Headache (Cephalgia)

Definition: Pain or discomfort from level of brows back to suboccipital region. Tension headache "fter exhaustive dail# activities ,eck spasm -ense of di&&iness Toxic-febrile $lu% influen&a% common cold% tonsillitis% p#rexia% mild infection *ncephalitis )eningitis *pileptic fits ,eck stiffness !onfusion /etraction ophtalmoplegia .ack of $ever consciousness $ocal laterali&ing )eningism 0 signs 'eadache ,on attention *ncephaletic headache !erebritis Vascular (non-migranous headache '#pertensive 1ccipital -ense of tightness of head and scalp ,on postural ,on throbbing 2suall# dull aching nature 'igh diastolic 3P+ high vol. pulse pressure (ntracerebral vascular tumors or hematoma -evere throbbing -"' 4 neck stiffness% spasm or retraction Vascular "V) Throbbing Postural on and off !arotid-cavernous fistula 4 self audible bruit !luster headache "ttacks of severe agoni&ing headache -tart on one side in orbital and frontal region and spreading same side of head and neck 2nilateral !on5unctival in5ection .acrimation /hinorrhea $lushing -weating 3rief ( min 4 6h 2suall# at night !haracteri&ed b#: /egularit# and occurrence in cluster - *ver# 78h for a few weeks or mon - $ollowed b# long period (up to 9 mon+ or 6# where pt completel# free "lchoholic beverages% histamine in5ection% heat !old

!ause "ssociate d s#mptom+ !haracte r

Ttt+ Decrease b#

/est% sleep )inor analgesia% ,-"(Ds

"ntip#retic "ntibiotic !-$ tapping

"ssociated s#mptoms+ !haracteristic

(ncreased (!T -evere% persistent% agoni&ing of sufficient duration )ore in earl# morning Vomitting not essentiall# pro5ectile or preceded b# nausea but relieves some of the headaches )a#be blurring of vision (papilloedema

Ps#chogenic 1rgan neurosis% part of both reactive and endogenous depression and ps#chosomatic disorders -ense of burning at top of vault% even can feel head warmer )inor tran:uili&ers

Ttt

Post investigator# iatrogenic headache "n# intubations e.g. gastrointestinal tubes% catheter% chest endoscop# (s carried under local% spinal or surface anaesthesia ,ot harmful% lasting for hours )inor analgesic