Pressure, tightness, or pinching headaches

Introduction Headache is one of the most common symptoms in the clinic. It is usually limited to the upper part of the skull, including the eyebrow arch, the upper edge of the ear wheel and the pain above the occipital kyphosis. There are many reasons for headaches, some of which are serious fatal diseases, but the diagnosis of the cause is often difficult. Heavy pressure, tightness or jaw-like headaches are caused by work stress, fatigue, anxiety, lack of exercise, poor sitting posture, and the like.

Cause

It is caused by work stress, fatigue, anxiety, lack of exercise, poor sitting posture and so on. Most of the patients are 30 to 40 years old. They have been working on the desk for a long time. The special position during work causes the head and neck muscles to contract. The tension, anxiety, irritability and insomnia often make the headache worse.

an examination

Related inspection

Blood pressure brain CT examination sinus examination

1. Chronic onset, mainly caused by mental stress, a small number may be caused by eye, sinus and cervical muscle lesions and cervical vertebra hyperplasia.

2. Presenting pain, tightness and pain in the front head, neck pillow, head and top, etc., a few can be extended to the affected shoulder and back, the symptoms are mostly bilateral.

3. Local muscles have tenderness and traction pain, and neck muscles may have increased muscle tone.

4. Electromyography can increase the excitability of the cervical muscles and increase the motor unit potential.

5. Can exclude increased intracranial pressure, intracranial infection and hypertension.

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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