STUDY - Technical - New Dacian's Medicine
Headaches
(2)
Translation Draft
We continue with the presentation of the "technical" elements (presented by classical medicine) related to headache.
Headache due (later) to the lumbar puncture usually begins within 48 hours, but can be delayed up to 12 days, with an incidence of between 10 and 30% in those who have the puncture.
The headache is strictly positional, starting when the patient sits or stands up and is reduced to clinostatism or abdominal compression. The longer the patient is upright, the longer the latency before the headache occurs. It is made worse by shaking the head and compressing the jugular vein. The pain is usually deaf, but can be pulsatil, its location being occipitofrontal.
The nausea and stiffness of the neck often accompany headacheand and occasionally patients mention blurred vision, photophobia, tinnitus and vertigo. Symptoms resolve after a few days, but can sometimes persist for weeks or months.
Reducing the volume of cerebrospinal fluid (CRL) decreases brain support, so when the patient is upright, the brain support structures are probably dilated and strain the pain-sensitive dural sinuses, which results in headache. Intracranial hypotension often occurs, but severe headache after lumbar puncture may be present having normal CRL pressure.
Post-traumatic headache occurs after seemingly simple head trauma, especially after road collisions, with many patients complaining of headache, dizziness and memory disorders. Anxiety, irritability and difficulty concentrating are other characteristics of the syndrome.
Symptoms may resolve after a few weeks or may persist for months or even years. Post-traumatic headache can occur even if the person does not describe loss of consciousness due to head trauma.
Typically, neurological examination is normal, except for behavioural disorders, and computed tomography (CT) or magnetic resonance imaging (MRI) images are unrevealing. Chronic subdural hematoma can sometimes mimic this disorder. Although the cause of the disorder related to post-traumatic headache is not known, it should not generally be regarded as a primary psychological disturbance.
Temporal arthritis (with giant cells) is an inflammatory arterial disease that frequently involves extracranial carotid circulation. It is a common disease in the elderly, with an average age of onset of 70 years, with women accounting for 65% of cases. 50% of patients with temporal arteritis will go blind due to damage to the ophthalmic artery and its branches (ischemic optic neuropathy induced by giant cell arteritis being the leading cause of rapidly evolving bilateral blindness in patients over 60 years of age).
Typical initial symptoms include headache, rheumatic polymyalgia, maxillary claudication, fever and weight loss. Headache is the dominant symptom and often occurs with generalized malaise and muscle pain.
Headache can be one-sided or bilateral and is temporally localized in 50% of patients, but may involve any and all regions of the skull. Pain usually occurs gradually, a few hours before maximum intensity is reached (occasionally explosive in appearance), is rarely pulsating and is almost invariably described as deep and troublesome, with flashy, nagging episodes similar to migraine pain.
Most patients can recognize that the origin of their headache is superficial, in the external area of the skull, rather than deep (the place of pain for people with migraine). Scalp sensitivity is present, often to a pronounced degree, brushing hair or resting the head on a pillow is difficult due to pain.
Headache is usually worsened at night and is often aggravated by exposure to cold. Sensitive red nodules or redness of the skin along the temporal arteries frequently occur in patients with headache, as well as sensitivity to the temporal arteries or, less commonly, to the occipital arteries.
Cough-induced headache is one of the syndromes with male predominance and is characterized by transient, severe headache after coughing, bending, lifting, sneezing or head flexion, persisting from a few seconds to a few minutes. Many patients associate the development of the syndrome with a respiratory infection of the lower tract accompanied by severe cough, or intensive bodybuilding programs.
Headache is usually diffuse, but is lateralized in almost a third of patients. The incidence of serious intracranial structural abnormalities underlying this disorder is 25%. Many migraine patients find that headache attacks can be caused by sustained physical exertion (the syndrome is thus referred to as headache or migraine exertion).
As a curiosity, there is also headache during intercourse. This is a syndrome with male prevalence (ladies "have it" before, preventively), attacks occur periorgasmic, with sudden outburst, and decrease within minutes if sexual intercourse is interrupted. These are almost always benign phenomena and usually occur sporadically, and if they persist or are accompanied by vomiting there is a suspicion of subarachnoid hemorrhage.
Headache in brain tumors is the main culprit of curing 30% of patients with brain tumors (and disrupts sleep in about 10% of patients). Headache syndrome is difficult to define, being deaf and deep, of moderate intensity, occurs intermittently, is made worse by exertion or change of position and is associated with nausea and vomiting (specific model rather migraine).
