intractable headache
Introduction
Introduction Symptoms of persistent headaches that persist for many years. 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.
Cause
Cause
Reasons for intractable headaches:
1. Brain lesions
(1) Infection with meningitis, meningoencephalitis, encephalitis, brain abscess, etc.
(2) vascular lesions: subarachnoid hemorrhage, cerebral hemorrhage, cerebral thrombosis, cerebral embolism, hypertensive encephalopathy, cerebral insufficiency, cerebral vascular malformation, thromboangiitis obliterans.
(3) Space-occupying lesions: brain tumors, intracranial metastases, intracranial leukemia infiltration, intracranial cysticercosis (cysticercosis) or hydatid disease (hydatidosis).
(4) craniocerebral trauma: such as concussion, brain contusion, subdural hematoma, intracranial hematoma, sequelae of brain trauma.
(5) Others: such as migraine [1], cluster headache (histamine headache), headache-type epilepsy.
2. Extracranial lesions
(1) Skull disease: such as skull base recession, skull tumor.
(2) cervical spondylosis and other neck diseases.
(3) neuralgia: such as trigeminal nerve, glossopharyngeal nerve and occipital neuralgia.
(4) Headache caused by eye, ear, nose and tooth diseases.
3. Systemic diseases
(1) Acute infection: such as influenza, typhoid, pneumonia and other febrile diseases.
(2) Cardiovascular diseases: such as hypertension, heart failure.
(3) Poisoning: such as lead, alcohol, carbon monoxide, organic phosphorus, drugs (such as belladonna, salicylic acid) and other poisoning.
(4) Others: uremia, hypoglycemia, anemia, pulmonary encephalopathy, systemic lupus erythematosus, menstrual period and menopausal headache, heat stroke, etc.
4. Neurosis neurasthenia and snoring headache.
Examine
an examination
Related inspection
Brain Doppler Ultrasound (TCD) Neurological Examination
Inspection and diagnosis of intractable headaches:
The patient's symptoms can be diagnosed. The medical history should be carefully asked. First of all, it is necessary to distinguish the nature of headache, whether it is pain, dull pain, sharp pain, jumping pain or dull pain; secondly, it is mainly based on headache or dizziness. Perform a detailed physical examination to help identify the pathology that supports the diagnosis. Even if there is no pathological sign after physical examination, if the patient has severe headache, it can not avoid heavy weight. Instead, the head CT should be checked first to eliminate serious intracranial diseases, so as to avoid misdiagnosis and mistreatment.
Diagnosis
Differential diagnosis
Differential diagnosis of refractory headache should be differentiated from brain-occupying lesion headache, epilepsy headache, cervical disease (such as vertebral artery compression, vertebral basilar artery insufficiency) headache.
Meningeal cancer (cancerous meningitis) also shows refractory headache in the early stage, which is easily misdiagnosed as migraine because of the concealment of the lesion.
