Headache as a symptom: how to correctly diagnose?
Pain is perhaps the only symptom that every person has felt at least once in a lifetime.And it's not about the usual bruises, but about the pain that is caused by a variety of pathologies.And at the first place in terms of cleanliness, the headache is right, which can turn a person's life into a nightmare.And if it is just a sign of another, hidden and from this even more dangerous disease, then it can not be ignored under any circumstances.Table of contents: Causes of secondary headache Head injuries Head and neck injury Skull and cranial lesions Intracranial hypertension( ICH) Brain tumors Intracranial substances and their abolition Intracranial infections Infections of cranial structures
Causes of secondary headache
Unlike primary headache,Which in itself is a disease and most often occurs in people who are in prolonged stress, secondary headaches appear against the background of other diseases.In the first case it is necessary to treat GB itself, whereas in the second case doctors struggle with the underlying illness, giving only a part of their attention to headaches.The pathology will leave - the headache will leave also.
This is the case in which there is such a symptom as a headache:
- Head and neck injuries.
- Spinal cord injuries( cervical spine) and skull.
- Lesions of intracranial structures not associated with blood vessels:
- brain tumors;
- intracranial hypertension of various origin;
- non-infectious meningitis;
- epileptic seizure.
- Toxic effects of various chemicals or the removal of such effects.
- Infections, including intracranial.
- Diseases in which the hormonal, acid-base, gas balance in the body is disrupted.
- Pathologies of various structures of the skull, including the facial.
- Mental diseases.
One of the main signs of brain concussion is a headache.Usually it is associated with the moment of injury or occurs immediately after the person returns to consciousness.However, often, especially with moderate or severe concussion, a person's head may not hurt at all.
Therefore, a doctor who monitors a patient injured to the head must identify other signs of a shock:
- behavior change;
- impaired concentration;
- reduced ability to assimilate new information;
- memory degradation;
- movement coordination disorders, etc.
Of course, the lion's share of these signs can be identified only with the help of people close to the victim.They will be able to notice changes in behavior and other indicators that can not be measured.
Concussion is by far not the only complication of craniocerebral trauma.As a result of a stroke, a person can develop intracranial hematomas, foci of a cerebral infarction( necrosis of the brain tissue), in the presence of a fracture of the bones of the skull, their fragments can also injure intracranial structures.That is why a single interview of the victim and his relatives is not enough for an accurate diagnosis. Doctors resort to instrumental and laboratory methods, such as:
- radiograph of the skull to detect fractures;
- magnetic resonance and computed tomography, allowing to see the smallest violations of brain structure;
- Ultrasound, which visualizes the possible displacement of the brain as a result of an increasing hematoma;
- lumbar puncture - with its help in the cerebrospinal fluid show an admixture of blood, which also indicates a hemorrhage between the membranes of the brain.
Neuropathologists or neurosurgeons are engaged in the treatment of craniocerebral trauma.It often happens that after a few hours a person, almost healthy in appearance, suddenly falls into a coma because of an intracranial hematoma not detected in time.Any patient with suspected concussion is hospitalized for observation.Activities primarily include resting the victim, prescribing him analgesics to eliminate headaches, drugs that reduce intracranial pressure, if necessary - anticonvulsant and sedatives, drugs for dizziness.
In the presence of hemorrhages in the cranial cavity, trepanation is performed.During this operation, the blood is removed and the wound is sutured.In the case of a hematoma, this is the only way to give a person a chance to survive.
Defeat of the vessels of the neck and skull
The brain is one of the most demanding blood supply organs.It is no accident that cardiac arrest leads to his death in just 5 minutes, while skin cells, for example, can live more than 6 hours after a complete cessation of nutrition.
The defeat of arteries feeding the brain inevitably affects its blood supply, and first of all it is manifested by one- or two-sided permanent headaches, often not responding to the use of strong enough painkillers.
Inflammatory lesions of central nervous system vessels are usually treated with precisely measured doses of hormonal agents and cytostatics.With the separation of blood vessels, an operation is performed to introduce a vascular prosthesis at the site of the vessel damage.Without treatment, a person sick with such diseases is doomed.
Intracranial hypertension( ASG)
This syndrome can develop due to a variety of diseases:
- brain injury;
- endocrine diseases;
- intracranial infections.The reason for this is the worsening of the outflow of cerebrospinal fluid from the cranial cavity during its normal development or the increase in its synthesis with adequate outflow. The
This is due to the appearance of obstructions to the outflow in the form of scars( after trauma), tumors, hypervitaminosis A, brain development abnormalities, etc. Headache is constant, in intensity it varies from mild to unbearable, causing vomiting( usually in the morning), Occurs mainly at night and in the morning.In parallel with this, a drop in efficiency, nervousness, instability of blood pressure, a sense of malfunction in the work of the heart, sweating and other vegetative signs are noted.
