Migraine, tension headache, hypertensive headache...One article teaches you to identify 10 types of headaches

*Only for medical professionals' reference.
Headache is not a simple topic, don't take it lightly! According to the International Standard for Classification of Headaches (ICHD-III), there are 14 types of headaches clinically, and each type contains several types of headaches
.

Among so many headaches, which ones are most likely to be encountered clinically? How to deal with it? Migraine▎ Overview of the most common clinical primary headache, the prevalence rate in the population is as high as 5%-10%, which means that there are at least 65 million patients in China
.

Most of the locations of headache attacks are as shown in the figure.
The pain is moderate to severe pulsatile headache, which can last for 4-72 hours, which greatly affects the life of the patient
.

▎Inducements The causes of migraine are very complicated.
According to the American Epidemiological Survey, about 70%-80% of patients have a family history.
At the same time, external factors (sound, light stimulation, etc.
) and life patterns (food, sleep, stress, etc.
) are also May cause migraine
.

▎Treatment Therefore, there are many treatment options for migraine.
If you consider treatment for the cause, you can let the patient record the time, place and condition of each attack in order to analyze the cause
.

For mild to moderate headaches, non-specific analgesics can be used in general treatment, such as non-steroidal anti-inflammatory drugs (acetaminophen, naproxen, ibuprofen, etc.
)
.

For moderate to severe headaches, migraine-specific treatment drugs such as ergot preparations and triptan drugs can be used
.

Because these two types of drugs have a strong vasoconstrictor effect, and long-term large-scale use can cause serious adverse consequences, therefore, for patients with moderate to severe headaches who have taken non-steroidal anti-inflammatory drugs (NSAIDs) in the past, they can continue to be given NSAIDs.
Drugs
.

Due to the complex triggers of migraine, some patients may suggest psychological counseling.
For chronic long-term migraine, some researchers in the United States believe that cognitive behavioral therapy is also a viable alternative
.

Cluster headache ▎Outline The reason why this disease got such a name is because its pain comes in groups and manifests itself as a series of intensive non-pulsating pain
.

The cluster period lasts for 2 weeks to 3 months, and each episode lasts 15-180 minutes
.

The location is shown in the picture, on one side of the eye socket or frontotemporal
.

During the attack, the patient is fidgeting, and some patients even hit the head with a boxing to relieve pain
.

The incidence of this disease is less than that of migraine, nearly 6.
8 per 100,000
.

▎Inducing cluster headaches generally have no family history, and can be induced by factors such as drinking, smoking, hypoxia, heat, or high altitude
.

The etiology is still unclear, but it is generally believed to be caused by intracranial and extracranial vasodilation
.

Horton believes it is related to the release of histamine
.

▎In the treatment of cluster headaches with poor effect of stabilizers, oxygen can be given (100% oxygen 8-10L/min, 10-15 minutes)
.

Triptan drugs can quickly relieve headaches
.

Sinus headache▎ Overview Compressive pain in the red area in the figure above may indicate sinus headache
.

Sinus headache can be exacerbated by sudden temperature changes or movement (including sudden head movement), and may be accompanied by fever, runny nose, and facial sweating
.

▎Induced sinusitis can cause sinus headaches
.

Colds, infections, weakened immunity, etc.
can cause sinusitis
.

▎Non-specific analgesics, decongestants, saline nasal spray, and nasal irrigation bags can be used for routine treatment
.

If sinusitis is caused by a bacterial infection, anti-infective treatment can be given.
For non-bacterial infections, nasal corticosteroids can be considered
.

Other steam humidification equipment and humidification programs can also relieve sinus headaches
.

Drug rebound headache▎ Overview Drug rebound usually occurs during long-term use of painkillers or overdose of painkillers.
The essence is a secondary headache, and the symptoms may be similar to tension headaches or migraines
.

There is a tendency to relapse every day, which can last for several hours
.

▎Incentives are mainly due to long-term or overdose of analgesics, which makes the body tolerate the drugs, resulting in a decrease in the efficacy of the original effective drugs.
Therefore, the headache is not significantly relieved when the painkillers are used again, and there is even a risk of headache rebound aggravation.

.

Common drugs that trigger rebound headaches include ibuprofen and acetaminophen
.

▎Treatment Reduce or stop the drug
.

It should be noted that the headache may worsen after the drug is stopped, and there will be temporary side effects such as hiccups, constipation, and vomiting
.

Tension headache ▎Overview 3/4 adults have experienced tension headache.
This type of headache has tightness, dull pain on both sides of the head, no pulsation, and mild to moderate pain
.

Although it is a common headache, as a transient disorder, the duration is not long, usually 20 minutes to 2 hours
.

If it persists, it may be one of the characteristic symptoms of anxiety or depression
.

▎Inducing stress and fatigue can induce tension headaches
.

In addition, squeezing, highlighting, noise, excessive cold or heat, or poor head, neck, shoulder girdle posture, and other factors that can induce permanent contraction of the head and neck muscles can all lead to tension headaches
.

▎Treatment to identify and avoid incentives is the most effective radical cure
.

In addition, physical therapy (including training the correct posture of the head and neck in daily life, massaging the shoulder and back muscles, etc.
), relaxation training, etc.
can help to improve tension headaches
.

In terms of drugs, NSAIDs are routinely used, and antidepressants can be given to authors with long-term and high frequency
.