The vomiting that precedes the onset of headache a few weeks before is characteristic of the brain tumors of the posterior fossa. There is also a so-called pseudotumor cerebri, a clinically similar headache in brain tumors (most of the patients being young and obese women), being an unusual condition accompanied by increased intracranial pressure, probably by poor absorption of CRL by arachnoid villosities. Additional manifestations are temporary blurring of vision, papillary edema with widening of blind areas and loss of vision in peripheral visual fields.
Headache caused by systemic diseases is common because there are few diseases that never manifest themselves through headache. These include infectious mononucleosis, systemic lupus erythematosus, chronic pulmonary failure with hypercapnia (morning headache), Hashimoto's thyroiditis, inflammatory bowel disease, many of HIV-associated diseases and sudden increases in blood pressure in the pheorochromocytoma and malignant hypertension.
The last two examples are the exceptions to the generalization that hypertension per se is a very unusual cause of headache (diastolic pressures of at least 120 mmHg being necessary for the development of headache in hypertension).
A full neurological examination is an essential first step in assessing a chronic headache. In most cases, an abnormal clinical examination should be followed by TC or MRI. Neuroimaging procedures are not indicated in patients with recurrent migraine and normal clinical examination. In other types of headache with normal examination imaging studies may be indicated, although the information obtained is reduced.
In these cases as screening examination of intracranial pathology, TC and MRI seem to be equally sensitive. A general assessment of recurrent headache should include renal and cardiovascular investigation by monitoring intraocular pressure and refraction. The cranial arteries are examined by palpation, the cervical spine by passive movements of the head and imaging, plus psychological evaluation of the patient.
The teenager with chronic chronic holocephalic or frontal daily headache is a special type of problem. Extensive diagnostic batteries are often irrelevant, including psychiatric evaluation. Fortunately, headaches tend to stop after a few years, so analgesic support can be useful for these teenagers to finish high school and get into college. In the last years of adolescence, the headache usually stops.
The relationship between headache and depression is not direct. Many patients with chronic daily headache cycles become depressed, which is a possible sequencing of phenomena. In addition, it is more than random the association of migraine with bipolar depressive disorders (manic-depressive) and with major unipolar depressive disorders.
Studies on large populations of patients with depression do not reveal prevalence rates of headache different from the general population, the high prevalence of headache in the general population may explain this paradox. The doctor should be cautious when considering that depression is the cause of recurrent headache.
Finally, an observation on recurrent headache that can be indicative. The dysfunction of the temporomandibular joint is an example, generally producing pre-urular pain associated with food chewing. Pain can irradiate the head, but it is not easily confused with headache per se.
On the other hand, patients with headache in the ventral decubit may notice that headaches are much more frequent and severe in the presence of a painful problem of the temporomandibular joint. Similarly, the headache can be activated by the pain accompanying the otological or endodontic surgical procedures.
Treatment of headache is generally ineffective until the cause of the primary pain problem is removed. Thus, pain in the head as a result of somatic disorders or trauma can reactivate a migraine mechanism, which had previously been put into regression.
Before moving on to the next group of pains (cervical and back pain) that I will "treat" it is good to make some clarifications (especially since even I, the author of these conspects, comments, presentations or whatever, I am bored of so many technical-medical details).
The value of classical medicine cannot be questioned, at least from the point of view of particularly extensive practice, the "study" power it has after so many hundreds of years of "improvement", "legalization", etc. The new medicine, even if it is older than the classical one many thousands of years ago, must be correlated, as a starting trampoline, to the classical (current) one either because of the general authority given to the results accumulated by this current, classical medicine, or as a general support for structuring all the information that will be presented (my effort being to make all those who go through the works aware , my take-overs, my processing that the medical world takes these things into account either instinctively, under the name of the doctor's medical flair, or directly by doctors who have "discovered" the validity of the mind's control over the trigger and, of course, direct or indirect healing, with the help of a doctor who acts classic, invasive or not, of any condition). So, you have to put up with many other technical-medical details, as I have arbitrarily called them, as I have endured the 3 years of medical school (and a few decades later), or as the doctors have endured the initial 6 + 3 years and the years that followed.
After all, everyone will act as they see fit, on the dorinm.ro website, and I will make an organizational structuring that will serve any type of reader (hence my dissatisfaction with the facilities of posting the knowledge I have and want to present to you), going as far as developing a symptomatic selection engine, known conditions, etc. and the most refined selection of what you want to go through. Help me, Lord, Creator, to carry all this out!