People suffering from increased intracranial pressure become meteosensitive, their health deteriorates, predicting a change in the weather.
First of all, of course, it is necessary to treat the condition that led to HFG: infection, swelling, concussion, etc. However, in some cases, it is necessary to fight and with this syndrome.To do this, use diuretics, enhancing the absorption of cerebrospinal fluid into the blood and its excretion.
In mild cases, sometimes limited to non-pharmacological methods - proper drinking regimen, manual therapy, massage, exercise therapy.In cases of severe HFG, it may be necessary to install a bypass route for the outflow of cerebrospinal fluid into the canal of the spinal cord if the main path is insurmountable.
With brain tumors, the headache is very variable.Often it resembles a tension headache, but it can differ both in localization and in intensity.This symptom occurs in 17% of all cases of oncological pathology of the brain, regardless of whether it is located in a primary tumor or a metastasis of cancer of another organ.
The compression of volumetric formation of brain structures leads to the development of intracranial hypertension, hydrocephalus, in which the headache is spread throughout the head and is strongest in the morning.After a few hours it subsides, in contrast to the tension headache.
When squeezing the nerve centers, there is symptomatology, corresponding to the defeat of a particular nerve - pareses, paralyzes local or generalized.
Like any oncopathology, brain tumors are treated with radiation, radio and chemotherapy.In some cases, microsurgical operations are used to remove volumetric formation.Eliminating the tumor or reducing it in size often leads to the disappearance and headaches.
Substance intoxication and cancellation
Many substances contribute to the occurrence of a headache when in contact with them.Poisoning with carbon monoxide, arsenic, alcohol, drugs, histamine, etc., can cause a diffuse headache, sometimes not stopping even with strong analgesics.Some medications may also have a side effect in the form of a headache.
There is an abusus headache caused by the abuse of pain medication.In this case, there is a kind of paradox - taking analgesics instead of reducing headaches promotes their strengthening after a short period of relative well-being.
Finally, sometimes the headache is caused by the withdrawal of the substance.It is well-known "breaking" when trying to stop drinking coffee.The headaches are constant, moderate and usually completely disappear within a few weeks after caffeine failure.
When poisoning with toxic substances, drugs, alcohol detoxification activities are carried out.With drug abusus, treatment is carried out by discontinuing the drug that caused the disease.For headaches with withdrawal syndrome, you should change the approach to rejecting the substance."Jump off" from him must be gradually, in parts reducing the dose.Thus, the body adapts to the changed circumstances and has time to develop internal anesthetics.
Meningitis and encephalitis - these two terrible words are known to many.The headache with some forms of these diseases is so monstrous that even grown-up people turn into maddened creatures writhing from her.In young children, it causes a continuous monotonous cry.The nature of the pain is bursting, pressing, it usually covers the entire head.
Depending on the microbe that caused the disease, antibiotics, antiviral agents, drugs that improve cerebral circulation and outflow of cerebrospinal fluid, anesthetics and glucocorticoids are used.
Infections of the cranial structures
Sinusitis, periodontitis - this is the most common cause of headaches when the structures of the skull are affected.
Genyantritis, frontalitis, etmoiditis - inflammation of these paranasal sinuses is accompanied by a moderate permanent exhausting patient with a headache that only partly reacts to taking analgesics.This pain is associated with irritation of the inflammatory process of the cranial nerves, which transmit impulses to the painful centers of the brain.
For chronic inflammation of the facial skull structures, antibiotics, anti-inflammatory and analgesics are used.With sinusitis the doctor can perform a puncture of the corresponding sinus and even a full operation.Painful sensations abate as the inflammation disappears in the appropriate organ.
Headache is one of the most frequent clinical signs of a variety of diseases.Even a simple classification of various headaches takes 9 pages of small text.It is obvious that it is extremely difficult to identify the cause of the appearance of this symptom independently.Simple reception of tablets "from the head" is just a "crutch" that does not heal, but temporarily removes the acute phenomenon.And you do not need to treat a symptom, which is a headache, but a disease that provoked his appearance.And here nobody can cope better than a doctor.
If you have any questions, we recommend that you view this video review:
Bozbey Gennadiy, medical reviewer, ambulance doctor.