Headache( headache) - Causes, symptoms and treatment. MF.

There is no state of more frequent and having more numerous and diverse causes than a headache.
More GAZakharin wrote in 1889: "Painful conditions of the soft parts of the head and bones of the skull and face, so many nerves of the head, organs of higher senses, and most importantly of the brain, in which, apart from its independent lesions, affect different ways of influencing disorders in all other parts of the body, here are the causes of the frequency of headache or severity. "A headache is called any painful sensation in the head region.

Possible causes of a headache

Every person, even a healthy one, has ever had a headache. Any catarrhal disease with an increase in the temperature of the type of acute respiratory disease, SARS will necessarily give an intense headache. Stress, changes in weather conditions, overeating and malnutrition, sleep disturbances, overheating and hypothermia, physical overstrain, smoking, alcohol, any disease or condition leading to oxygen starvation and malnutrition of the brain and its membranes will lead to headaches. Headache is present in many diseases, and sometimes it can be the only and leading manifestation of the disease. Headache can be caused by the pathology of any structures of the head and neck.

The basis of the development of headache is irritation of pain receptors of the dura mater, cerebral arteries, trigeminal, glossopharyngeal, vagus nerves and skin nerves, head muscles, cervical spinal roots. The most severe headache occurs when the vessels, the cranial nerves, the dura mater are irritated, since they are richly endowed with nervous sensory receptors responsible for pain sensitivity. Neurochemical changes cause a headache and affect the emotional - behavioral aspect of the perception of pain. The emotional component determines the degree of suffering, facial expressions, gestures, posture, verbal characteristics of pain.

Headache can be pulsating, squeezing, bursting, blunt;light, medium and heavy, one-sided and bilateral, frontal with a sense of pressure on the eyes, temporal, parietal, occipital;different duration and frequency;with harbingers and without;with concomitant neurologic symptoms and without it;with increasing blood pressure and lowering blood pressure;with nausea and vomiting;with dizziness;with visual impairment. .. as you see the variety of suffering and combinations are huge. Intensity, duration, localization, nature of the course, repeatability are important for the diagnosis.

The head can sometimes get sick and in a healthy person, but intense, first-time pain, often recurring, of the same type, increasing should necessarily lead to a doctor. The main thing is not to miss a serious disease addicted to analgesics.

According to the international classification, the headache is distinguished:

• - migraine,
• - tension headache,
• - cluster headache,
• - headache, not associated with structural brain damage,
• - with traumatic brain injury,
• - with vascular diseases,
• - for diseases of intracranial structures,
• - for medications, chemicals and their cancellation,
• for infections,
• for metabolic disorders,
• for cranial nerve pathology.

Headache may be primary, that is, be the main manifestation of the disease: tension headache, migraine headache, cluster headache, idiopathic headache, pain from external compression, cold pain, pain with physical exertion, sexual activity.

Cluster headache

Secondary headache is a headache, as a manifestation of another disease: head trauma, vascular disease, intracranial diseases, infection and intoxication, metabolic disorders. Secondary headaches can result from countless causes, ranging from life-threatening conditions such as brain tumors, strokes, meningitis, and subarachnoid hemorrhages to less serious but common causes, such as caffeine abuse and the withdrawal of analgesics( pain medication).Many people suffer from a "mixed" type of tension headache in which a secondary headache can cause migraines.

Disease, a symptom of which can be a headache

Headache is an obligatory symptom for vascular diseases: vegetative-vascular dystonia, hypertension, transient ischemic attack, stroke, subarachnoid hemorrhage, intracerebral hematoma, vascular malformation, arteritis, venous dyskirculation.

Vegeto-vascular dystonia can give a very diverse headache and its combination with dizziness, nausea, neurotic disorders, fluctuations in blood pressure. Exacerbations occur more often with changes in weather conditions, nervously - emotional overloads.

With of hypertensive disease , the headache is more often localized in the occipital region, bursting, combined with heat in the head, dizziness, noise in the head, flashing "flies" before the eyes, swaying, nausea, pain in the heart.

