Headache
Headache
Origin of headache:
- Stimulation of peripheral nocioreceptors due to tissue injury
- Damage of pain producing pathways of peripheral or central nervous system.
COMMON CAUSES of HEADACHE
Primary Headache Secondary Headache Tension-type Systemic infection
Migraine Head injury
Idiopathic stabbing Vascular disorders
Exertions Subarachnoid Hemorrhage
Cluster Brain tumour
Pain producing cranial structures: Scalp, Middle meningeal artery, Dural sinuses, Falx cerebri, Proximal segments of large pial arteries.
Headache is of two types:
Primary Headache
Definition:Here, headache and it's associated features are disorder in itself(without any exogenous cause) .
Structures involved
- Large intracranial vessels and dura matter
- Peripheral terminal of trigeminal nerve innervating these structures
- Caudal portion of trigeminal nerve
- Ventro posteromedial thalamus and cortex
- Pain modualting system in brain
Types of primary headache
a) Migraine
b) Tension type
c) Cluster headache
d) Trigeminal Autonomic Cephalgia
Secondary Headache
Definition: It occurs due to some exogenous disorder(eg. Upper respiratory tract infection)
Causes
- Meningitis-Acute and severe with stiff neck and fever
- Intracranial hemorrhage: Same as meningitis but fever absent
- Brain tumour
- Temporal arteritis
- Glaucoma
- Consider-Meningitis, SAH, Epidural/Subdural Hematoma, Glaucoma, Tumour, Purulent sinusitis
- Neurological examination
- Lumbar puncture
- CT, MRI
- Cranial artery palpitation
- Evaluation of cervical spine by effect of passive movement of head
- Investigation and imaging of CVS and renal system by BP monitoring and urine examination
- Psychological state evaluation
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