Chronic Daily Headache and Imaging

by Carlo Raj, MD

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    Our topic now brings us to chronic daily headache. Most often evolve out of tension type though. Almost universally associated with analgesic abuse. As I said, you’re using the analgesics so that you can take care of the tension headache. But then at the same time, because you’re so addicted to these analgesics, you end up developing headache because of the analgesics Pain is generally reported as severe. Our patients can carry out daily activities, but they’re not very happy. First, the treatment is cessation of analgesic. That’s where you begin. These drugs, it’s one of those situations where it’s like the catch-22. What do you do? I mean, the patient is in pain, you’ve got to take something. But then you take something and you start abusing it, and you don’t even realize it’s happening. Then this itself can cause a secondary issue. Welcome to chronic daily headache. Tricyclics for underlying migraine or tension type headache. Topic here brings us to an important trigeminal neuralgia issue. It comes under your subacute or chronic headache. Pain usually described as being electric, shooting. You’ve heard of sciatica. And what do you know about that pain? It’s shooting, it’s trigeminal, a nerve. So, you have sciatica or trigeminal nerves, and when you have nerves that are being affected, then the pain here is “shooting.” Or lancinating, lasting seconds. So, very quick. Boom, literally, a shooting pain up and down that particular nerve of concern. Milder itching or burning may also be present between the attacks. That’s important. Pay attention to that. “Doc, I feel itchy. I have the shooting pain and then I feel itchy.” But this, you need to make sure that you ask. The patient doesn’t even know to offer such information. Neuralgia of your fifth cranial nerve, trigeminal. Most...

    About the Lecture

    The lecture Chronic Daily Headache and Imaging by Carlo Raj, MD is from the course Headache. It contains the following chapters:

    • Chronic Daily Headache
    • Imaging

    Included Quiz Questions

    1. A headache due to Trigeminal neuralgia
    2. A headache due to Temporal arteritis
    3. Cluster headache
    4. Tension headache
    5. Migraine headache
    1. Multiple sclerosis
    2. Guillain-Barre syndrome
    3. Picks disease
    4. Schizophrenia
    5. Multiple myeloma
    1. Carbamazepine
    2. Tricyclic antidepressants
    3. Over the counter analgesics
    4. Sumatriptan
    5. Ergotamine
    1. CT without contrast
    2. CT with contrast
    3. MRI
    4. X-ray
    5. Ultrasound

    Author of lecture Chronic Daily Headache and Imaging

     Carlo Raj, MD

    Carlo Raj, MD

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