Venous dysfunction will give a dull two-sided headache in the evening and in the morning, heaviness in the head, pressure, raspiranie.

With the acute stroke , his first symptom is an intense sharp headache.

With , the temporal arteryitis of is a pulsating severe headache in the temporal region.

Headache with vascular diseases is combined with impairment of cognitive functions, asthenia, emotional lability.

Headache occurs with craniocerebral trauma - bruises, brain concussion, brain contusion, compression of the brain, epi- and subdural hematomas. Acute craniocerebral injury is always accompanied by a headache. Depending on the severity of the injury and the degree of loss of consciousness, the pain will be of varying intensity and localization, accompanied by nausea and vomiting. There is a delayed headache in traumatic hematomas, that is, everything is right after the injury( "light interval"), and after a while the condition worsens, there is an intense headache and focal neurological symptoms. Headache can be a consequence of a craniocerebral trauma, when there is a disturbance of liquorodynamics.

Headache is a symptom of of meningitis, encephalitis, an infectious viral and bacterial nature, viral infections of .Acute infection always debuts with a high fever and headache, diffuse, bursting, heaviness, with a feeling of pressure on the eyes and ears, often with nausea and vomiting. In the future, neurological symptoms are associated with meningitis and encephalitis, in the case of acute respiratory infections - a runny nose, sore throat, cough. ..

Headache occurs with a single or prolonged intake of nitrates, alcohol, ergotamine, analgesics, caffeine, drugs, contraceptives, hormones.

Headache occurs with hypoxia of any genesis .

Headache is a symptom for eye diseases - glaucoma, strabismus, refractive disorders. When glaucoma, the patient may have a headache, which is dull, aching, often combined with pain inside the eye, behind the eye. The patient feels like a feeling of bursting, heaviness behind the eye and in the head. This is primarily due to high intraocular pressure.

Headache will be present with diseases of the ear and paranasal sinuses, teeth of .The localization of pain will correspond to the area of ​​inflammation - above the maxillary sinus or over the frontal, shooting in the ear, associated with movement of the jaws, chewing.

Headache is a mandatory symptom of neuralgia of cranial nerves : trigeminal, glossopharyngeal, occipital. This short-term paroxysmal very strong pain, stitching, "shooting", "like an electric shock," in the zone of innervation of the affected nerve. More often the attack is provoked by conversation, swallowing, chewing, brushing teeth, shaving, washing with cold water, emotions, physical exertion, touching the trigger points. From intense pain the patient stops, does not speak, does not eat. In the interictal period, there is no pain.

Headache occurs with pathology of the cervical spine - degenerative-dystrophic pathology, instability of the cervical vertebrae, discogenic radicular symptoms. The head thus hurts more often in the occipital or occipital parietal region and neck, the pain is associated with the turns of the head, the inclination of the head forward, the neck muscles are also painful. The pain can be blunt severe, and maybe intense, prolonged, more often one-sided localization, with possible irradiation in the forearm and arm. The head cervicogenic pain is provoked by mechanical factors - movements in the cervical region, forced uncomfortable long posture, hypothermia, external pressure on the neck muscles or spinous processes of the cervical spine.

Headache may be a symptom of metabolic disorders with oncological diseases, diabetes, renal insufficiency .Headache with this dull, heavy, aching, persistent or increasing, accompanied by cognitive impairment and asthenia.

Headache for infectious diseases

Headache is a fairly common symptom in infectious diseases. Most often this is a consequence of intoxication, i.e.effects on the organism of a sick person of toxins of a microorganism( most often with influenza, ARVI).In this case, the headache occurs against the background of typical signs of intoxication - an increase in body temperature, sometimes chills, aches in muscles, pain in the eyes. The most common headache for colds and influenza of moderate intensity, and passes after taking antipyretics.

