Localized headache

Introduction Local headache This is a vascular neuropathic headache that is a functional disease. Headache refers to a type of pain characterized by head pain. It is one of the more common clinical symptoms. Headaches are often caused by overwork, tension, cold, and lack of sleep. After a break, enough sleep will disappear, but the headache caused by certain diseases is a kind of signal that can't be recovered after rest, which should cause us to pay attention. The cause of headache is very complicated. There are intracranial extracranial parts of the skull and systemic. Need to find out the cause and then symptomatic treatment.

Cause

Most of them are caused by long-term emotional stress, stress, mental work, excessive thinking, excessive sleep, and poor wind and cold stimulation.

an examination

Related inspection

Brain CT examination brain MRI examination EEG examination brain nerve examination

The examination should focus on the key points, that is, after considering the most likely one or several diseases according to the consultation materials, first check them to confirm or deny certain diagnoses as soon as possible. For example, patients with headache and vomiting should consider intracranial lesions if their medical history does not meet migraine, glaucoma, epilepsy, gastrointestinal lesions, etc., and a series of nervous systems and related laboratory tests should be performed as soon as possible until clarification diagnosis until.

After clearing the cause of the headache, sometimes further examination is required due to:

1 There may be more than one cause of headache. For example, patients with migraine are prone to hypertension. In addition to neurasthenia after headache, brain headache can also be combined with other types of headaches with intracranial complications.

2 The cause of a headache can be followed by headaches of another cause. Such as sinusitis can induce supraorbital neuralgia, otitis media can be secondary to intracranial abscess. Be vigilant in the clinical.

Differential diagnosis

First, migraine, more common in young women, about 2 / 3 of patients have a family genetic background; 10% of patients have obvious visual dysfunction, aphasia and other aura symptoms before the onset; pain is more on one side, periodic Attack, each time the nature is similar, accompanied by sweating, dizziness, palpitation, pale or flushing, and even abdominal pain, diarrhea and other symptoms of autonomic dysfunction, vasoconstrictor ergotamine after use is significant, most patients experience years Symptoms gradually diminish or disappear after ten years to menopause.

Second, cluster headache, more common in middle-aged men, no aura symptoms before the attack, sudden at night or sleep, the pain is intensely intensive, and quickly reach the peak, starting from one side of the eye or a single side, The rapid expansion even spreads to the ipsilateral shoulder and neck, which is a pain or burning pain. The standing can be relieved, accompanied by pains such as flushing, tearing, and stuffy nose in the ipsilateral eye. It lasts for 10 minutes to 2 hours without obvious nervous system. Positive signs, if necessary, a histamine test can assist in diagnosis.

Third, the pain of sinusitis, often located in the forehead and nasal roots, morning exacerbation with nasal congestion, purulent sputum, etc.; some patients with neck muscle pain and post-headache due to secondary muscle contraction, examination of nasal discharge with purulent discharge lesions, The tenderness of the sinus is obvious.

Fourth, neurosis headache, is a common clinical manifestation, the part is not fixed, generally manifested as tight head, heavy pressure, numbness, pain, tingling and other levels of mood fluctuations, fatigue, insomnia, etc. Closely related usually has a long course of disease, and the condition is fluctuating, often accompanied by symptoms of autonomic dysfunction such as palpitations, muscle fibrillation, excessive sweating, flushing, and numbness in the limbs.

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