Headaches and Migraines

Headaches

Primary headaches : migraine, tension type, cluster, chronic daily 

Secondary headaches : meningitis, brain tumour, cerebral aneurysm, subdural hematoma 

Tension headaches

Manifestations:

  • Bilateral
  • dull aching
  • diffused with sensation of tight band around head

Treatment:

  • massage
  • acupuncture
  • NSAIDS

Chronic Daily headaches

Headaches that occur 15 days or more in a month, can be from med overuse, migraines, post-traumatic 

Migraines:

  • Trigeminal nerve is activated

The initial vasoconstriction followed by vasodilation of blood vessels increases pressure within cranium eliciting pain from the blood vessels and meninges 

Triggers: some food, abnormal levels of stress, change in sleeping patterns 

Types:

  • Migraine with aura :
    • symptoms last 4-72 hours
    • unilateral, pulsating,
    • moderate to severe
    • aggravated by activity
  • Migraine without aura 
    • most common 
    • Pain is pulsating, throbbing
    • Unilateral typically
    • Sensitivity to light 
  • Ophthalmoplegic migraine
    • Rare
    • Transient paralysis of cranial nerve 3 – oculomotor 
  • Hemiplegic migraine
    • Rare
    • Sudden hemiparesis accompanied by aphasia and confusion

Treatment: 

  • Avoid triggers 
  • Pharmacological – SSRIs
  • Cluster headaches
  • When several attaches occur in a day for a period of days, weeks or months followed by remission 
  • Episodic and chronic 

Manifestation:

  • Sudden
  • Severe
  • Unilateral
  • Unrelenting pain in orbital, temporal, supra orbital and infra orbital 
  • Lasts 30 minutes to 2 hours 

Head Injuries

Causes:

  • MVA
  • Falls
  • sports injury
  • violence

Types:

Primary head injuries

Caused directly by injury ; concussion, contusion, laceration

Concussion

Momentary interuption of brain function with or without loss of non-consciousness

Manifestations:

  • post-concussion syndrome
  • irritability
  • insomnia
  • poor concentration

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: