Diffuse headache

Introduction Diffuse headache is one of the clinical symptoms of vascular headache. Vascular headache is the most common type of headache in outpatients, because the cause of such headaches comes from blood vessels, so it is collectively called vasogenic headache. Angiogenic headaches are divided into two major categories: primary and secondary. Headache caused by vasomotor dysfunction of the head, called primary vascular headache; headache caused by clear cerebrovascular disease (such as stroke, intracranial hematoma, cerebrovascular disease, etc.), called secondary Sexual headache.

Cause

1 acute ischemic cerebrovascular disease: transient ischemic attack; thromboembolic cerebrovascular disease.

2 intracranial hematoma: subdural hematoma; epidural hematoma.

3 subarachnoid hemorrhage.

4 unruptured vascular malformations: arteriovenous malformations; intracapsular aneurysms.

5 arteritis: giant cell arteritis; other systemic vasculitis; primary intracranial arteritis.

6 carotid or vertebral artery pain: carotid or vertebral artery block; (primary) carotid pain; headache after arterial incision.

7 venous thrombosis.

8 arterial hypertension: acute reaction to exogenous substances; pheochromocytoma; malignant hypertension; pre-eclampsia and eclampsia.

9 headaches associated with other vascular disorders.

an examination

Related inspection

Brain MRI examination CT examination of cerebrospinal fluid pathogens

1, cerebrospinal fluid: increased intracranial pressure, mostly bloody. There is no cerebral hemorrhage that has not broken into the subarachnoid space. Although the cerebrospinal fluid has no blood, the white blood cells can be slightly higher and the protein is slightly higher.

2, CT scan: CT has a high diagnostic value for acute cerebral hemorrhage, providing a reliable basis for clinical qualitative, localization and quantification.

3, MRI scan: MRI scan is particularly sensitive to the diagnosis of posterior fossa hemorrhage, due to bone artifacts, the posterior fossa lesions often show unclear on CT, so MRI shows that brain stem hemorrhage and cerebellar hemorrhage is significantly better than CT.

Differential diagnosis

1. A headache accompanied by severe vomiting suggests an increase in intracranial pressure. Headaches can be seen in migraine after vomiting.

2. Headache with vertigo is seen in cerebellar tumors and vertebrobasilar insufficiency.

3. Headache with fever is common in systemic infectious diseases or intracranial infections.

4. Chronic progressive headache with psychiatric symptoms should pay attention to intracranial tumors.

5. Sudden increase in chronic headache and conscious disturbance suggest that cerebral palsy may occur.

6. Headaches with visual impairment can be seen in glaucoma or brain tumors.

7. Headache with meningeal irritation suggests meningitis or subarachnoid hemorrhage.

8. Headache with epilepsy can be found in cerebral vascular malformations, intracerebral parasitic diseases or brain tumors.

9. A headache with a neurological disorder may be a neurological headache.

10. Cluster headaches are more common in middle-aged men. There are no aura symptoms before the attack. When they are suddenly at night or during sleep, the pain is intense and intense and peaks quickly. It starts from the side of one eye or the side of the eye and expands rapidly. Even spread to the shoulder and neck of the same side, it is a pain or burning pain, standing can be relieved, accompanied by flushing, tearing, stuffy nose, runny nose, etc., the pain lasts for 10 minutes to 2 hours, no obvious nervous system Positive signs, if necessary, a histamine test can assist in diagnosis.

11. Sinusitis pain is often located in the forehead and nasal roots, increased in the morning, with nasal congestion, purulent sputum and so on. Some patients have neck pain and post-headache due to secondary muscle contraction.

Examination of the nasal cavity showed purulent secretions, and the tenderness of the lesioned sinus was obvious.

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