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Monday, August 7, 2017

Headache

Headaches

Definition

· Headaches are extremely common - most people have a headache at some time in their life. Most headaches disappear on their own (with a little time) or with the help of mild pain relievers.

· Children's also have headache, before they reach the age 10, research shows that before puberty headache is common in boys. Adult women experience more headaches than adult men, and they're often linked to a woman's menstrual cycle.

Types of Headaches

· Tension headache – do to muscle-contraction headaches. Everyone suffers from this at some time. Muscles in your scalp, neck, and face tighten and contract, causing spasms and pain. Psychological factors such as anxiety, fatigue (e.g., eyestrain), and stress (e.g., long periods of concentration) as well as mechanical factors such as neck strain (e.g., working on a computer for prolonged periods) are often the culprits behind a typical tension headache.

· Cluster Headache -tend to occur in clusters over a few days, weeks, or months with long headache-free periods lasting from months to years. In some cases, they are triggered by alcohol. The cause is not known.
· Migraine headache- The cause of migraine is not known but many trigger factors are recognized. These include hormonal changes (during a woman's menstrual cycle), certain foods (e.g., chocolate, aged cheeses), beverages (e.g., red wine), strong odours, lack of sleep, and even stress. It is not uncommon to experience mixed tension-migraine headaches.

· Sinus Headache - They can occur after a bout of upper respiratory infection, such as a cold. Along with the headache, people often have a runny or stuffy nose. Sinus headaches are caused when bacteria invade and infect the nasal sinuses.

Symptoms

· Tension headache - constant pressure or a dull ache that affects the entire head. begins slowly, with the ache usually focused above the eyes. There's a feeling of tightness across the forehead or at the back of the neck. Its last for an hour or a day.

· Cluster Headache - pain lasting about 20 to 90 minutes at a time. They typically start during sleep. The ache and pain is limited to one side of the head and can be extremely severe. They are often accompanied by other symptoms on the side of the headache such as redness and tearing of the eye, drooping eyelid, and nasal stuffiness and dripping.

· Migraine Headache - They often occur as one-sided head pain but can sometimes affect both sides. The location, duration, and intensity of pain vary widely from person to person as well as from one episode to another. Migraine is usually a pulsating pain, often with other symptoms such as nausea, vomiting, visual disturbances, and hypersensitivity to light, noise, and smells. A migraine attack can last from hours to days, averaging 12 to 18 hours per episode.

· Two types of Migraine – Aura and with out aura.

Complications

· headaches can occasionally be a sign of something more serious. Very severe high blood pressure (above 180/110 mm Hg), stroke, brain tumour, or an aneurysm (a dilated weakened blood vessel) in the brain may cause headaches. Meningitis (an infection of the brain's lining) may also cause a headache. Warning signs are a sudden onset of headache accompanied by fever, stiff neck, and visual problems (double vision).

· gets worse over days or weeks

· is accompanied by impaired neurological function (e.g., loss of balance, weakness, numbness, or speech disturbance) and double vision (could signal a stroke)

· is accompanied by persistent nausea and vomiting
· is accompanied by seizures, mental disturbances, and loss of consciousness
· is associated with a fever or stiff neck (could signal meningitis)
· is different than the usual pattern of headaches you have experienced
· strikes suddenly with great intensity
· wakes you from sleep or is worse when you lie down

Diagnosis

· Head CT Scan /MRI scan
· Lumber Puncture / CSF analysis
· Cerebral Angiogram - to find out any malfunction or AVM , aneurysm.

Treatment and Prevention

· Tension Headache - Taking an over-the-counter pain reliever such as acetaminophen* or ibuprofen, and finding ways to relax, rest, correct poor posture, and exercise can all help to relieve and prevent headache pain.

· Cluster Headache – Steroid ,NSAID,calcium channel blocker to reduce blood pressure and some antimagraine drugs.

· Sinus Headache - require antibiotics or other treatments to clear up the infection. Once the infection is gone, the headache will go away, too.

· Migraines can be treated with over-the-counter pain relievers, such as acetylsalicylic acid (ASA), acetaminophen, or ibuprofen, if the headaches are mild.

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