Headache is one of the most common symptoms. In total, there are about two hundred types of headaches – all of them are in the International Classification of Headaches and are divided into two groups: primary and secondary.
There are various reasons why people ignore going to the doctor. A person can have a migraine, a severe and frequent migraine. He constantly relieves her with painkillers and does not understand that the pill hurts her head even more. He believes that a headache is something that his parents, a neighbor on the landing, and colleagues have. He believes that everyone suffers from this, that this does not require medical supervision at all. People do not know that headaches can be treated.
There is another problem. The man turned to the doctors, and he was told: “drink painkillers, what else can we do.” He did not receive adequate treatment. He was left with this headache and continues to drink pills.
There are people who, after 1-2 attacks of intense headache, run to do an MRI scan to check if a tumor has formed. They find nothing and, in principle, calm down, they don’t go to the doctor. They continue to live with a headache, then it changes its character, begins to become more frequent. They again think: “Something is wrong, it’s like something has grown” – and as a result, they again come to MRI. And then they come to the doctor for an appointment with four MRI results over the past five years and an unresolved problem.
If the patient has headaches once a month, they quickly disappear, and the person quickly returns to work, and this suits him, you can use those drugs that are available without a prescription. If the patient wants to improve the quality of his life, he wants that he does not have this headache at all or that it completely disappears not within a day, but two hours, he should make an appointment with the doctor.
You should definitely go to the doctor if a person suffers from a migraine or if he often drinks pills, and his headache intensifies and becomes more frequent.
Secondary headaches are those pains that are associated with other diseases. That is, a headache is a symptom of a disease, such as sinusitis, sinusitis, otitis media, or the pathology of the temporomandibular joint.
Primary headaches are independent diseases of the brain, and not a consequence of other diseases. And 10% of all headaches are secondary. The remaining 90% are primary pains.
The first thing that neurologists do when taking a patient with a complaint of a headache is to try to rule out secondary pain. The doctor should know that the patient does not have another disease that can cause a headache. There are “red flags” that help neurologists suspect a secondary headache. For example, if headaches first appeared after 50 years; if headaches are accompanied by focal neurological symptoms; if headaches are accompanied by fever; if headaches dramatically change their character and so on.
Migraine headaches are separate bouts of headache between which a person is completely healthy, nothing bothers him. The first migraine attacks usually occur at a young age. The peak falls on 30-40 years. With age, the number of patients with migraine decreases. Migraine is often found among Russians – 21% of the working population from 18 to 65 years old suffers from it. This is a lot.
The headache of tension does not have any special vivid manifestations – nausea, vomiting or discomfort from light / sounds during an attack. Compared to migraine, this is a “milder” headache – it usually goes away from taking paracetamol, ibuprofen, or even from a short rest and relaxation.
Stress headaches can be rare or chronic. In the second case, patients experience pain for 15 or more days a month, but this is not common and requires serious preventive therapy.
The mechanism of the formation of such pain is associated with pericranial muscles (these include the temporal, frontal, occipital, sternocleidomastoid muscles. – Ed. ) – they are overstrained. This can be due to stress, prolonged emotional or physical stress, uncomfortable posture, and other reasons.
Cluster (bundle) headache is rare – from 100 to 400 people per 100,000 suffer from it. Such a headache bothers for a certain period, for example, one month or a half months a year. The rest of the time, the person is healthy, the pain does not bother him. An episode of pain can last an hour and a half, sometimes a little less. Headache is extremely intense, it can reach 10 points out of 10 on the pain scale (cluster pain is one of the most severe pains in principle; it can even lead to suicide). Typically, such pain occurs at 4-5 in the morning. Cluster pains are accompanied by the following symptoms: twisting sensations in the temporal and fronto-orbital region, lacrimation, redness of the eye and nasal congestion – all on one side. More often men suffer from these headaches.
