Location of headache and what it means: What Your Headache Location Tells You
Headache Location Meaning: What Can It Tell You?
Headaches are ubiquitous, but not every type of head pain is the same. Specific intensities, patterns, and, most importantly, headache location, can tell you a lot about why your head hurts and what you should do.
Defining a Headache
A headache is any pain isolated in or around the head, so identifying its cause can be difficult. Most headaches can either be classified as primary (caused by some problem in the head’s pain-sensitive regions, not related to a disease) or secondary (appearing as symptoms of an illness). Different headaches are most easily identified when they occur, how they feel, and where they feel.
Some rare headaches occur due to neuralgia (nerve pain) in facial or cranial nerves, such as the occipital (causing intense burning pain on one side of the scalp or eye). Most headaches, however, occur due to natural interactions between chemicals in the body, high blood pressure (and hydration), lack of sleep, or sore neck and shoulder muscles.
If you can isolate your pain to a specific part of your head, you may be a step closer to figuring out what kind of headache you are experiencing. If your pain is severe and you are experiencing any of the following symptoms, please consult a doctor:
- Very intense and sudden onset of severe head pain
- Extreme nausea, followed by vomiting
- A sudden jump in temperature (fever above 102° F/38.8° C)
- A fever accompanied by a stiff neck
- Fainting spells
While isolating the pain-related headache location can help identify its origin, it is still good to get a medical professional’s proper diagnosis. If you have not had any of the symptoms above, but are always worried about your headache, be sure to see a doctor.
Front of the Head
If your headache location is primarily in the front half of your head – especially near the forehead and nose – it may be related to your sinus. Hay fever and other allergies can produce similar symptoms to the common cold, putting pressure on the sinus due to inflammation and excess mucus. If you feel congested in addition to having a headache, you may be dehydrated from your cold.
Pain around the sinus absent of any other symptoms suggesting a cold or allergy, maybe some other form of sinus infection. These are relatively rare, and it is worth noting that migraine pain can also occur around the forehead and nose, often isolated or concentrated on one half of the head as well. If the pain is more concentrated behind your eyes than your forehead and nose, it may result from restlessness or excessive eyestrain.
However, most of the time, these headaches are a form of tension headache. Tension headaches are a common type of primary headache usually caused by muscles around the neck and head contracting that causes discomfort and a feeling as though a band was tightening around your skull. These headaches may be triggered by stress or eating something you are sensitive to (common triggers being aged cheeses, certain nuts, alcohol, or caffeine).
Back of the Head
Another common area for headaches is the back of the head. Ruling out apparent causes such as physical trauma, headaches around the head’s back is often caused by the neck. Anything from muscle contractions or discomfort caused by poor posture to a more severe issue with the cervical spine (the vertebrae in your neck) may cause a growing headache in the back of your head.
The neck is the second most likely spot for a herniated disc, the first being the lower back. A herniated disc is a condition wherein the shock-absorbing disc between your vertebrae leaks some of its contents through cracks or damage, pressing on the nerves around it. This compression is what may lead to pain, numbness, or weakness in the surrounding area.
If you have recently been to the doctor and received a lumbar puncture, also known as a spinal tap, then your brain may be low on spinal fluid. This can lead to a low-pressure headache, also known as spontaneous intracranial hypotension (SIH). Other signs that you may have a headache related to your spinal fluid are getting worse if you sit up or stand but improve if you lie down.
Around the Temples
Migraine and tension headaches may cause pain mainly around the temples, but if the pain is more severe or if you have recently had issues with your jaw or trigeminal nerve, or more specifically the mandibular nerve, then your pain may be related to compression or entrapment of the nerve, especially if it is not going away.
Another condition that may cause isolated pain in the temples is temporal arteritis. Due to arthritis – a condition wherein the arteries are swollen and potentially inflamed. Conditions related to the muscles or joints in your jaw, known as temporomandibular joint (TMJ) disorders, can cause pain mainly in the temple area.
On One Side of the Head
If the headache location occurs mostly on one side of the head, it is likely a migraine or cluster headache. Cluster headaches are characterized by excruciating one-sided pain, usually with a very severe and sudden onset, and typically coming and going in waves for anywhere from a few days to over a month. They are not life-threatening but can be debilitating and very painful.
Cluster attacks usually happen at night, and episodes themselves last a few minutes or up to three hours. While most other headaches have an associated chemical or physical cause – a trigger, like a particular food, emotional stress, or pressure – cluster headaches appear seemingly random and maybe mostly genetic. Their reason is still not completely understood.
Seeking Treatment for Chronic Daily Headaches
The standard treatment is an over-the-counter painkiller – usually an anti-inflammatory like ibuprofen or an analgesic like acetaminophen. Simple home remedies and creature comforts can go a long way as well – staying hydrated, getting rest in a cool dark room, and keeping one’s eyes away from harsh lights.
When these do not suffice, treatments are usually individualized by a doctor. Depending on the cause of your headache, a doctor may attempt to relieve the pain through various pharmacological therapies, including anticonvulsants, combination treatment of caffeine and analgesics, antidepressants, or triptans.
