What pathologies is the headache on standing up?

Pain in the head is a companion of a variety of diseases. It can speak both of general pathology and of local head disease. Infectious diseases, vascular pathologies, metabolic disorders, voluminous brain formations can cause malaise. Time and conditions of symptom appearance, duration and strength, localization are important. For example, a sharp pain in the head when getting up can be a sign of serious pathologies.

Causes of

Headache when getting up is called still orthostatic. The following conditions can trigger it:

• lumbar puncture;
• head trauma;
• orthostatic hypotension;
• neurosurgical interventions;
• anatomical features of the meninges;
• genetic factors( Marfan syndrome, Ehler-Danlos syndrome).

Orthostatic headache is a dull pain in the head of a large force that occurs when the stalk is up. It stops when you are lying down. It is accompanied by a drop in intracranial pressure.

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Circulation of liquor and cause of leakage

Liquor is in constant motion. It is produced in the vascular plexuses of the brain's ventricles, up to 700 ml of liquid is produced per day, but its constant volume is 150-270 ml. From the cerebral ventricles, it penetrates into the subarachnoid space of the brain and spinal cord. The venous system is absorbed through the arachnoid membrane. Due to the stable volume, the pressure inside the brain is maintained.

The liquor balance is on the verge of production and suction. Loss of fluid will lower the pressure. A possible factor of leakage may be a defect in the membranes of the brain. This is usually the result of trauma( TBI) or medical manipulation.

Often after spinal cord puncture, epidural injections or neurosurgical operations, patients say that the head hurts when they get up. These symptoms appear 48 hours after the intervention, but sometimes their manifestation is delayed for up to seven days.

Please note! Some head injuries are accompanied by the symptom of a "teapot": leakage of the cerebrospinal fluid occurs through the nose. Sometimes the symptom appears for no apparent reason.

Genetic syndromes of Ehler-Danlos and Marfan are manifested by defects in the development of connective tissue, which affects all joints. Perhaps the curvature of the spine, looseness of the joints. There may be a leakage of cerebrospinal fluid, which will result in a sharp headache when you get up.

Important! Sometimes lowered intracranial pressure has extracerebral causes - dehydration, uremia or the abuse of diuretics.

The mechanism of pain formation

The human brain is a very delicate structure. The surrounding water shell carries a protective function, it plays the role of a shock absorber with small shakes and shocks. The pressure of the liquid is of a constant nature and obeys the laws of physics. When rising from a horizontal position, the cerebrospinal fluid rushes downward under the action of gravity with the brain.

With a normal amount of fluid, sudden body lifts do not cause a headache. If the cerebrospinal fluid is not enough, the meninges are stretched, and pain arises. The brain vessels are constantly pulsating in time with the heart. Therefore, pain can acquire a pulsating hue.

Diagnosis

For the diagnosis of intracranial hypotension, a thorough examination is necessary. The absence in the anamnesis of recent head injuries and interventions with violation of the integrity of the meninges complicates the diagnostic search. According to the results of MRI, it is possible to suspect a decrease in intracranial pressure. This is characterized by the following features:

• thickening of meninges;
• shells are well contrasted;
• the amygdala of the cerebellum is displaced downwards;
• in the subdural space accumulates liquid;
• pituitary gland is enlarged in size( see Pituitary adenoma);
• extension of subdural veins.

If nasal discharge is not associated with a runny nose, you can conduct a study for beta-2-transferrin, which is specific for cerebrospinal fluid.

To determine the location of fluid leakage, use CT-myelography or radioisotope cisternography. But interpreting the results of research is very difficult.

To determine the general dehydration, it is enough to conduct a survey. Long-term vomiting, diarrhea, excessive physical activity especially in hot weather with insufficient drinking regimen will lead to this condition. Then there will be complaints of pain in the head when you get up. In a general analysis of the blood for dehydration will indicate "thickening of the blood" - an increase in the amount of hemoglobin and erythrocytes. Urine in such people is concentrated, diuresis is reduced.

Diuretics are prescribed for diseases of the circulatory system, edema. An incorrect intake regimen, an independent increase in dose will also lead to loss of fluid.

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Treatment

Therapy is performed etiological. If the cause of the disease is puncture or surgery, the bed rest is prescribed for several days, soon the patient stops complaining that the head hurts when getting up.

In the area of ​​the spine, the defect of the membrane is treated with a "blood patch".The patient is taken blood and injected into the place of the intended opening. Curled blood will play the role of cork. If such a procedure is not possible, the defect is large, then surgical treatment is performed. The prognosis for this disease is favorable.