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Cause and diagnosis of frequent severe head pain neck and temples

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The Most frequent complaint with which patients come to the doctor, is a headache. In half of all cases – this is the only problem that concerns the person of working age. According to statistics, three times more often affects women. In childhood frequency of episodes of cephalgia increases during puberty. The ratio of girls to boys is 2:1.

Headache in the occiput and temples

Most people consider it to be the cause of fatigue, take painkillers and rest until the next episode. But it is a symptom of many diseases, not always associated with the head. It happens when the system attacking the body.

According to the International classification of headaches of the 3rd version (2013) release cranially primary and secondary. Primary is the main manifestation of the disease. Occurs in 97% of all cases. Secondary – one of the symptoms of another disease. Diagnosed in 2.7%. Singled in the third part of the rare form of neuralgia – 0.3% of cases.

problem Description

Tension Headache is often the cause of discomfort of the localization. In second place tsefalgii on the background of arterial hypertension, intracranial hypertension and chronic venous insufficiency. The pathogenesis of all cases, the clinic is largely the same: diffuse pain in the temporal areas or the back of the head; feeling of fullness or compression; pulsation in the head; loss of coordination; blurred vision; tinnitus; nausea, sometimes vomiting at the peak of cephalgia.

The causes of pain in the head:

  • physical and mental strain;
  • stress
  • instability of the cervical vertebrae;
  • poor posture
  • heredity
  • hypertension
  • head injuries
  • mass lesion
  • degenerative disc disease of the spine, disrupt the normal flow of blood;

Causes of pain in the temples:

  • vascular dystonia;
  • hypotension
  • anemia
  • infection
  • intoxication and poisoning;
  • hay fever
  • stress
  • long-term use of analgesics;
  • hormonal changes
  • inflammation of joint.

Tactics survey

The Cause will be determined after examination of the patient. The first stage begins with a visit to a General practitioner. After collecting complaints, anamnesis and examination of the patient, the therapist assigns a diagnosis routine:

  1. oak.
  2. OAM.
  3. ECG.
  4. Biochemical research of the kidneys, liver, coagulation.

Consultation of the ophthalmologist, otolaryngologist, gynecologist. Sometimes you need the opinion of a psychiatrist and a psychologist. At this stage it is already possible to put the diagnosis of cephalgia ENT-pathology, hay fever, Autonom syndrome. After receiving all data, a preliminary examination and survey of these specialists a patient goes to a neurologist for further evaluation. Analyzing the patient's complaints and symptoms, put the preliminary diagnosis.

Tactic survey with headache in the occiput and temples

Features symptoms and complaints

ComplaintsTime occurrenceRatio F : M

ReasonsSymptomsCharacteristic headache
tension Headachesudden headacheAny age2 : 1Long work with muscle tension in the head and neck; emotional labilityCranially begins in the neck, covers the entire head. The low tolerance of loud noisespressure or tightness (like in the wrap, close the cap), bilateral
hypertensionhigh blood pressure, fatigue, headaches of a different nature, dizzinessAfter 45 years3 : 1changes in correlation between the substances responsible for normal blood pressure, increased vascular tone, oxygen starvation of tissues of the brainDuring BP aching head. Often nausea and vomiting, neurological disordersBurning, bursting, throbbing
Intracranial hypertensionHeadache in the morning, swelling, frequent vomitingAny age1 : 1the Violation of the outflow of CSF from the craniumGain in the horizontal position, vomiting, not bringing reliefarching Diffuse radiating to neck
Posttraumatic craniallyAfter suffering a head injury began tsefalgiihistory of trauma2 : 1 always Appears after stress, physical stressthe Degree of injury does not correlate with the intensitypainCephalalgia different localization and intensity
Cervicogenic craniallyAppearance in one half of the head, discomfort in neckOccurs after an awkward turn of the head or working in an awkward body position1 : 1Vertebrobasilar insufficiencyalways Starts with the head moving in the frontal area and temples, dizziness, pain in shouldersAlways unilateral specific localization blunt character
Migraineintense throbbing pain in one side of the head, more at the temples10 years old3 : 1Heredity, monthly hormonal changes, strong odors, bright light, noise Photophobia, phonophobia, chills, nausea, vomiting, palpitations, dizziness, fainting. In 30% there is an auraIntense, often unilateral paroxysmal
Aboutusa craniallyStronger headache after taking analgesicsMore than three months of continuous treatment with analgesics2 : 1Long-term use of analgesicsa Significant increase tsefalgii after taking painkillersAlways bilateral;
The compression of the temples
moderate intensity
Cephalalgia hay feverwith the weight of the head, cranially, symptoms of AllergySeasonal1 : 1Edema of the mucosa, disturbing the blood circulation nasal Congestion, sneezing, lacrimationArching, more at the temples
Cephalalgia with ENT pathology (sinusitis, rhinitis)the symptoms of colds, craniallya cold1 : 1Edema of the mucosa, disturbing the blood circulationRunny nose, feverArching, more at the temples