We continue with the presentation of the "technical" elements (presented by classical medicine) related to headache.
Headache due (later) to the lumbar puncture usually begins within 48 hours, but can be delayed up to 12 days, with an incidence of between 10 and 30% in those who have the puncture.
The headache is strictly positional, starting when the patient sits or stands up and is reduced to clinostatism or abdominal compression. The longer the patient is upright, the longer the latency before the headache occurs. It is made worse by shaking the head and compressing the jugular vein. The pain is usually deaf, but can be pulsatil, its location being occipitofrontal.
The nausea and stiffness of the neck often accompany headacheand and occasionally patients mention blurred vision, photophobia, tinnitus and vertigo. Symptoms resolve after a few days, but can sometimes persist for weeks or months.
Reducing the volume of cerebrospinal fluid (CRL) decreases brain support, so when the patient is upright, the brain support structures are probably dilated and strain the pain-sensitive dural sinuses, which results in headache. Intracranial hypotension often occurs, but severe headache after lumbar puncture may be present having normal CRL pressure.
Post-traumatic headache occurs after seemingly simple head trauma, especially after road collisions, with many patients complaining of headache, dizziness and memory disorders. Anxiety, irritability and difficulty concentrating are other characteristics of the syndrome.
Symptoms may resolve after a few weeks or may persist for months or even years. Post-traumatic headache can occur even if the person does not describe loss of consciousness due to head trauma.
Typically, neurological examination is normal, except for behavioural disorders, and computed tomography (CT) or magnetic resonance imaging (MRI) images are unrevealing. Chronic subdural hematoma can sometimes mimic this disorder. Although the cause of the disorder related to post-traumatic headache is not known, it should not generally be regarded as a primary psychological disturbance.
Temporal arthritis (with giant cells) is an inflammatory arterial disease that frequently involves extracranial carotid circulation. It is a common disease in the elderly, with an average age of onset of 70 years, with women accounting for 65% of cases. 50% of patients with temporal arteritis will go blind due to damage to the ophthalmic artery and its branches (ischemic optic neuropathy induced by giant cell arteritis being the leading cause of rapidly evolving bilateral blindness in patients over 60 years of age).
Typical initial symptoms include headache, rheumatic polymyalgia, maxillary claudication, fever and weight loss. Headache is the dominant symptom and often occurs with generalized malaise and muscle pain.
Headache can be one-sided or bilateral and is temporally localized in 50% of patients, but may involve any and all regions of the skull. Pain usually occurs gradually, a few hours before maximum intensity is reached (occasionally explosive in appearance), is rarely pulsating and is almost invariably described as deep and troublesome, with flashy, nagging episodes similar to migraine pain.
Most patients can recognize that the origin of their headache is superficial, in the external area of the skull, rather than deep (the place of pain for people with migraine). Scalp sensitivity is present, often to a pronounced degree, brushing hair or resting the head on a pillow is difficult due to pain.
Headache is usually worsened at night and is often aggravated by exposure to cold. Sensitive red nodules or redness of the skin along the temporal arteries frequently occur in patients with headache, as well as sensitivity to the temporal arteries or, less commonly, to the occipital arteries.
Cough-induced headache is one of the syndromes with male predominance and is characterized by transient, severe headache after coughing, bending, lifting, sneezing or head flexion, persisting from a few seconds to a few minutes. Many patients associate the development of the syndrome with a respiratory infection of the lower tract accompanied by severe cough, or intensive bodybuilding programs.
Headache is usually diffuse, but is lateralized in almost a third of patients. The incidence of serious intracranial structural abnormalities underlying this disorder is 25%. Many migraine patients find that headache attacks can be caused by sustained physical exertion (the syndrome is thus referred to as headache or migraine exertion).
As a curiosity, there is also headache during intercourse. This is a syndrome with male prevalence (ladies "have it" before, preventively), attacks occur periorgasmic, with sudden outburst, and decrease within minutes if sexual intercourse is interrupted. These are almost always benign phenomena and usually occur sporadically, and if they persist or are accompanied by vomiting there is a suspicion of subarachnoid hemorrhage.
Headache in brain tumors is the main culprit of curing 30% of patients with brain tumors (and disrupts sleep in about 10% of patients). Headache syndrome is difficult to define, being deaf and deep, of moderate intensity, occurs intermittently, is made worse by exertion or change of position and is associated with nausea and vomiting (specific model rather migraine).
