Tension headache

Introduction A tension headache is also known as a muscle contraction headache. The disease is more common in young and middle-aged children. Children can also get sick. There is no difference between male and female. The symptoms at the beginning of the disease are milder and gradually worsened. The clinical features of tension-type headache are dull pain, no pulsation, headache. Located in the top, sputum, forehead and occipital part, sometimes there are pains in the above parts, the degree of headache is mild or moderate, not aggravated by physical activity, often complaining of heavy pressure on the head or tightness of the head. In addition, the neck of the pillow is tight and stiff, especially when turning the neck. There is no fear of light or phobia. A small number of patients are accompanied by mild irritability or depression. The examination includes no positive signs of nervous system examination, and cranial muscles such as neck occipital part. Muscle, top of the head and upper part of the shoulder muscles often have tenderness. Sometimes, the patient feels relaxed and comfortable. The CT or MRI of the brain should be normal, without high blood pressure and obvious ENT.

Cause

Tension headaches are caused by persistent contractions of the head and neck muscles, and there are three reasons for this contraction:

(1) As a result of anxiety or depression accompanied by mental stress.

(2) A secondary symptom of headache or other parts of the body as a cause.

(3) Due to poor posture of the head, neck and shoulder straps.

an examination

Related inspection

Cerebrospinal fluid lactic acid cerebrospinal fluid lactate dehydrogenase cerebrospinal fluid neurotensin urinary fistula brain CT examination

1. EEG, EMG examination.

2. Special examination of ophthalmology.

3. Radionuclide (isotope) examination, X-ray examination, nuclear magnetic resonance (MRI) examination, CT examination.

Differential diagnosis

Migraine

Vascular headache is common in young and middle-aged children and children with headaches located on one side of the forehead, with pulsating and jumping pain, often accompanied by nausea and vomiting. For the onset headache, there may be visual disturbances before headache, such as blind spots in blurred vision. Auras such as hemianopia can also start a partial headache without any warning. It usually lasts for hours or days and relieves a very small number of patients with migraine persistence. A small number of patients with migraine may coexist with a tension headache, making it difficult to distinguish between the two.

2. Cluster headache

It is vascular and associated with hypothalamic dysfunction. The headache is located on one side of the forehead and the full head headache is intense and without aura. The headache is rapid and can suddenly stop the episode with conjunctival hyperemia, tears and sputum and sweaty few hangs and sag every day and can occur several times in sleep. Each episode lasts for several tens of minutes to several hours, and can be consecutive Its a few weeks. However, the remission period can be as long as several months to several years. It is not difficult to identify the patient's history and seizures in detail.

3. Trigeminal neuralgia

It is a paroxysmal short-term pain in the distribution area of the facial trigeminal nerve. Each pain is only a few seconds, and it occurs several times a day to dozens of times. Pain, such as knife cutting, burning or acupuncture, is often induced by brushing, talking, and chewing. Patients often point to a location that induces pain, called a "trigger point." The disease occurs in middle-aged and elderly people, with more than 2, 3 branches of the trigeminal nerve. If the first branch is affected, it should be noted that it should be distinguished from ETTH.

4. Headache caused by intracranial space-occupying disease

Such diseases include intracranial tumors with intracranial metastases, brain abscesses, and brain parasitic diseases. Such headaches are often accompanied by jet vomiting and fundus edema due to increased intracranial pressure, but can be misdiagnosed as tension-type headaches in the early stage. For patients with short-term headaches, in addition to paying attention to fundus changes, careful nerves System checks are extremely important. If signs such as pathological reflexes are found, it is often indicated that it is not a tension-type headache, and brain CT or MRI should be used in time to help identify.

5. Headache caused by chronic intracranial infection

Such diseases include tuberculous meningitis, fungal meningitis, cysticercosis (cysticercosis) meningitis, and syphilitic meningitis. These meningitis all have headache as early symptoms, usually accompanied by fever, but some atypical patients, only low fever in the early stage and negative meningeal irritation are easily misdiagnosed as tension headache.

6. Headache caused by autoimmune meningoencephalitis

Such diseases include neurobehide, Vogt-Koyanagi-Harada syndrome, and central nervous system sarcoidosis. These diseases can cause inflammatory reactions and headaches when they involve the meninges or brains, and they are not necessarily accompanied by fever, so they are easily misdiagnosed as tension headaches.

7. Headache caused by abnormal intracranial pressure

Such diseases include benign intracranial hypertension of the intracranial hypotension syndrome and normal intracranial pressure hydrocephalus. Such patients are mainly headache-like headaches. Intracranial hypotension syndrome is often caused by excessive absorption or decreased secretion of cerebrospinal fluid. The cause of benign intracranial hypertension is often accompanied by visual impairment. Taking too much tetracycline or vitamin A, empty sella and may induce during pregnancy. Normal intracranial pressure hydrocephalus is common in brain trauma or subarachnoid hemorrhage. The cause of the disease may be related to cerebrospinal fluid malabsorption during recovery. Such diseases can be identified by lumbar puncture to measure intracranial pressure and brain CT examination.

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