Methods of diagnosis and the results of the survey

With the initial diagnosis, the neurologist is planning further study to clarify the pathology of pain. Special methods of examination possible in the outpatient clinic and the specialized Department. If necessary appointed consultations with an endocrinologist, vertebroneurology, a neurosurgeon.

Differential diagnosis

Radiology researchEEGREGMRI (CT)Lumbar puncture
pathology of the bones of the skull, changes in the Turkish saddle, strengthening of finger impressionsthe Presence of blackouts in sinusesTemporal disritmia;
focal signs;
changes in the activity
Violation of intra - and extracerebral circulationchanges vasculature;
the bulk of education; expansion of ventricles of the brain
changes the cerebrospinal fluid;
high pressure the cerebrospinal fluid;
the presence of blood
Posttraumatic cranially.
Intracranial hypertension.
Extensive education
Sinusitis
hay fever
Headache;
extensive education;
intracranial hypertension
Cervicogenic cranially;
migraine;
tension headache;
hypertension
Aneurysm;
extensive education;
hydrocephalus
Meningitis;
hydrocephalus;
subarachnoid hemorrhage

Threatening condition accompanied by headache

  1. the Appearance of sudden severe pain in one side of the head.
  2. the First episode of cephalgia in the area of one temple at the age of 55 years and over.
  3. impaired vision, until the loss of its fields.
  4. speech disorders.
  5. Fever.
  6. Repeated vomiting, not bringing relief.
  7. Dizziness or loss of consciousness.

Dangers of pain in her neck and temples

These conditions should alert the patient or his relatives and requires urgent treatment. The first episodes of pain in the occipital and temporal areas easy pain. In the absence of adequate treatment, the process becomes chronic, in which lost control over the status and possible disability of the patient. Practice shows that access to a doctor and treatment started on time, help the patient to maintain performance, and in some cases life.

Sources:

  1. "the Treatment of tension-type headache: from old myths to modern concepts of" D. V. Sergeev. BC “Neurology” №12, 2015
  2. "Sex and headaches", A. M. Weiner, A. B. Danilov, laboratory of pathology of the autonomic nervous system, Department of neurology, FPO, MMA. I. M. Sechenov, Moscow, Russia. The journal "Pain" No. 2 2005
  3. "Chronic brain ischemia – from diagnosis to therapy" P. A. RakIN, S. N. Vyhovska, M. B. Novikova, A. Y. Dorogina. BC “Neurology” №12, 2015
  4. "a Headache in General practice" Y. E. Azimova, V. V. Osipov, sbei HPE First MSMU n. A. I. M. Sechenov of rmph, Moscow. The magazine "doctor" №5, 2014.
  5. "post Traumatic headaches" O. V.Vorobiev, A. M. Weiner, Department of neurology, fppo MMA. I. M. Sechenov, Moscow, Russia. The Magazine "Consilium Medicum" №1/ №2 / 1999.
  6. "Hemorrhagic manifestations of the syndrome of transient cerebral vasoconstriction. The incidence, features and risk factors" A. Ducros, U. Fiedler, R. Porcher, M. Boukobza, K. Stapf, M.-G. Bousser, Journal of the Russian national Association for combating stroke No. 1, 2011
  7. "the Options of headache in schoolchildren" Rachin A. P., J. B. Yudelson, Chair of neurology and psychiatry FPC and PPP, Smolensk state medical Academy.