The cyclical nature of this headache indicates the work of the hypothalamus (a small area in the diencephalon. – Ed. ) – it regulates a huge number of cyclic unconscious actions of a person and processes beyond his control: sleep, hunger, menstrual cycle. In the course of MRI studies, this was confirmed – during cluster headaches, the hypothalamic zone is active.
Cluster pain is treated during an attack by oxygen inhalation. It is pointless to drink pills – they will not have time to act. You can also take triptans (a group of drugs designed specifically to relieve a migraine attack. – Ed. ) In the form of subcutaneous injections. Prevention consists in the appointment of special drugs, such as verapamil. This is an antiarrhythmic drug that cardiologists prescribe for heart rhythm disturbances. In case of headache, it is assumed that it acts on the ion channels in the brain cells.
Other primary headaches
These are not all types of primary headaches. There are trigeminal autonomic (autonomous) cephalgia. In addition to cluster headaches, these include paroxysmal hemicrania and SUNCT syndrome (short-term unilateral neuralgic headaches by conjunctival injection and lacrimation). There is also a primary cough and hypnosis headache. All these types of pain are extremely rare, and so far little is known to doctors and scientists about them.
There are several misconceptions about secondary headaches. For example, everyone knows about osteochondrosis. But not everyone knows that osteochondrosis is not a diagnosis, but natural age-related changes in the spine that occur in absolutely all people after a certain age. It’s like skin, its quality also changes with age. Osteochondrosis, which radiologists see on an X-ray, MRI or CT (computed tomography), is not considered a reason to make a neurological diagnosis. Although there really are headaches that arise due to the pathology of the upper cervical spine (three upper cervical segments). Such pains are called cervicogenic.
The pathology of the joints of the three upper cervical vertebrae can give reflected pain to the head. That is, the problem is in the joints, and pain occurs, for example, in the forehead. To make a diagnosis of cervicogenic headache, it is necessary to find a causal relationship between the effect on the cervical spine (palpation of these joints or head rotation) and the appearance of a headache in the patient. Such headaches are rare – they make up 0.5-2% of all secondary pains.
Further. Many people like to do ultrasound of blood vessels and generally check blood vessels. Some doctors warm up this situation – they say that headaches occur due to impaired blood supply, venous outflow. In fact, vascular headaches (there is such a subgroup in the classification) are headaches associated with damage to intracranial vessels; they rarely happen. Such pain can occur if an aneurysm ruptures, a hemorrhage occurs, or the vessel wall breaks up. Due to a violation of blood supply, a headache does not appear – it is impossible, the brain is deprived of pain receptors.
Another myth: a headache occurs due to increased intracranial pressure. Such a diagnosis is often made to children. In fact, an increase in intracranial pressure can occur only for two reasons. The first is the formation, for example, of a tumor inside the skull. Since the skull does not stretch, according to the law of physics, if any additional volume appears, this will lead to an increase in pressure inside the skull.
Symptoms of this increase: headaches intensify in a horizontal position, standing a person is much easier to bear pain. The second reason is the idiopathic increase in intracranial pressure, when the pressure rises without any volumes, formations and other visible reasons, but this condition occurs in 1-2 people per 100,000 population. This type of headache is more common in overweight women. Pains appear daily amplified in a horizontal position. The main thing is that such headaches are characterized by progressive loss of vision due to edema of the optic disc.
Do I need to always drink pills
It all depends on the intensity of the pain and how it affects the quality of life. If a headache bothers a person by 2-3 points on a 10-point scale, it makes sense to exhale, go outside, breathe, relax. But at the same time, there is nothing wrong with taking a pill if your head hurts rarely and you do not drink pain medication more than once a week. In the case of migraine, it is better to immediately take a pill – the likelihood that the attack will end faster will be higher.
But if a person is constantly worried about headaches and constantly drinks pain medication, this, on the contrary, will aggravate the situation – pains will begin to appear more often. In this case, you can not resort to a pill every time – you need to see a doctor.