Why the head hurts?the Headache
the Headache represents one of the most often found painful states at the person. It is often difficult to estimate its value in view of the fact that it can be a signal of a serious disease or reflect only a condition of tension or exhaustion. Fortunately, the last in most cases takes place, and only in exclusive situations she really warns about intra cranial frustration. Thanks to the dual nature, good-quality or potentially malignant, the headache requires to itself attention of the doctor. System approach to a problem of a headache does necessary broad knowledge of internal and surgical diseases which symptom it can be, and clinical methodology which does not allow to leave any of the usual and cured cases unexplored.
The localizations of a headache given relatively are often informative. If a source of pain are extra cranial structures as it happens usually, it is possible to define a pain source rather precisely. The inflammation of an extra cranial artery causes pain in the vessel location. Pathological changes in additional bosoms of a nose, teeth, eyes and the top cervical vertebras cause not so accurately localized pain but nevertheless having rather certain area of distribution. Intra cranial damages of a back cranial pole cause pain in zatylochno - zadnesheyny area, gomolateralny if damage unilateral. Located over cerebellar mashed damages cause lobno - temporal pains, also gomolateralny in relation to damage if it is localized on one party. However localization of pain is not always informative or can even mislead. Ear pain, for example, though can mean an ear disease, irradiates from other parts of the body, for example necks more often, and eye pain can be reflected in a nape or cervical department of a backbone.
Pain over a maxillary bosom or in a forehead
Meets at an infection or to blockade of bosoms of a trellised bone and wedge-shaped bosoms pain is localized around one or both orbits or in a darkness. It usually is followed by morbidity when pressing on skin in the same places. This pain can have two surprising features: if the pain pulsing, then it can be eliminated with compression of a carotid on the same party, bodies; it tends to arise and cease in the same hours (for example, pain arises when awakening and disappears when the patient accepts vertical position; it comes back again in late morning hours).
the Headache is localized in eye-sockets, area of a forehead or a headache in a nape and has the resistant, aching, stupid, but not intensive character
This pain can arise after long overfatigue of eyes, for example at hard work with small objects. Violation of an eye muscle, far-sightedness, an astigmatism and violations of convergence and accommodation can cause long reduction of extra eye muscles, including frontal, temporal and even parietal. Increase of intraocular pressure at sharp glaucoma or iridotsiklit cause resistant, aching, but not intensive eye pain. When this pain is intensive, it can extend throughout an eye branch of a trigeminal nerve. Pain at diabetic neuropathy the III cranial a nerve, intra cranial aneurism, a hypophysis tumor, thrombosis of a kavernozny sine and a paratrigeminalny syndrome often irradiates in an eye.
of Pain in a nape and the top part of cervical department of a backbone
Such reflected pains especially often are observed on average and advanced age at patients with reamatoidny arthritis and spondilezy cervical vertebras; they tend to arise also after an injury of a neck of the " type; blow switch “. If a source of pain are the joint or an articulate bag, then the first movements after several hours of rest are limited and painful. In effect, provoking of pain as a result of active and passive movements in a backbone has to indicate traumatic or other injury of joints. It is more difficult to explain pain at the miofibrozit which is characterized by emergence of small knots, painful at pressing, in the field of an attachment to a skull of cervical and other muscles. This indistinctly probed educations it is still not enough data on the nature, it is impossible to judge by them whether really they are a pain source. Small knots can be shown only by deep morbidity at touch reflected by pain, or an involuntary secondary protective spasm of muscles. It is characteristic that pain is constant I (do not pulse) extends from one half of the head to another. Pain can amplify when cooling the head or on draft. This pain though from time to time and strong, seldom interferes with a dream.
Massage of muscles and heat cause unpredictable action, but in certain cases eliminate pain.