Odontogenic headache▎ Overview of the head syndrome caused by the tooth itself and periodontal tissue disease
.

Odontogenic headaches are mostly located in the temple, forehead, and face of the affected side, and are mostly throbbing, dull, and tingling, with a tendency to exacerbate paroxysmal aggravation
.

Patients with chronic dental disease may show migraine-like symptoms
.

▎Inducements The bacteria in the tooth lesions and the harmful metabolites released can cause headaches, and the nerve reflexes of the lesions can also cause pain
.

▎Treatment of the primary disease is the most effective measure.
Almost all patients have their headache symptoms improved after the primary disease is under control
.

However, due to the role of the trigeminal nerve, many patients often have unbearable pain and should be actively treated symptomatically
.

Carbamazepine and phenytoin can be used for the treatment of trigeminal neuralgia, and nerve block injections can be considered for more severe patients
.

Sibelin can be given to patients with migraine-like attacks
.

Dehydration headache ▎ Overview of the headache that occurs when the body is dehydrated, which can occur on the front, back or side of the head, and can also resemble a tension headache
.

Dehydration headaches are characterized by increased headaches when moving, especially when walking
.

▎The mechanism that induces dehydration headaches is currently not fully understood.
Some studies suggest that vasoconstriction caused by dehydration may affect the blood oxygen supply of the brain and cause headaches
.

▎Therapy supplements water and electrolytes and maintains water and electrolyte balance
.

Pay attention to the intake of water and electrolytes to prevent dehydration
.

Burning Mouth Syndrome (BMS)▎Overview Although it has been known for more than 100 years, it was not until 2004 that BMS was included in the second edition of ICHD as a disease by the International Headache Association
.

Although the incidence of BMS in the general population is only about 0.
7%, it is as high as 12%-18% in menopausal women
.

It is a primary burning sensation in the mouth, which generally lasts for more than 2 hours and recurs for more than 3 months
.

The patient's oral mucosa has a normal appearance and oral touch
.

BMS is not life-threatening, but it greatly affects the quality of life of patients and can cause depression
.

▎Inducing factors BMS is affected by many factors, and one third of cases are clearly caused by many factors
.

The main inducement drugs-antihypertensive drugs, anticoagulants, antidepressants, antipsychotics, antiretroviral drugs, estrogen replacement therapy, metoclopramide and dehydroprogesterone chemotherapy can all cause BMS
.

At the same time, research also proves that nerve influence factors cannot be ignored in BMS
.

▎Treatment of BMS is extremely difficult to treat and there are no targeted drugs
.

According to the different causes of BMS, various methods can be used to treat at the same time
.

Conventional drugs include benzodiazepines, antioxidants, lipoic acid and the like
.

Studies have also shown that psychotherapy is helpful to patients in some cases
.

Cold irritation headache▎Overview of the headache caused by exposure to cold air or ingestion of ice food (such as ice cream) is cold irritation headache
.

Unlike other headaches, this type of headache lasts for a short time, so few people will seek medical treatment for it.
It should be noted that cold stimulation headaches can affect migraines (48%) and tension headaches (23%)
.

The areas of cold-stimulated headache are the frontal (61%) and temporal (48%)
.

▎Induced by low temperature, the anterior cerebral artery dilates rapidly, and cerebral blood flow increases, causing pain
.

▎Slow down the treatment or stop eating ice food and leave the cold environment
.

Or drink warm water to relieve
.

Hypertensive headache ▎ Overview Headache is a common symptom of hypertensive patients, and its type is related to age.
There are more migraine headaches in young adults and more general headaches in the elderly
.

Headaches are often heavy, intermittent dull pain, fullness and throbbing pain, and sometimes persistent.
Severe headaches are rare
.

It is characterized by gradually getting worse from midnight to early morning, and it can be relieved after getting up to engage in activities
.

▎Incentives can be caused by high blood pressure itself or by excessive mental stress
.

The mechanism of headache can be divided into three types: the mechanical action of high blood pressure causes abnormal expansion of blood vessels, the stimulation of arterial wall pain receptors causes headaches; reflexive contraction of head muscles can cause tension-like headaches; brain dysfunction can cause intracranial vasomotor contraction The disorder produces headaches
.

▎Treatment is based on the treatment of the primary disease
.

Psychotherapy can be carried out on patients
.

Reference materials: [1] Expert consensus group for diagnosis and treatment of tension-type headache.
Expert consensus on diagnosis and treatment of tension-type headache: Chinese Journal of Neurology, 2007: 496-497 [2] Expert consensus group on headache classification and diagnosis.
Expert consensus on classification and diagnosis of headaches: Chinese Journal of Neurology, 2007: 439-495 [3] "Merck Family Medical Handbook"-Cluster Headache [4] Wei Kaimin; What is the matter with drug rebound headache, PLA Health 2013 06 Period [5]AACP Headaches and Dental Health https:// P, Manzoni GC.
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Curr Pain Headache Rep.
2010 Aug;14(4):284-91[6 ] Odontogenic headache China Knowledge Network http://wiki.
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The international classification of headache disorders: 2nd edition.
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[7]Headache Classification Committee of the International Headache Society (IHS).
The international classification of headache disorders, 3rd edition (beta version).
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[8] Giudice M.
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.

Hypertensive headache
.

http:// M.
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Source of this article: Medical Neurology Channel Author of this article: Xiong Tuotuo Editor in charge: Mr.
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