Headache stroke

Stroke, hypertension, or migraine headache Stroke, hypertension, or temporary vascular problem of many possible sites Blood clot in legs... 

One of the earliest symptoms of hypertensive crisis is headache (usually occipital), followed by a stiff or sore neck, nausea, vomiting, sweating, fever, chest pain, dilated pupils, and bradycardia or tachycardia. If a hypertensive crisis occurs, immediate medical intervention is necessary to reduce the blood pressure Strokes (cerebrovascular accidents) and death have been reported. 

Adverse reactions include transitory stinging on initial instillation, blurring of vision, mydriasis, increased redness, irritation, discomfort, and increased IOP. Systemic adverse reactions include headache, browache, palpitations, tachycardia, arrhythmias, hypertension, myocardial infarction, and stroke. 

The patient may complain of weakness on one side of the body, inability to speak, loss of vision, vertigo, or falling. Stroke patients may complain of headache however, with hemorrhagic stroke, the headache can be severe. 

Signs and symptoms Headache, vomiting, stupor, hemiparesis, aphasia, visual disturbances, and seizure transient ischemic attack is a strong predictor for stroke. Behavioral and performance changes may be present in patients with asymptomatic infarction. 

Antispasmodic. Easing muscle cramps as well as psychological stress, elder tea has been used for headache, eyelid twitching, palsy, epilepsy, stroke, paralysis and the spasms that accompany asthma. Affected body parts can also be rubbed with elder flower infusions. Parts used flowers, berries. 

The answer is b. (Hardmanr p 444.) This patient ate tyramine-rich foods while taking an MAOI and went into hypertensive crisis. Tyramine causes release of stored catecholamines from presynaptic terminals, which can cause hypertension, headache, tachycardia, cardiac arrhythmias, nausea, and stroke. In patients who do not take MAOls, tyramine is inactivated in the gut by MAO, and patients taking MAOls must be warned about the dangers of eating tyramine-rich foods. 

Adverse effects include postural hypotension with associated CNS symptoms, reflex tachycardia, headaches and flushing, and occasional nausea. Excessive hypotension may result in MI or stroke. Noncardiovascular adverse effects include rash (especially with transdermal nitroglycerin) and methemoglobinemia with high doses given for extended periods. 

Adverse effects of estrogen include nausea, headache, breast tenderness, and heavy bleeding. More serious adverse effects include increased risk for coronary heart disease, stroke, venous thromboembolism, breast cancer, and gallbladder disease. Transdermal estrogen is less likely than oral estrogen to cause nausea, headache, breast tenderness, gallbladder disease, and deep vein thrombosis. 

Neuromuscular symptoms include altered mental status, abnormal behavior, seizures, stupor, and coma. Hypercapnia can mimic a stroke or CNS tumor by producing headache, papilledema, focal paresis, and abnormal reflexes. CNS symptoms are caused by increased cerebral blood flow and are variable, depending in part on the acuity of onset. 

An effect on blood pressure was shown in the study by Clark and Litchfield (1969) in which subcutaneous injections of PGDN to anesthetized rats at 5, 10, 20, 40, 80, or 160 mg/kg resulted in a dose-related fall in mean arterial blood pressure (measured in the cannulized femoral artery) within 30 min with recovery over the next 12 h. The maximum drop in blood pressure correlated with the maximum concentration of PGDN in the blood. However, a drop in blood pressure did not occur in human volunteers who inhaled 0.5 ppm PGDN for 7.3 h. Rather, a mean elevation of diastolic blood pressure of 12 mm Hg was associated with severe and throbbing headaches (Stewart et al. 1974). A drop in blood pressure and decreasing stroke volume can result in brain ischemia, causing the dizziness and weakness reported by one subject after exposure at 0.5 ppm for 6 h in the Stewart et al. (1974) study as well as in occupationally exposed workers (Horvath et al. 1981). 

Other effects caused by methamphetamine include headaches, decreased appetite, dry mouth, dilated pupils, trembling, chest pains, increased respiration and shortness of breath, hyperthermia (elevated body temperature), insomnia, and nausea and vomiting. In more severe cases (i.e., overdoses) it can produce seizures and convulsions, stroke, heart attacks, and death. The risk of encountering these more serious side effects are greatly increased when methamphetamine is used in combination with other drugs like cocaine, marijuana, alcohol, and heroin. 

CNS- Fatigue headache pseudotumor cerebri, including headache, visual disturbances, and papilledema dizziness drowsiness insomnia lethargy malaise nervousness paresthesias seizures stroke syncope weakness suicidal ideation suicide attempts suicide psychosis emotional instability aggression violent behaviors. Depression has occurred and has subsided with discontinuation of therapy and recurred upon reinstitution. 

The sahcylates are useful in the treatment of minor musculoskeletal disorders such as bursitis, synovitis, tendinitis, myositis, and myalgia. They may also be used to relieve fever and headache. They can be used in the treatment of inflammatory disease, such as acute rheumatic fever, rheumatoid arthritis, osteoarthritis, and certain rheumatoid variants, such as ankylosing spondylitis, Reiter s syndrome, and psoriatic arthritis. However, other NS AIDS are usually favored for the treatment of these chronic conditions because of their lower incidence of GI side effects. Aspirin is used in the treatment and prophylaxis of myocardial infarction and ischemic stroke. 

A 0.5% incidence of migraines has been reported among users of oral contraceptives. Migraine headaches may be a warning signal for an oncoming stroke, and immediate discontinuation of oral contraceptive use is recommended. 

CS386 Alvaro, L. C., I. Iriondo, and F. J. Villaverde. Sexual headache and stroke in a heavy cannabis smoker. Headache 2002 42(3) 224-226. 

Hypertensive crises are characterized initially by headache, but can evolve to include neck stiffness, chest discomfort, palpitations, confusion, and, ultimately, hemorrhage or stroke. Treatment of MAOI-associated hypertension may include a watch-and-wait stance by the patient if the symptoms are mild. Some patients have the ability to check and monitor their own blood pressure. Others may consult with a physician for blood pressure checks and observation, but if symptoms are severe, the patient may need to go to an emergency room or self-medicate. Standard emergency room treatment is intravenous phentolamine, an a-adrenergic blocker, continuous monitoring and management until blood pressure is normalized without medication. Some doctors will provide patients with small doses of chlorpromazine or nifedipine to treat hypertension if a problem arises. 

These potential benefits are balanced by a slightly increased risk of gallbladder disease, hypertension, myocardial infarction, cerebral infarction, and pulmonary embolism. The increased risk of stroke and heart attack associated with the pill is accentuated when compounded by other risk factors, including smoking, migraine headaches, and advancing age. Indeed, convincing data support an upper age limit of 35 years for oral contraceptive use by women who smoke. 

Adverse effects include nausea, dizziness, skin rash and headache. Though it is not useful as an antianginal drug, but it has been employed for prophylaxis of coronary and cerebral thrombosis in post MI and post stroke patients, as well as to prevent thrombosis in patients with prosthetic heart valves. 

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