The vomiting that precedes the onset of headache a few weeks before is characteristic of the brain tumors of the posterior fossa. There is also a so-called pseudotumor cerebri, a clinically similar headache in brain tumors (most of the patients being young and obese women), being an unusual condition accompanied by increased intracranial pressure, probably by poor absorption of CRL by arachnoid villosities. Additional manifestations are temporary blurring of vision, papillary edema with widening of blind areas and loss of vision in peripheral visual fields.
Headache caused by systemic diseases is common because there are few diseases that never manifest themselves through headache. These include infectious mononucleosis, systemic lupus erythematosus, chronic pulmonary failure with hypercapnia (morning headache), Hashimoto's thyroiditis, inflammatory bowel disease, many of HIV-associated diseases and sudden increases in blood pressure in the pheorochromocytoma and malignant hypertension.
The last two examples are the exceptions to the generalization that hypertension per se is a very unusual cause of headache (diastolic pressures of at least 120 mmHg being necessary for the development of headache in hypertension).
A full neurological examination is an essential first step in assessing a chronic headache. In most cases, an abnormal clinical examination should be followed by TC or MRI. Neuroimaging procedures are not indicated in patients with recurrent migraine and normal clinical examination. In other types of headache with normal examination imaging studies may be indicated, although the information obtained is reduced.
In these cases as screening examination of intracranial pathology, TC and MRI seem to be equally sensitive. A general assessment of recurrent headache should include renal and cardiovascular investigation by monitoring intraocular pressure and refraction. The cranial arteries are examined by palpation, the cervical spine by passive movements of the head and imaging, plus psychological evaluation of the patient.
The teenager with chronic chronic holocephalic or frontal daily headache is a special type of problem. Extensive diagnostic batteries are often irrelevant, including psychiatric evaluation. Fortunately, headaches tend to stop after a few years, so analgesic support can be useful for these teenagers to finish high school and get into college. In the last years of adolescence, the headache usually stops.
The relationship between headache and depression is not direct. Many patients with chronic daily headache cycles become depressed, which is a possible sequencing of phenomena. In addition, it is more than random the association of migraine with bipolar depressive disorders (manic-depressive) and with major unipolar depressive disorders.
Studies on large populations of patients with depression do not reveal prevalence rates of headache different from the general population, the high prevalence of headache in the general population may explain this paradox. The doctor should be cautious when considering that depression is the cause of recurrent headache.
Finally, an observation on recurrent headache that can be indicative. The dysfunction of the temporomandibular joint is an example, generally producing pre-urular pain associated with food chewing. Pain can irradiate the head, but it is not easily confused with headache per se.
On the other hand, patients with headache in the ventral decubit may notice that headaches are much more frequent and severe in the presence of a painful problem of the temporomandibular joint. Similarly, the headache can be activated by the pain accompanying the otological or endodontic surgical procedures.
Treatment of headache is generally ineffective until the cause of the primary pain problem is removed. Thus, pain in the head as a result of somatic disorders or trauma can reactivate a migraine mechanism, which had previously been put into regression.
Before moving on to the next group of pains (cervical and back pain) that I will "treat" it is good to make some clarifications (especially since even I, the author of these conspects, comments, presentations or whatever, I am bored of so many technical-medical details).
The value of classical medicine cannot be questioned, at least from the point of view of particularly extensive practice, the "study" power it has after so many hundreds of years of "improvement", "legalization", etc. The new medicine, even if it is older than the classical one many thousands of years ago, must be correlated, as a starting trampoline, to the classical (current) one either because of the general authority given to the results accumulated by this current, classical medicine, or as a general support for structuring all the information that will be presented (my effort being to make all those who go through the works aware , my take-overs, my processing that the medical world takes these things into account either instinctively, under the name of the doctor's medical flair, or directly by doctors who have "discovered" the validity of the mind's control over the trigger and, of course, direct or indirect healing, with the help of a doctor who acts classic, invasive or not, of any condition). So, you have to put up with many other technical-medical details, as I have arbitrarily called them, as I have endured the 3 years of medical school (and a few decades later), or as the doctors have endured the initial 6 + 3 years and the years that followed.
After all, everyone will act as they see fit, on the dorinm.ro website, and I will make an organizational structuring that will serve any type of reader (hence my dissatisfaction with the facilities of posting the knowledge I have and want to present to you), going as far as developing a symptomatic selection engine, known conditions, etc. and the most refined selection of what you want to go through. Help me, Lord, Creator, to carry all this out!
Respect
for you, all those who resist to go through this long
introductory part of my marathon about new
medicine!
medicine!
Dorin, Merticaru