Headache is a very common complaint of patients because it is a universal experience. While it may be a rare symptom for some, for others it may be a life-limiting chronic disease or a life-threatening disease. Many patients fear that it may be a symptom of a serious underlying disease.
CAUSES OF HEADACHE
Migraine, one of the most common diseases characterized by headache, has attracted a lot of attention in recent years. .
1. MIGRAINE:
– The cause of migraine is unknown, but some triggers have been observed frequently.
– Most patients have a family history of migraine. There is a history of it.
– Stress, changing sleep hours, menstruation, alcohol use, caffeine withdrawal, eating various foods, etc. It can be attributed to situations such as.
– It may develop after seemingly minor head traumas; Diagnosis and treatment can prevent prolonged discomfort.
MIGRINE TYPES
Simple Migraine: Characterized by widespread or unilateral throbbing head discomfort in the brain. It is a pain. Nausea, vomiting, discomfort with light, discomfort with noise and/or loss of appetite may accompany the headache.
Classical Migraine: Vivid visual effects of colors often occurring in geometric shapes within the visual hemifield. It occurs through dreams in the form of strings of light. Throbbing headache is usually on the opposite side of the visual findings, and the patient may experience nausea, vomiting, discomfort from light and sound, and loss of appetite. Migraine with aura is accompanied by temporary neurological disorders such as visual field disorders and hemisensory loss.
Treatment: If possible, stimulating factors should be removed first.
TREATMENT THAT STOPS MIGRAINE PAIN EARLY
Use of ergotamine and dihydroergotamine (dhe), which are available in oral, sublingual and suppository forms. This method should be avoided in women who want to become pregnant, in those with uncontrolled hypertension, in those with sepsis, in those with kidney-liver failure, and in those with coronary, cerebral or peripheral vascular diseases. Nonsteroidal anti-inflammatory drugs (NSAIDs) can stop migraines. Analgesics can also be used for symptomatic relief.
Sumatriptan, a serotonin agonist, is an effective agent in the treatment of migraine.
Preventive Treatment: Drug use and headache-inducing situations. It can be expressed as making changes in the patient's behavior.
In medical treatment, beta-blockers, tricyclic antidepressants, calcium channel blockers, NSAIDs or valproic acid can be used to prevent migraine. The patient is guided in the selection of drug therapy in order to partially use the effect of a certain drug (an effect other than the headache-preventing effect) according to the need and partly to prevent it. A low dose should be given initially, and as the dosage is increased, its therapeutic benefits and undesirable side effects should be adjusted. The dose may be increased until a beneficial response is achieved or undesirable side effects occur. It is necessary to use a maximal dose for several weeks before considering a drug to be ineffective.
Biofeedback treatment can reduce patients' migraine attacks, which are more associated with stress.
2. A MUSCLE STRESS OR TENSION HEADACHE
– Characterized by band-like discomfort around the head. These types of headaches usually occur during the day and may be linked to emotional stress. The muscles of the back of the neck and the back of the head are often sensitive and may be in spasm. It can be difficult to distinguish between this type of headache and a simple migraine.
– Treatment requires painkillers, muscle relaxants, warm wet heat, and sometimes antidepressive medications and psychotherapy.
>3. CHRONIC DAILY HEADACHE
– Patients with migraine or tension headaches may develop chronic daily headaches suddenly or as a result of overuse of analgesics or ergotamines. Treatment consists of stopping excessive medication use. Prophylactic migraine medications may also help prevent headache recurrence.
4. CLUSTER HEADACHE
– Cluster headaches are severe headaches around the eyes. thirty to ninety It lasts minutes and occurs once or several times a day for several weeks or months. With unilateral pain, tearing on the same side as the pain, conjunctival hypermia, nasal congestion and Horner syndrome occur. The typical patient is a middle-aged man. Patients with this type of headache usually walk around, unlike migraineurs who seek quiet and dark places.
– As treatment, the treatment that stops the pain initially and is symptomatic is 100% oxygen, ergotamines, analgesics. or sumatriptan. Prophylactic treatment includes lithium, calcium channel blockers or corticosteroids.
5. TEMPORAL (GIANT CELL) ARTERITIS
– Giant cell arteritis should be investigated in patients over the age of 50 who complain of a headache focused on a temple or located in the occipal area.
– Associated symptoms are visual disturbances, jaw caludication, fever, atragia myalgia, and weight loss. Approximately 50% of these patients also have polymyalgia rheumatica.
– Corticosteroid treatment provides rapid recovery.
6. SELECTIVE INTRACRANIAL HYPERTENSION
– It has no known cause, but is found with obesity, pregnancy, oral contraceptives, systemic SLE, and many other conditions. The development of a fairly constant and widespread headache together with clear consciousness, papilledema and normal neurological examination is suggestive of this disease. Blurred vision may occur, and vision loss is the most severe complication. CT or MRI scan is recommended for diagnosis.
7. TRIGEMINAL NEURALGIA
– It is a syndrome that is often idiopathic, but may be associated with multiple sclerosis (MS), neoplasia, and vascular rings that compress the trigeminal nerve. Lightning-fast, severe facial pain, often with a trigger point, is suggestive of trigeminal neuralgia. There is no loss of facial sensations.
8. HEADACHES RESPONSIVE TO INDOMETHASIN
– Characterized by severe, unilateral pain that may improve with indomethacin treatment. Chronic paroxysmal hemicrania, waking from sleep at night, lasting from 2 minutes to 2 hours, with autonomic features It is characterized by frequent, painful, multiple attacks (up to 40 per day).
– Alcohol can stimulate attacks. Episodic paroxysmal hemicrania is characterized by multiple attacks (6 to 30 per day) lasting up to half an hour, waking people from sleep at night and accompanied by autonomic features. Remissions lasting months or even years may occur.
As mentioned above, headache manifests itself in the form of different diseases. The first step of successful treatment is a safe, reliable and specific diagnosis. For this reason, headache complaints always require further evaluation to determine the cause.
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