However, headache is also a characteristic sign of a terrible disease - meningococcal infection. In the most dangerous forms of meningococcal infection - meningococcemia( when microorganisms enter the blood) and meningococcal meningitis( with damage to the meninges) - headache is one of the first symptoms. Meningococcal infection is extremely dangerous, there are lightning-fast forms of the disease, leading to death in a few hours;timely diagnosis of the disease is extremely important for successful treatment.

In all cases, in addition to the headache, there are symptoms of major diseases. Differential diagnosis deals with a doctor.

Examination of a patient with a headache

Given the variety of reasons that can cause a headache, the patient needs a comprehensive examination. Consultations of the oculist, the therapist, the neurologist, if necessary the neurosurgeon, infektsionista are necessary.

From laboratory tests, the most common use is a general blood test, sugar, lipidogram, then as necessary. Functional research includes dopplerography, electroencephalography, computer and magnetic resonance imaging, examination of the cervical spine and thyroid gland. The volume of the appointed examinations is individual and is appointed taking into account all complaints of the patient and the revealed somatic diseases.

Treatment of a headache

Treatment of a headache depends on the type and severity of the headache and on other factors such as the age of the patient. Treatment of headache, as a symptom of these diseases, is the treatment of the underlying disease. Having established an accurate diagnosis, the doctor will prescribe the treatment.

Analgesics are used for relief of acute headache - nonsteroidal anti-inflammatory drugs - paracetamol, ibuprofen and combined preparations based on them with the addition of antispasmodics, caffeine - solpadine, pentalgin, panadol, imeth, nospalgin. .. tablets and capsules, instant powders and effervescent tablets - a huge arsenalin the fight against pain. Independently, you can take and one and two, but long-term use is unacceptable - you need to go to the doctor, seek and eliminate the cause of the headache.

Depending on the diagnosis, valproates, gabapentins, muscle relaxants, sedatives, B vitamins, venotonics, diuretics, antioxidants, neuroprotectors, vascular drugs can be used.

Physiotherapy - darsonvalization of the head and cervical collar zone, electrophoresis, acupuncture, massage, water procedures, sanatorium treatment, can be used for treatment. Once again I repeat - the treatment will be appointed by the doctor individually. You can not choose the drug from the proposed list and be treated. The doctor will explain what means you can use to stop a severe attack exactly in your case, what to take as prevention. After all, if the cause of the headache, for example, a brain tumor, there can not be cured by tablets, surgery in the neurosurgical department is required. Abuse of analgesics as self-medication can cause a number of side effects from the gastrointestinal tract, liver, kidneys.

Doctor's consultation on headache

Question: What is an abusural headache?
Answer: this is a headache caused by a regular chronic drug intake - analgesics - aspirin, nonsteroidal anti-inflammatory drugs, barbiturates, benzodiazepine drugs, ergotamine. Chronic pill taking becomes a "lifestyle", the analgesic effect decreases, the number of tablets increases.
The headache should be disturbed for at least 15 days a month, strengthened when the drug is withdrawn, about a month after the drug is discontinued. For treatment, it is necessary to abolish the drug in outpatient or inpatient settings with the prescription of symptomatic drugs for the removal of side effects. For prevention, you should not abuse these groups of drugs.

Question: How to reduce the headache with a cold?
Answer: Take quickly soluble forms of medicines - koldreks, fervex, solpenni, imet with a noch, you can rub whiskey and forehead with fresh lemon, take compote from hawthorn, multivitamins.

Question: Which headache is especially dangerous?

Answer:

• If the headache is accompanied by vomiting, especially when vomiting does not bring relief to
• If the headache does not go away after taking the antipyretic pain medication
• If it is difficult due to neck pain to lift the head from the pillow from the prone position
• Whenoccurrence of any infringements of consciousness
• At occurrence of an eruption. For meningococcal infection is characterized by hemorrhagic rash - i.e.small hemorrhages in the skin, which have the appearance of dark red spots that do not protrude above the level of the skin, do not turn pale when pressed. Appear most often on the buttocks, legs, stomach, and then can spread throughout the body.

The doctor - neurologist Kobzeva S.V.