Extracranial headache

Introduction The most important and common type of extracranial headache is vascular headache, which presents pulsating pain or pain associated with the pulse. Headache, heat, exertion, coughing, etc. can all aggravate headaches. Examination can be seen that the radial artery bulges, the pulsation is enhanced, and the headache can be alleviated after compression. Headache is one of the most common clinical symptoms in the clinic. It is the subjective feeling of the human body for various pain-causing factors and belongs to the category of pain. The pain-causing factors can be physical, chemical, biochemical or mechanical, and the like. These factors stimulate the sensory nerve endings located in the intracranial and extracranial tissue structures and are transmitted to the brain through the corresponding conduction pathways for perception.

Cause

Headache, heat, exertion, coughing, etc. can all aggravate headaches. Examination can be seen that the radial artery bulges, the pulsation is enhanced, and the headache can be alleviated after compression.

Extracranial lesion

(1) Skull disease: such as skull base recession, skull tumor.

(2) cervical spondylosis and other neck diseases.

(3) neuralgia: such as trigeminal nerve, glossopharyngeal nerve and occipital neuralgia.

(4) Headache caused by eye, ear, nose and tooth diseases.

an examination

Related inspection

Brain nerve examination, brain CT examination, brain MRI examination, electroencephalography, brain function imaging

Laboratory inspection

1. Blood biochemistry, electrolytes and cytology: understanding changes in blood cells and biochemistry and their relationship to headaches.

2. Cerebrospinal fluid examination: It is of great significance for the diagnosis of subarachnoid hemorrhage and intracranial inflammation.

Film degree exam

According to the specific situation, EEG, brain ultrasound, radionuclide brain scan, cerebral blood angiography and other examinations. The rapid development of imaging diagnostic technology provides an important basis for the diagnosis of brain diseases. For example, CT scan and MRI have strong resolution on brain tissue, so vascular lesions (such as vascular malformations, cerebral aneurysms) and The diagnosis of space-occupying lesions (brain and malignant tumors) is of great help. It can show the location of the lesion, the size, the structural changes of the affected part and the degree of cerebral edema around it, and the pressure on the ventricles. Magnetic resonance imaging is better than CT in the diagnosis of cerebrovascular disease. Transcranial Doppler ultrasonography (TCD) can penetrate the skull and directly obtain intracranial blood flow information, which is of great significance for the diagnosis of cerebrovascular diseases and blood circulation in the brain. CT, MRI and TCD are non-invasive methods and are easy for patients to accept. They are an important means for diagnosing brain lesions.

Differential diagnosis

Need to be identified with the following symptoms:

Neuropathic headache: Neuropathic headache mainly refers to tension headache, functional headache and vascular neuropathic headache, which is caused by mental stress and anger. Chinese medicine belongs to the category of headache, brain wind and head wind, and it belongs to qi and blood deficiency. Caused by liver yang, sputum and so on.

Deep headache: Deep headache is more common in brain abscesses, encephalitis, brain tumors, and radiates to the ipsilateral side.

Headache after craniocerebral injury: Early headache of craniocerebral injury is related to soft tissue injury, cerebral edema, intracranial hemorrhage, hematoma, infection, etc. Late headaches are quite common, mostly debilitating, called "traumatic neurosis" or "post-traumatic syndrome." However, a large proportion of patients have other headaches either concurrently or separately, and the mechanism is very complicated.

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