Headache is on of the most common symptoms ecountered by physicians

Headache is on of the most common symptoms ecountered by physicians. Headache is a symptom of a number conditions of the head that defined as pain or discomfort in the head, scalp or neck. Seventy percent of the population have headaches at some time.

Headache is caused by a disturbance of the pain-sensitive structures in the head. The brain in itself is not sensitive to pain, because it lacks nociceptors. Several areas of the head and neck have the pain-sensitive structures. The pain-sensitivd structures are divided in 2; within the cranium (blood vessels, meninges, and the cranial nerves) and outside the cranium (the periosteum of the skull, muscles, nerves, arteries and veins, subcutaneous tissues,eyes,ears, sinuses and mucous membranes).

Irritation of the pain-sensitive structures relays nociceptive information to the brain by cranial nerve V or by the upper cervical roots. Sensory of thf CN V ; opthalmic division, maxilary division, and mandibular division

Primary headache are not associated with caused by other disease or that do not have an underlying structural. The type of these headache are migrain, tension type,and cluster


More than 28 million America suffer from migraine that age of onset is typically in teens or early twenties. They affect women more commonly than men( thred times). These headaches are associated with nausea and vomiting, photophobia, and phonophobia.

¤ Classic Migraine

  • migraine with aura.
  • begins with visual disturbance (the most common type of aura).
  • warning symptoms may occur anywhere from a few minute to 24 hours before the headache.
  • sensory or motor symptoms can also occur.

¤ Common Migrain

  • without aura.
  • the majority of migraine.
  • be associated with an aura, a transient focal neurologic symptom that usually precedes the headache and lasts between 15 minutes and 1 hour.

¤ Treatment of Migrain

  1. preventing
    by avoiding triggers ; redwine,cheese,and other foods that precipitate an attack.
    medication ; beta blockers ,calcium channel antagonists, tricylic antidepressants,and some anticonvulsants.
  2. Abortive therapy
    analgesics such as acetaminophen, aspirin or NSAIDs.
    ergot alkaloids and selective serotonin agonists (contraindication : uncontrolled hypertension or coronay artery disease).


  • the most common type of primary headache disorder.
  • bilateral with squeezing quality.
  • involving the back of the neck.

The same medications used in treating migrain are effective for tension type headache. Analgesic, muscle relaxant, physical therapy, stress management may be beneficial


  • Occur in cyclic disorder, one to three times per day during a cluster.
  • can last up to several months.
  • the remission can be months to years.
  • commonly have ipsilateral conjunctival injection, lacrimation, nasal congestion.


  1. avoid precipitant ( alcohol or streuous exercise).
  2. prophylaxis.
    by using verapamil and lithium.
  3. symptomatic treatment.
    inhalation of pure oxygen, which is over 90% efective


Secondary headache are caused by associated disease such as subarachoid hemorrhage, temporal arteritis, pseudotumor cerebri, post lumbar puncture, and other neurologic causes. (dr. rend-san)

Source: Headache or Cephalalgia @ HealthyCase

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