diease

Head ache


Head ache overview and Definition

The person might experience head ache once in his lifetime.  The causes of the head ache vary from person to persons.


Structure of Head ache

Types of Head Ache:

Tension Headache:

They are the most common form of headache among the adults and teens. They cause mild to moderate pain and relieves by itself. They do not show much symptoms.

Migraine:

Migraine headaches are often termed as throbbing pain. They can last from 4 hours to 3 days and happen one to four times a month. In addition to the pain the people also tends to suffer from sensitivity to light, noise, smell , nausea and vomiting. Loss of appetite, upset stomach and belly pain can also occur.

Cluster headaches:

       These headaches are the most severe form of the headache. The person might experience burning or piercing type of pain in the back or around the eyes.  The patient might feel so much discomfort. On the side of the pain the eyelid droops, pupil becomes smaller, eyes becomes red and the eyes makes the tears.  The nostrils on that side shows stuffs up. These types of headaches occur many time a day and hence it is termed as cluster headache. The person might feel the headache one to three times per day which might last 2 weeks to 3 months. The duration of each headache is 15 minutes to 3 hours. The person cannot sleep nicely.

Hormonal headache:

The hormonal changes during pregnancy, periods and menopause can causes headaches. The hormonal alterations due to birth control pills and hormonal replacement therapies can also cause headaches. When the headache takes before 2 days or the starting of the first 3 days of the period it is called as menstrual period.

New daily persistent headache( NDPH):

The headache can go on for atleast 3 months or longer. It is of unknown cause but it might be due to infections, flu like illness, surgery or stressful event.

Rebound headaches:

It takes place one to three times a day or more than 10 times a week.  It often gets worsen in the morning.

 

There are two types of headache that is chronic head ache and remitting head ache. The duration of the remitting headache is 6  months.

Chronic head ache:

It happens 15 days or more in a month for greater than 3 months. The maximum duration of the pain is 4 hours. It is usually one of the four types of the primary headaches.

  • Chronic migraine
  • Hemicrania continua
  • Chronic tension headache
  • New daily persistent headache

Types of headache:

Sinus headache:

The site of the sinus headache includes cheekbone, bridge of the nose and forehead. The sinus are the cavities that are found in the facial regions. The inflammation of those structures result in sinus headache.

Post traumatic headache:

It usually starts after the 2-3 days after the head injury. The person might feel vertigo, a dul; ache that gets worsen over time, lightheadedness, memory problems, fatigue and irritability.

Exercise headache:

When the person is over active then the muscles in the head, neck and scalp need more amount of blood for the supply. This might result in pulsating pain on both sides of the head that lasts for 5 minutes to 48 hours.

Hemicrania continua:

It is the chronic headache that occurs in the same side of the head and neck. The person might feel red eyes, running nose, droopy eyelid, contracted iris.

Ice Pick headaches:

It lasts for only few seconds.

Spinal headache:

The type of headache is common after the lumbar puncture or epidural or spinal injections. These procedure involves the puncturing of spinal cord. Hence the fluid leakage from the spinal cord might result in pain.

Thunderclap headache:

It comes out suddenly and causes severe pain. The  causes might include:

  • Blood vessel tear, rupture, or blockage
  • Head injury
  • Hemorrhagic stroke from a ruptured blood vessel in your brain
  • Ischemic stroke from a blocked blood vessel in your brain
  • Narrowed blood vessels surrounding the brain
  • Inflamed blood vessels
  • Blood pressure changes in late pregnancy


Pathophysiology

The brain by itself is not responsible for the pain because it lacks pain receptors. But there are several areas that belong to the head and neck have multiple pain receptors that can cause pain. These include extracranial arteries, middle meningeal artery, large vein and venous sinuses, cranial and spinal nerves, head and neck muscles, the meninges, falx cerebri and also the parts of the brainstem, eyes, ears, teeth and linjng of the mouth. Pial arteries are responsible for the pain production.

Headaches often results from traction to or irritation of the meninges and blood vessels. blood vessel spasms, dilated blood vessel, inflammation or infection of meninges and muscular tension can also stimulate the pain receptors.  Migraines occurs due to the dysfunction of the nerves in the brain. The theory proposed by the wolff suggest that the migraines are caused by the constriction of the blood vessels that are found intracranially and the dilatation of the blood vessels that are found extracranially. But the theory is not accepted. Aura is caused due to the hyperactivity of the neurons in the cerebral cortex which is called as cortical spreading depression followed by a period of depressed activity.

Tension headaches are thought to be caused by the activation of the peripheral nerves in the head and neck muscles.

Cluster headaches involve overactivation of the trigeminal nerve and hypothalamus in the brain.


Clinical signs & symptoms

throbbing pain

nausea

fatigue

radiating pain towards the eyes

inability to concentrate on work.


Differential Diagnosis

  • Physical exam and medical history: Your doctor will perform a general health exam, looking for signs of diseases or illnesses. Your doctor will also ask questions about past and current health conditions, surgeries and medical treatments and family history of disease.
  • Blood test: It is used to check any abnormalities in the cells present in the blood.
  • Biopsy: Through a small hole in the skull, a doctor uses a needle to take a sample of tissue. A laboratory studies the sample to identify details from the tumor, including how fast it is growing and whether it is spreading.
  • Imaging tests: CT scan, MRI scan SPECTs and PET scans help the physician to locate the headache.
  • CT scan :
  • It is used to view 3 Dimensional image of the structures that are needed to be    investigated.
  • MRI scan:
    • It uses the soft tissue image of the organ. It uses the both the magnet and radio waves. It is used to view blood vessels, other structures and also the detailed images of the brain.
  • Neurological exam: During a neurological exam the physician might check for reflexes and           

                       mental status of the patient.

  • Spinal tap: A doctor uses a small needle to remove fluid from around the spine. A laboratory examines this fluid to look for any abnormalities.


Prevention

Reduces the stress

Maintains the healthy lifestyle

Practise yoga