Sharp, strongly expressed, localized deeply in a skull
Expansion of the inflamed vessels of brain covers and stagnation of blood in these vessels probably are the main reason for pain.
the Pulsing pain in occipital and frontal lobes of a brain
the Headache at a tension
the Headache at a tension usually happens bilateral, is frequent with diffusion distribution from the top of a skull. Usually pain is localized in zatylochno - zadnesheyny area or in both frontal lobes. Though this feeling is described by the patient as pain, detailed inquiry can reveal other symptoms, namely feeling of overflow, compression or squeezing of the head (as though the head was pulled together with a hoop or it is clamped in a vice) on which waves of long, stupid, but not intensive pain are imposed. The attack is characterized by more gradual beginning, than at migraine, and quite often described as pulsing “ vascular “ headache. In the conditions of an emotional stress or strong alarm the headache at a tension can sharply arise, and disappear within several hours or 1 - 2 days. More often it remains within weeks or months. In effect, it is the only type of a headache which has property not to be interrupted neither in the afternoon, nor at night for a long time. Though the patient can fall asleep, every time when it wakens, he feels a headache; usually soothing medicines in this case slaboeffektivna. Contrary to migraine the headache at a tension meets more often in the middle age and can remain for many years.
the Headache at an angioma and aneurism
of Supervision showed that pain begins suddenly or very sharply, and reaches a maximum. within several minutes. Such neurologic disorders as sight violation, a unilateral sleep of a body, weakness or aphasia, can precede or arise after a headache and proceed after it disappears. In case of hemorrhage the headache is often extremely heavy and localized in a nape and a neck, lasts for many days and is combined with rigidity of a neck.
Headaches at tumors of a brain
the Headache represents the most characteristic symptom of a tumor of a brain. Unfortunately, character of this pain is insufficiently specific. Pain can be localized deeply, to be not pulsing (or pulsing), stupid, but not intensive, or splitting the head. Attacks last from several minutes to an hour and more and repeat several times during the day. Physical activity and often changes of position of the head can provoke pain, and the bed rest reduces it. Awakening at night from - for pains, though is typical, has no diagnostic value. Sudden severe vomiting is characteristic at the last stages of a disease. In process of growth of a tumor painful attacks become more frequent and intensive; pain sometimes proceeds almost continuously. If the headache has unilateral character, then at 9 of 10 patients it arises on the same party, as a tumor. Located over cerebellar mashed tumors kpered from an interaurikulyarny circle of a skull, and a tumor of a back cranial pole &ndash are projected; kzad from it. The bilateral frontal and occipital headache to which the unilateral headache preceded, speaks about increase in intra cranial pressure.
Headaches at internal diseases
Skilled doctors are informed on many states at which the headache serves as the prevailing disease symptom. These states include fevers of any origin, long influence of carbon monoxide, chronic diseases of lungs with a giperkapniya (at which headaches often arise at night), gipotirerz, a syndrome of Kushinga, a syndrome of cancellation of kortikosteroidny medicines, chronic influence of nitrites or preparations of an ergot, occasionally Addison`s illness, aldosteronprodutsiruyushchy tumors of adrenal glands, use of contraceptive medicines, sharp rise in arterial pressure, for example at a feokhromotsitoma, and sharp anemia with the content of hemoglobin is lower than 100 g/l. Hypertensia in itself seldom causes a headache.
Treatment of a headache
Major importance in treatment of a headache have detection and elimination of the diseases which are its cornerstone or functional violations.
At the usual, daily headache caused by fatigue, osty experiences or excess consumption of alcohol and tobacco it is recommended to try to remove the cause which caused it and to appoint symptomatic treatment acetilsalicylic acid (0,6 g) or the acetaminohair dryer (0,6 g) through everyone 6 - 8:ch. To eliminate the chronic headaches belonging to the category of usual migraine or headache at a tension much more difficultly. Soothing medicines can reduce pain, but seldom eliminate it. Usually patients appoint to themselves from 4 to 8 tablets daily within several years, despite obvious inefficiency of such treatment.