In severe cases of chronic daily headaches, depending on the cause, nerve blocks and interventions such as Botox injections may help relieve the pain. Alternative or herbal treatments may help some patients with migraine. However, it is still heavily advised to review any supplements or herbal medication with your doctor to avoid unwanted drug interactions.
What does the location of my headache mean?
If you have a headache, its location in your head can help you to determine its cause. This is because different types of headache are known to affect certain parts of your brain.
There are many different types of headache. Knowing what type you have will help you to find out how best to treat it, and what you can do to reduce the risk of getting another.
Headache locations: Where is the ache?
Use the chart below to find out what type of headache you may have based on where the pain is.
|Headache location||Likely cause||Other possible causes|
|Back of head or neck||Tension headache, migraine||Chronic tension headache, occipital neuralgia, giant cell arteritis (rare), subarachnoid haemorrhage|
|Top of head||Tension headache||Migraine, head injury, giant cell arteritis|
|Front of head||Tension headache, migraine||Sinus headache|
|Left side of head||Migraine, cluster headache||Hemiplegic migraine (rare)|
|Right side of head||Migraine, cluster headache||Hemiplegic migraine|
|Behind 1 eye||Cluster headache||Migraine, aneurysm|
|Forehead and face||Tension headache, cluster headache||Sinus headache, migraine|
|Temples||Tension headache||Migraine, cluster headache, giant cell arteritis|
|No specific location, generalised||Subdural haematoma, raised intracranial pressure, intracranial infection (e.g. meningitis), space-occupying lesion|
The most common are tension headaches and migraines.
Cluster headaches are more rare but tend to be linked to a specific area, making it easier to know when you may have one.
Tension, migraine and cluster headaches are all forms of primary headache. This means they’re not caused by a specific health condition, injury or illness.
They’re usually caused by an everyday problem such as skipping meals, not drinking enough water or poor posture.
When you have a headache you should always try to stay hydrated and get plenty of rest.
Do I need to see a doctor for my headache?
Usually, a headache is nothing to worry about, but you should seek medical help quickly if you have a headache and:
- your headache starts suddenly and the pain is severe
- you’ve recently injured your head
- your headache is constant and becomes more severe
- your headache starts suddenly after coughing or sneezing, or a change in movement or posture
- you’re confused or can’t remember things
- your speech is slurred
- your vision is blurred
- 1 of your eyes is red
- you have a rash
- your jaw is painful
- your neck is stiff
Common types of headache and their locations
If you have a headache, it’s most likely to be a tension-type headache.
This can cause pain almost anywhere on your head — the back of your head and neck, on top of your head, around the front, or on the sides of your head between your eye and forehead (temples).
You can usually identify a tension headache by the type of ache you have. The pain can be mild to moderate, and it may feel dull and achy.
Tension headaches often feel like there’s pressure being applied to your scalp. Your neck muscles may also feel tense or tight.
They tend to last between 30 minutes to a few hours, but can go on for several days or even longer (chronic tension headache).
Why do I have a tension headache?
Tension headaches have many causes, including:
- not getting enough sleep or drinking enough water
- lack of exercise
- bright lights and glare
- sensitivity to sounds and smells, like perfume
- problems with posture — this can put extra strain on your back, neck and shoulder muscles which can cause tension, leading to a headache
If you think you have a tension headache, it’s not usually necessary to see a doctor, as you can treat it at home by easing the tension around your head and neck.
Activities like yoga, massage or other forms of exercise may help, or even a warm bath to relax your muscles. If your posture may be to blame, try to make changes to improve it.
A doctor may advise you to take a painkiller, such as paracetamol, for a tension headache if the pain is preventing you from doing everyday tasks. Speak to a pharmacist or doctor for further guidance on whether to use these medications and how to get and use them.
A migraine will usually cause a throbbing pain on the left or right side of your head. However, migraine pain can sometimes affect both sides of your head, the back and front of your head and neck, and your face.
Unlike tension headaches, migraines can come with other symptoms, not just pain. You may feel sick, be sensitive to noise and light and need to lie down in a dark room until it passes.
Why do I have a migraine?
It’s not clear why migraines happen, and different types of migraine can have different causes. They can be caused by:
- drinking a lot of alcohol (a ‘hangover headache’)
- not getting enough quality sleep
A menstrual migraine in women can be due to hormonal changes.
If your migraine is particularly painful or keeps returning, see a doctor.
A doctor may advise you to take a painkiller for a migraine if the pain is stopping you from doing everyday tasks. Speak to a pharmacist or doctor for further guidance before taking any medications.
Cluster headaches are more rare than migraines and tension headaches but they tend to strike in a particular location.
This is usually on the left or right side of your head, and you may get pain behind the eye and around the forehead and temple on the affected side of the head.
With a cluster headache, the pain comes on quickly and can be so sharp and severe that you can’t lie still or relax at all. It may develop during the night and typically lasts between 15 minutes to 3 hours.
It can come in waves (clusters) of pain every day for between 4 and 12 weeks.
Why do I have a cluster headache?
Heavy smoking appears to increase your risk of having a cluster headache. You may also be more likely to get them if someone in your family also has them.
