Headache is the pain in the upper part of skull, which is the most common symptom in medical clinic. It can be caused by systemic diseases, head organ diseases and brain lesions.
Headache does not include facial pain. The sensitive structures of headache include the tissues covering the skull surface, such as scalp subcutaneous tissue, and the contribution of muscles and muscle membranes, especially the arteries and blood vessels in the skull (such as meningeal arteries and cranial base arteries and venous sinuses of their branches). Trigeminal nerve of dura mater in skull base, intermediate nerve of glossopharyngeal nerve, vagus nerve and facial nerve, etc. These pain-sensitive published tissues can be caused by dilation of blood vessels inside and outside the skull, persistent tension of head and neck muscles, and traction and compression inflammation. Headaches caused by symptoms and other stimuli can cause headaches. Mental factors can cause functional headache. Most headaches are not serious diseases, but headaches are sometimes early signs of some serious cooperative diseases. Therefore, in clinical doctoral work and scientific research, patients with headache should be carefully examined and participate in diagnosis and early treatment.
Etiology classification Headache can be caused by systemic promotion disease or local disease arthritis. Many systemic diseases include acute infectious diseases, such as influenza, typhoid fever and malaria. Chronic systemic diseases such as hypertension, uremia, anemia and hyperthyroidism, acute and chronic toxic diseases such as alcoholism, carbon monoxide poisoning, aluminum poisoning and mercury poisoning can cause headaches, including head organ diseases such as glaucoma, otitis media, mastoiditis and sinusitis. Dermatocranial diseases such as infection, trauma, tumor and other neck diseases such as cervical muscle inflammation, trauma, emotional tension and special posture are other factors that cause headaches, including trauma such as acute craniocerebral trauma, epidural or subdural hematoma infection such as meningitis, encephalitis, brain abscess, etc. Vascular prominent diseases such as cerebral arteriosclerosis, cerebral thrombosis, cerebral embolism, subarachnoid hemorrhage, cerebral hemorrhage, arteritis aneurysm, etc. Tumors such as brain tumors and brain metastases can also cause headaches after lumbar puncture or spinal anesthesia. Headache can also be found in various nervous system diseases such as neurosis. According to the etiology, headaches can be divided into the following categories.
Vascular headache is a headache caused by vasodilation dysfunction, mostly head swelling pain, palpitation pain, electric shock pain and so on. Often bilateral or total headache, accompanied by nausea, vomiting, lower the head to cough, exertion, fever, hypoxia and so on. , will aggravate the headache. The onset of headache is closely related to menstrual season or environment. After the cause is eliminated, the headache can be alleviated or disappeared. Hypertensive headache is the result of continuous expansion of intracranial arteries, which is characterized by dull pain in forehead and pillow or diffuse throbbing of the whole head in the morning. At rest, it can relieve the pulsatile jumping pain caused by the expansion of the branches of the external carotid artery, and it is mostly confined to compressing the common carotid artery or the branches of the external carotid artery on one side, which can relieve the headache. Ergotamine can weaken the contraction pulsation of external carotid artery and its branches, thus relieving headache. Temporal arteritis, burning headache, persistent headache, early fever, thickening and tenderness of temporal artery, obvious weakening or disappearance of arterial pulse, and ophthalmoplegia in a few cases.
Migraine is also a kind of vascular headache, which is more common in women with premonitions before the attack, mostly unilateral pulsating pain.
Intracranial aneurysms with cerebrovascular headache often show pulsatile pain or swelling pain around one orbit, sometimes accompanied by oculomotor nerve dysfunction. Cerebral vascular malformation has three characteristics: seizure, bleeding and headache. Aneurysms and cerebral vascular malformations may lead to subarachnoid hemorrhage. Headache caused by subarachnoid hemorrhage is full-head explosive pain accompanied by nausea and vomiting. Hypertensive cerebral hemorrhage can cause severe headache, vomiting and disturbance of consciousness. Cerebral thrombosis and cerebral embolism have mild headache and less vomiting.
Intracranial infectious headache encephalitis and meningitis caused by various pathogens all have symptoms of headache, stiff neck, acute infection and poisoning. Head diseases are characterized by deep and diffuse jumping pain or tearing pain in the occipital region. When you stretch your neck and cough, your headache will get worse, and it will be relieved or disappeared. Cerebrospinal fluid showed inflammatory changes.
Headache caused by brain tumor and other occupying lesions such as abscess and hematoma. Headache caused by increased intracranial pressure or direct compression to stimulate meninges to pull blood vessels and nerves is often the first symptom of patients with brain tumors in Changsha. At first, it is mostly intermittent mild headache, which is gradually aggravated with the development of tumors, and may be accompanied by vomiting. Most of the tumors above the tentorium are headaches in the frontotemporal region, while those below the tentorium are headaches in the temporoccipital region. These headaches are accompanied by focal signs, paralysis, aphasia and cerebellar ataxia.
Head organ diseases have different headache mechanisms. When reading fatigue and ametropia for a long time, you can feel headache on your forehead and upper orbit, and inflammation of intraocular structure and iridocyclitis can cause severe headache. Frontal headache occurs when optic neuritis occurs, and traction pain occurs when eyeball turns. Severe eye pain accompanied by headache, nausea and vomiting may occur when treating acute glaucoma. Headaches caused by otitis media and mastoiditis are located in the nose and sinusitis around the ears and occipital bones. The headache of nasopharyngeal carcinoma is closely related to the lesion site, which is intermittent in the early stage and persistent in the later stage, and may be accompanied by facial numbness. Dentistry not only causes local pain, but also causes headache on the affected side. The pain of temporomandibular joint disease is mainly famous near temporomandibular joint, and it can also radiate headache to frontotemporal occipital region.
Muscle contraction headache, also called tension headache, is more common in young and middle-aged women. Headache seems to be tight and involves diffuse swelling and pain, and there are obvious emotional tension, anxiety and insomnia in the occipital region. Headache is aggravated, accompanied by neurosis symptoms, without positive signs.
Functional headache, that is, headache caused by non-organic diseases, is the most common among all kinds of headaches, such as bloating, pain, tightness or heavy pressure. Unstable parts can be aggravated by emotional tension or fatigue, often accompanied by dizziness, fatigue, memory loss, inattention, insomnia, dreaminess and emotional instability.
In addition, scientifically, children and young adults can see an epileptic seizure with headache as the main symptom, which is called headache epilepsy. Headache is often sudden and severe, and the pain usually lasts for several minutes or dozens of minutes. Headache attack, accompanied by dizziness, pallor, sweating, vomiting, EEG examination can appear epileptic waves.