Headache Flashcards
Other term of headache
Cephalalgia
• Pain or discomfort in any region within the head
Cephalalgia
Diffuse pains in various parts of the head with pain not confined to any distribution of a nerve
Cephalalgia
for headache in general
46
for migraine
11
for tension type headache (TTH)
42
for chronic daily headache
3
GBD 2019
Headache disorders 14th among global causes of DALY (disability-adjusted life years);
10h among females; 2nd among young adult female (15-49yo); 10th among young:
adult men
WHO
one of 10 most disabling conditions for the 2 genders and one of 5 most disabling for women
Pain insensitive structures of the head
Brain parenchyma
Ependyma
Choroid
Pia
Arachnoid
Dura over convexity
Skull
Mechanism of Headache
Intra/extracranial artery distention, traction, dilation
• Traction or displacement of large intracranial veins and their dural envelope
• Compression, traction or inflammation of cranial (CN 11, III, V, VII, IX, X) and spinal nerves
• Meningeal irritation and increased ICP
Mechanism of Cranial Pain
- Intracranial mass lesion
-Dilation of intracranial or extracranial arteries (and possibly sensitization of these vessels)
-Cerebrovascular Disease
-Paranasal sinus infection - Ocular Origin
-Meningeal Irritation
— Lumbar puncture and low CSF pressure
- Headache aggregated by lying down
-Exertional headache
Seizures, alcohol ingestion, nitroglycerine and nitrates, MSG
Dilation of intracranial or extracranial arteries (and possibly sensitization of these vessels)
throbbing or steady headache; increased pulsation of meningeal vessels activates pain sensitive structures within their walls or around the base of the brain
Febrile illness
• Dilation of intracranial or extracranial arteries (and possibly sensitization of these vessels)
Effects
• Extremely rapid rises in BP
• Cough and exertional headaches
Most strokes due to vascular occlusion does not cause head pain
vascular occlusio CVD
severe, persistent headache localized on the scalp then becomes diffuse
Extracranial temporal and occipital arteries (giant cell arteritis)
upper neck or postauricular pain
Occlusion and dissection of vertebral artery
projected to occiput
Basilar artery thrombosis
Ipsilateral eyebrow, forehead above
ICA Dissection, MCA Occlusion
Eye
Expanding intracranial aneurysm or PComm and distal ICA
Symptoms of inflamed temporal artery
Headache
Fatigue
Fever
Vision loss
Tear in the intimal layers of wall of carotid artery leading to either
Intramural Hematoma
Aneurysmal dilation of vessel
Both > Stasis > Microemboli > Ischemic CVA
Group of paired air-filled spaces that surrounds the nasal cavity
Sinuses