Cause and diagnosis of frequent severe head pain neck and temples
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.
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:
- oak.
- OAM.
- ECG.
- 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.
Features symptoms and complaints
Complaints | Time occurrence | Ratio F : M | Reasons | Symptoms | Characteristic headache | |
tension Headache | sudden headache | Any age | 2 : 1 | Long work with muscle tension in the head and neck; emotional lability | Cranially begins in the neck, covers the entire head. The low tolerance of loud noises | pressure or tightness (like in the wrap, close the cap), bilateral |
hypertension | high blood pressure, fatigue, headaches of a different nature, dizziness | After 45 years | 3 : 1 | changes in correlation between the substances responsible for normal blood pressure, increased vascular tone, oxygen starvation of tissues of the brain | During BP aching head. Often nausea and vomiting, neurological disorders | Burning, bursting, throbbing |
Intracranial hypertension | Headache in the morning, swelling, frequent vomiting | Any age | 1 : 1 | the Violation of the outflow of CSF from the cranium | Gain in the horizontal position, vomiting, not bringing relief | arching Diffuse radiating to neck |
Posttraumatic cranially | After suffering a head injury began tsefalgii | history of trauma | 2 : 1 | always Appears after stress, physical stress | the Degree of injury does not correlate with the intensitypain | Cephalalgia different localization and intensity |
Cervicogenic cranially | Appearance in one half of the head, discomfort in neck | Occurs after an awkward turn of the head or working in an awkward body position | 1 : 1 | Vertebrobasilar insufficiency | always Starts with the head moving in the frontal area and temples, dizziness, pain in shoulders | Always unilateral specific localization blunt character |
Migraine | intense throbbing pain in one side of the head, more at the temples | 10 years old | 3 : 1 | Heredity, monthly hormonal changes, strong odors, bright light, noise | Photophobia, phonophobia, chills, nausea, vomiting, palpitations, dizziness, fainting. In 30% there is an aura | Intense, often unilateral paroxysmal |
Aboutusa cranially | Stronger headache after taking analgesics | More than three months of continuous treatment with analgesics | 2 : 1 | Long-term use of analgesics | a Significant increase tsefalgii after taking painkillers | Always bilateral; The compression of the temples moderate intensity |
Cephalalgia hay fever | with the weight of the head, cranially, symptoms of Allergy | Seasonal | 1 : 1 | Edema of the mucosa, disturbing the blood circulation | nasal Congestion, sneezing, lacrimation | Arching, more at the temples |
Cephalalgia with ENT pathology (sinusitis, rhinitis) | the symptoms of colds, cranially | a cold | 1 : 1 | Edema of the mucosa, disturbing the blood circulation | Runny nose, fever | Arching, 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 research | EEG | REG | MRI (CT) | Lumbar puncture | |
pathology of the bones of the skull, changes in the Turkish saddle, strengthening of finger impressions | the Presence of blackouts in sinuses | Temporal disritmia; focal signs; changes in the activity | Violation of intra - and extracerebral circulation | changes 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
- the Appearance of sudden severe pain in one side of the head.
- the First episode of cephalgia in the area of one temple at the age of 55 years and over.
- impaired vision, until the loss of its fields.
- speech disorders.
- Fever.
- Repeated vomiting, not bringing relief.
- Dizziness or loss of consciousness.
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:
- "the Treatment of tension-type headache: from old myths to modern concepts of" D. V. Sergeev. BC “Neurology” №12, 2015
- "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
- "Chronic brain ischemia – from diagnosis to therapy" P. A. RakIN, S. N. Vyhovska, M. B. Novikova, A. Y. Dorogina. BC “Neurology” №12, 2015
- "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.
- "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.
- "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
- "the Options of headache in schoolchildren" Rachin A. P., J. B. Yudelson, Chair of neurology and psychiatry FPC and PPP, Smolensk state medical Academy.