makes me think its associated with this however if it doesnt go away or gets any worse make an appointment with your GP

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Tension Headache

Extracranial

  • Usually associated with stress (work related or personal life) 
  • Vague dull headache

Management: I havent found any reason for your headache to be associated with your eyes what I would advise is that if it gets any worse or persists make an appointment with your GP. 

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Psychotic or Malingering Headache

External 

  • Random location
  • Very Specific discription of pain

Management: I cant see any reason for the pain to be the cause of your eyes if your pain gets any worse or persists visit your GP


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Migraines

Extracranial 

  • Can be associated with foods such as coffee, chocolate, red wine. 
  • Associated with nausea/vomiting
  • Associated with visual disturbances 
  • Can last for anything from hours-a week
  • Photophobia
  • Can only be relieved by sleep/ lying in a dark room

Management: Advise trip to the GP 

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Raised Intracranial Pressure

Intracranial 

  • Can cause extreme pain
  • Disc may look like a champagne cork 
  • Heamorrhages around edges of disc
  • Swelling of optic disc
  • Undefined margins 
  • Worse with increasing pressure: bending over, coughing etc

Causes: begnin intracranial pressure, tumour

MANAGEMENT: SEND TO HOSPITAL


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Giant Cell Arteritis

Intracranial

  • inflammation of the temporal artery
  • usually in Px of 70+
  • sore on chewing (skin moving over artery)
  • can cause blindness or death caused by blockage of the artery and a stroke. 
  • Generally unwell feeling with weight loss

MANAGEMENT: SEND TO HOSPITAL

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Meningitis

Intracranial

  • Fever, neck stiffness, vomiting (GENERALLY UNWELL)
  • Photophobia
  • Severe headache

EMERGENCY SEND TO HOSPITAL 

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Extracranial

  • More Common
  • Usually referred pain
  • Less serious 

Causes:

  • Inflammation of nerves in eyes, ears, teeth etc
  • Prolonged muscle contraction eg neck
  • Vascular conditions
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Intracranial

  • More serious
  • The minority of headaches

Causes: 

  • Vascular conditions
  • Conditions affecting the mininges 
  • Distortion of a pain sensitive area eg a tumour
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