Headache is a very common complaint and people have met with absolute headache in different periods of their life. Headache is usually caused by structures sensitive to pain in the neck and head These structures are:
Scalp
Neck muscles
Intracranial vessels and nerves
The cerebral cortex.
As can be seen, the brain itself is not sensitive to pain. Therefore, pain will not occur unless a growing mass in the brain pushes the veins or nerves and stretches the cerebral cortex. For this reason, many patients with brain tumors do not suffer from headaches.
Tension Headache: It usually starts around the age of 20. However, it can also be seen in older ages. .
It is a non-throbbing pain that starts in the neck and radiates to the back of the head. In stressed and tense people, neck muscles involuntarily contract for a long time, causing pain. In addition, this contraction stretches the skin of the head from the nape, causing pain that spreads to the eyes and temples. Head and neck movements, rubbing the neck muscles can reduce the pain. On examination, the neck muscles are tense and painful. Sometimes painful swellings may occur in the hand. The pain continues uninterrupted for days and months, but it does not get worse over days and weeks, although it decreases and intensifies from time to time.
In treatment, antidepressant drugs that will relieve the patient’s tense and stressful state should be used together with pain relievers. In addition, massage and hot application to the neck will be relaxing.
DIFFERENCES OF TENSION HEADER FROM MIGRAINE
Tension-type headache:
Mostly caused by stress
Usually bilateral. Very rarely, it can be unilateral
Nausea may occur, but vomiting is not seen
. One week – 15 days pass with pain. The pain is not severe
The pain is not in the form of a crisis, it is not throbbing
Visual disturbances are not present before the pain starts
Movement does not increase the pain.
Holds the entire head.
It spreads from the back of the head to the front
Hypertension Headache: Headache is not seen much in hypertension, which is usually settled and does not cause major fluctuations. However, in hypertension, which shows great ups and downs during the day, there is a severe, throbbing pain in the neck. In addition to headache, epileptic seizures, fainting, and visual disturbances can sometimes be seen. In addition to a salt-free diet, pain relievers are used together with blood pressure medications in the treatment.
Anoxic Headache: Headaches can be seen in conditions that cause a decrease in oxygen in the blood, such as lung diseases, anemia (anemia).
Post-traumatic pain: Headache, dizziness, irritability, and fatigue are seen in the period following head trauma.
Headache Caused by Causes of High Pressure in the Head: It occurs with the growth of masses such as tumor, cyst, bleeding, abscess in the skull. Headache frequency and severity increase as the days and weeks pass. Eventually it becomes permanent. The pain is more severe in the morning. Vomiting accompanies the headache in the later stages, it is remarkable that it occurs without nausea. The pain is exacerbated by coughing, sneezing and straining. There is not much relief with painkillers. The occurrence of double vision with headache is a very important finding. In this case, an absolute intracranial mass should be suspected. In its treatment, drugs and serums that reduce intracranial pressure and edema are used, along with pain relievers. The main treatment is removal of the mass inside the head. Medication saves time until surgical treatment.
Sinusitis Headache: The inflammation of the air-filled spaces called sinuses in the forehead and facial bones is called sinusitis. Sinusitis headaches occur in the front of the head, around the nose and eyes, and in the upper jaw. It is usually exacerbated when the head is tilted forward. Atmospheric pressure changes (airplane travel, mountain or elevation) can initiate pain. Inflamed sinuses should be treated with antibiotics or surgically.
Neuralgic Headache: These are unbearable pains that usually spread to the face, around the eyes, upper jaw and teeth, lower jaw and teeth, lasting for 1-2 seconds, like a lightning flash. Pain may occur when touching an area on the face or lip. The pain is so severe and unbearable that patients may even consider committing suicide due to the severity of the pain. It is formed by tumors or compression of the nerve called the trigeminal nerve, which provides the sense of the face. Painkillers do not respond. Epilepsy drugs (anti-epileptic drugs) are successful in treatment. However, sometimes, when there is no response to the drug, the pressure of the nerve is removed with the operation. The surgical success rate is quite high.
Another major headache for physicians is a leaky type of hemorrhage that consists of an enlargement (bubble) in the brain vessels called an aneurysm. In this type of bleeding, called subarachnoid hemorrhage, the patient has a severe and sudden onset headache, localized to the neck, that he has not experienced before. The patient may lose consciousness in the first hours of the headache. There are vomiting. Applying to the hospital with suspected bleeding will save the patient’s life.
In addition, headache is seen in eye diseases (glaucoma, lens defects), ear and scalp infections. In the treatment, the pain will be eliminated with the treatment of these diseases.
MIGRAINE
It is a throbbing, moderate or severe headache that usually comes in attacks and lasts from a few hours to a few days. It is usually in one half of the head, but it can be bilateral. Headache is often accompanied by nausea, vomiting, discomfort from light, noise, and smell. The pain increases with movement and coughing and sneezing.
Migraine is generally divided into two groups. Migraine with aura and migraine without aura. Only 10 percent of migraines have auras. Aura is the complaints encountered in migraine with pre-symptom. Most of these symptoms are vision related. The patient reports seeing bright lights, zig-zag lines or blurred vision, loss of vision in one area or an area. In some patients, vision is temporarily lost in one eye during a pain attack. In addition, numbness in the arms and legs, dizziness, and speech disorders are also seen. It takes 20-30 minutes, and then the pain begins.
The exact cause of the disease is not known yet. Environmental factors may be effective, it is more common in genetically predisposed people (who has a family history of migraine). Sudden narrowing and then enlargement occur in the cerebral vessels. A number of chemical substances formed after these contractions and expansions cause pain by stimulating the nerves. It can be seen in childhood.
It is more common in women than men. In women, just before the menstrual bleeding, it can cause pain due to the decrease in the hormone Estrogen in the blood. In advanced ages, it may disappear after menopause in women. It decreases and disappears during pregnancy. Migraine sufferers are more likely to have migraine in their close relatives. Genetic defect has been demonstrated only in some special types of migraine.
Factors Triggering Migraine Attack
Some chemicals in food and drink may play a role in the occurrence of pain. Pain-inducing foods and beverages, processed meats (salad, sausage, sausage) wine, aged cheese, pickled foods, smoked meat and fish, sweeteners (containing aspartame)
Altitude changes, air travel
Air pollution , cigarette smoke, perfume, other strong odors and chemicals
Bright light or flickering light (fluorescent)
Loud and continuous noise
Changes in weather (pressure, temperature and humidity change, southwestern)
Seasonal changes (autumn and spring are the worst times)
Hunger, skipping meals
Sleeping too little or sleeping, sleep disorders
Birth control pills
Hormonal changes in women (menstrual period)
Excessive excitement , sadness, joy
The factors that cause pain may differ for each patient. It would be appropriate for the patient to keep a diary on the days of migraine attacks in order to detect them. By taking notes about the food and drinks he eats, drinks and daily activities, he can identify the common causes in the painful period. Other factors that trigger a migraine attack may be:
Treatment in Migraine: There are two ways to treat migraine.
1-Acute attack treatment. Painkillers, used in migraine attacks
2-Prevention treatment for attacks: It is applied especially if the attacks are very frequent and impair the patient’s quality of life. Whether the patient has pain or not, he should take medicine every day. In this way, the frequency of attacks is reduced, as well as a decrease in the severity of pain.
