The headacheany type of headache, affects approximately 50% of the adult population in the world. He headache It occurs in the meninges, the membranes that surround the brain, where the sensory endings of the trigenous nerve are located. When activated, among other stimuli, by stress, hunger, food or ingredients, odors or muscle overload, it sends messages to the thalamus, the brain nucleus. , which connects with areas that activate pain awareness. There are more than 150 types of headaches and according to a study published in 2015 by the World Health Organization, it is the sixth cause of disability worldwide.
Causes of headache
Various
The triggers for headaches can be diverse. Although each type of specific headache can have its own triggers, the general reasons are usually: lack or excess of sleep, medication consumption, hormonal changes, obesity, mental overexertion due to low educational level at school, alcohol consumption, food intake or additives, stress or family history.
Headaches can be grouped into primary ones, with their own characteristics, and secondary ones, which are usually a consequence of another disease.
Primary headaches:
– Tension headache. It is common and usually mild. It is caused by muscle tension in the head. Pressure is felt on both sides of the head, forehead and neck. It can last a day or several and even become chronic.
– Migraine or migraine. Pains of varying intensity that can be very strong. It can be episodic or recurrent, becoming chronic. It starts on one side of the head and spreads to the rest. It is usually pulsatile and may be accompanied by nausea and vomiting as well as photophobia, phonophobia and osmophobia (phobias of light, noise and smells respectively). It improves with rest and is usually caused by stress, although its origin is usually hereditary.
– Cluster headache. Very intense episodes that occur between one and eight times a day, including at night, with durations of 15 to 180 minutes. It does not improve with rest but rather causes restlessness. It is more common in men and begins around age 30.
– Hemicranial headache. Episodes of very intense pain lasting from two to thirty minutes more than five times a day. It can be paroxysmal or chronic. It affects only one side of the head.
– Unilateral neuralgiform headache with conjunctival injection and tearing (SUCNT). It is very rare and usually affects men over 50 years of age with episodes of moderate to severe intensity between five seconds and a few minutes but many times a day. They have been added up to 200 times.
– Cough headache. Pain that lasts between one second and thirty minutes with discomfort that lasts hours after an episode of coughing, sneezing or lifting weights, among other efforts.
– Headache due to physical exertion. Pain caused by practicing high-intensity exercise. It is pulsatile and lasts between five and 48 hours.
– Headache associated with sexual activity. It usually occurs when reaching orgasm on both sides of the head and lasts from minutes to hours.
– Headache due to cryostimulus. Caused by cold that is felt on the head: by contact, because it is inhaled or because it is ingested. It is usually unilateral, sharp and short-lived,
– Hypnic headache. It appears in the dream and causes an awakening. It lasts between 30 and 180 minutes and may be accompanied by nausea.
– Neuralgia of the trigenius. Sharp, stabbing pain with an unexpected start and end that appears on the face or one side of the face. It lasts a few seconds and the trigger is the activation of a “trigger zone” when chewing, talking, blowing your nose or shaving.
Secondary headaches:
– Headache due to trauma. Produced by a blow to the head or an explosion with foreign bodies entering the head.
– Headache due to cerebral vascular pathology. Produced by an occlusion, an arteriovenous malformation, a stroke, cerebrovascular accident or an aneurysm.
– Headache due to substances. The cause is the abuse of substances such as drugs or alcohol or frequent exposure to carbon monoxide or nitric oxide.
– Due to infections such as sinusitis, meningitis or encephalitis. It usually presents with fever.
– Due to psychiatric pathology such as anxiety or depression.
– Due to high blood pressure.
– Due to a tumor or increased intracranial pressure. The pain worsens when lying down and sudden vomiting occurs.
– Due to hypotension of the cerebrospinal fluid after a lumbar puncture, epidural anesthesia or head trauma.
– Due to Chiari malformations, a structural problem at the base of the skull.
– Due to dehydration.
– Due to dental problems.
– Due to glaucoma.
Headache symptoms
Headache
Frequent and disabling headache in part or all of the head of moderate to severe intensity. The pain can be: throbbing, cramp-like, explosive, drill-like, or oppressive. Other symptoms may be: almost closed or drooping eyelids, nausea or vomiting, pupils with different dilation (anisocoria), red eyes, watering or vertigo.
You should go to the doctor urgently if there are alterations in vision such as black spots, distortion, double vision or bright lights, speech problems, facial spasms, tingling sensations in the arms and legs, weakness in an extremity, skin rash, fever or stiffness in the neck.
Diagnosis of headache
Medical history, neurological examination and tests
To obtain a diagnosis, the first step is to prepare a medical history that will include the type of pain, its location, habits, possible triggering factors and associated symptoms. The neurologist will examine the head, eyes, ears, throat, and neck.
He or she will also order a blood test and imaging tests such as x-rays of the paranasal sinuses, cranial computed tomography, cranial magnetic resonance imaging, computed tomography or magnetic resonance angiography, and lumbar puncture. Exceptionally, isotopic cisternography or CT-myelography may be ordered to study cerebrospinal fluid hypotension.
Headache treatment and medication
Adapted to the type of headache
Each case or type of headache will require a specific approach but normally there are lifestyle guidelines that usually include good sleeping habits, avoiding tobacco, alcohol, following a healthy and balanced diet rich in fiber to avoid constipation and exercising. moderate.
Among the pharmacological options for migraines, rapidly absorbed non-steroidal anti-inflammatories are usually prescribed in the event of an outbreak and if there is no response, triptans (selective serotonin agonist drugs). The order can be reversed in moderate-severe crises. Hemicranial headache is treated with indomethacin; and cluster headache with triptans such as subcutaneous sumatriptan or intranasal zolmitriptan.
Headache prevention
Good habits and orderly life
The prevention guideline for headaches is a healthy and balanced diet low in fat and rich in fiber. Perform moderate exercise on a regular basis. Sleep well and have enough hours. Avoid alcohol and tobacco. Do not consume too many pain relievers and do not consume too much caffeine.
To control a crisis, it is recommended to rest in a quiet, dark room, place a cool cloth on your head and apply relaxation techniques.
When faced with a crisis, it is advisable to note the onset, type of pain, duration, the food eaten, the hours of sleep, as well as the reason for the outbreak to stop. Any alteration in the usual headache pattern, change in mood, or motor or visual abnormalities should prompt us to seek immediate medical attention.
#Headache #symptoms #vital
