Types of Vascular Migraine Headaches
Key Assessment Questions Related to Headache
• Is this the patient’s first headache?
• When did this headache start?
• Has the patient been injured recently?
• Have there been any personality changes?
• Has the patient experienced any memory loss?
• Has the patient had a recent infection?
• Does the patient have any problems with vision?
• Has the patient had any recent neurologic problems?
• Does the patient have hypertension? For how long?
• Does the patient have any emotional problems?
• What medication is the patient currently taking?
• Has the patient ever had a seizure?
Source: Sheehy’s Emergency Nursing: Principles and Practice, 4th Edition. Lorene Newberry, ed. St. Louis, Missouri: Mosby-Year Book, Inc.;1998.
Types of Vascular Migraine Headaches |
|
| Type | Description |
| Classic migraine | Aura that lasts 15-20 min; clears more quickly than it
develops; severe pain, usually unilateral, can be bilateral; lasts 30 min
to several days; photophobia, sound sensitivity, nausea, vomiting, and
anorexia; worsened by walking, straining, or sudden changes in body position;
occurs during increased stress and pregnancy.
Treatment includes ergotamines, sumatriptan (Imitrex) |
| Common migraine | Euphoria, hunger, depression, irritability, intense yawning,
generalized edema, and photophobia present; usually does not occur during
pregnancy.
Treatment includes ergotamines, sumatriptan |
| Cluster headache | Ten times more common in men; closely grouped attacks
over several weeks followed by remission of months or years; may have 12
or more headaches per day; more frequent in spring and fall; excruciating,
unilateral pain, usually behind eye or in temporal region; may travel to
ear, nose, and cheek; facial flushing, nasal congestion, lacrimation, rhinorrhea,
and salivation may be present; may wake patient from deep sleep or occur
during periods of rest after exhaustion.
Treatment includes oxygen, ergotamines, sumatriptan, prednisone, and, in some cases, lithium |
| Opthalmoplegic migraine | Begin during infancy or early childhood; headache and
paralysis of cranial nerve III; if untreated, prominent visual field defects
or blindness may occur.
Treatment includes ergotamines, sumatriptan, and steroids |
| Hemiplegic migraine | Visual field defects, numbness of mouth and/or extremities,
and various paresthesias; unilateral extremity weakness or paralysis; family
history positive for migraine.
Treatment includes rest, sedation, analgesia, and increasing CO2 levels; ergotamines contraindicated |
| Facial migraine | Unilateral episodic facial pain; associated with cluster
headache or common migraine
|
| Migraine equivalent | All features of migraine present except headache; symptoms
include vomiting, abdominal migraines, menstrual syndromes, precordialmigraines,
and periodic diarrhea, fever, mood changes, and sleep or trancelike states
|
| Source: Sheehy’s Emergency Nursing: Principles
and Practice, 4th Edition. Lorene Newberry, Ed. St. Louis, Missouri: Mosby-Year
Book, Inc.; 1998.
|
|
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.