Other triggers include drinking alcohol or exposure to perfume, paint or petrol fumes.
If you think you might have a cluster headache, see a doctor. It’s important to rule out anything more serious, like an aneurysm, which can have similar symptoms.
A doctor may advise you to take a painkiller for a cluster headache if the pain is preventing you from doing everyday tasks. Speak to your pharmacist or doctor for further guidance before taking any of these medications.
A sinus infection (sinusitis) happens when the passages inside your nose and head become inflamed due to an allergy or infection. This can occur after you’ve had the flu or a cold.
A sinus headache can be a symptom of a sinus infection, though this is rare.
If you have a sinus headache you’ll tend to feel a throbbing pain around your nose and face, forehead and front of your head, and this may get worse during the day.
You may also have earache, a runny nose, a high temperature and your face may feel tender.
Sinus headaches can be mistaken for migraines or tension headaches.
Treatment for a sinus headache
See a doctor if you think you have a sinus headache, especially if the pain is severe.
To help ease symptoms of pain around the nose or a blocked nose, try holding a cold towel or flannel to the affected area for 2 minutes a few times during the day.
As with any headache, you should also stay hydrated and try to get plenty of rest.
- If you have a headache, its location in your head can help you to determine its cause
- If you think you have a tension headache, you don’t usually need to see a doctor
- If you have a migraine and it keeps returning, see a doctor
- When you have a headache you should always try to stay hydrated and get plenty of rest
- See a doctor if you think you have a cluster or a sinus headache, especially if the pain is severe
How Your Headache’s Location Can Help You Treat It More Effectively
Front of Head or Face
Headaches that occur in the face or front of the head typically occur behind the eyes and nasal passages. These are related to allergies, hay fever, or sinus headache. If the headache is only behind the eyes, it is likely directly related to eyestrain. The best way to treat headaches in the front of the head or the front of the face is by identifying and treating sinus problems. If it’s related to eyestrain, visiting an eye doctor is the best first step to finding relief.
Back of Head
The last location you might experience a headache is in the back of the head. Headaches in the back of the head are usually related to arthritis in the neck, poor posture, or herniated disc. If the headache involves pain in the back of the head as well as the neck, it’s possible it’s caused by spontaneous intracranial hypotension from low spinal fluid pressure in the brain. If pain worsens when you stand, sit upright, sneeze or cough, strain, or engage in physical activity, these are signs that your headache is from spontaneous intracranial hypotension. We encourage you to seek medical attention.
Headache Treatment in St. Louis
If you suffer from frequent headaches and you haven’t found a treatment that works, you might have a temporomandibular joint disorder (TMD). TMD is a disorder that affects the jaw joints. When the joints become imbalanced, it causes the muscles to compensate for the imbalance by correcting themselves. This can lead to muscle strain that causes facial pain as well as headaches. TMJ disorders can also cause jaw pain, worn teeth, clicking and popping when opening and closing the mouth, and ear pain.
When Dr. Hill provides you with TMJ treatment, it will help relax the jaw joints and allow them to rest at their most optimal position. With treatment, the painful symptoms, including frequent headaches and migraines will go away.
If you’re looking for headache treatment in St. Louis, consider booking a consultation at Smile On Dental Studio in Clayton to learn if TMD is the cause. Please call (314) 678-7876 to get started.
Headache Locations, What They Mean, and Treatment
When you have a headache, it can be tempting to get into bed, pull the covers over your head, and try not to think about how lousy you feel until the pain has passed. But paying attention to the location of your pain is key, as it can indicate the type of headache you have. Once you know this, you’ll be better prepared to choose the right type of relief so you feel better, faster.
Here’s a guide to help identify different headache types based on where it hurts and to determine the best options for treatment.
Tension headaches can feel like a tight band that stretches across your head.1
Tension headache symptoms vary and can include:
- Mild to moderate dull, aching head pain
- Stiff muscles, tightness in the neck, shoulders, scalp, and jaw
There are two types of tension headaches:
- Episodic (occurring less than 15 times a month)
- Chronic (occurring more than 15 times a month over the course of more than three months)
Either type can last anywhere from a half hour to a week.2
While tension headaches might be brought on by many different factors, stress is the most common trigger.3 Researchers believe a heightened sensitivity to pain, and increased muscle tenderness, may also play a role in tension-type headaches.4
- Develop ways to cope with stress
- Massage the affected area
- Apply hot or cold compresses
- Ensure you get enough sleep and exercise5
- OTC pain relievers that combine acetaminophen, aspirin, and caffeine may also be effective6
Talk to your doctor for more information.
See how Excedrin Tension helps other tension headache sufferers manage their pain.
Cluster headaches develop as a cluster on one side of the head, usually in or behind one eye or at the temple.
Cluster headaches often come on during sleep and can last for a period of days, weeks, or even months before going into remission for long periods.7 Symptoms can include:
- Tearing eyes
- Runny nose
- Occasional flushed, sweaty skin on the affected half of the face prior to headache8
The exact cause is still unknown, but risk factors include smoking (more than half of sufferers are current or former smokers), familial history (close relatives who experience cluster headaches) and drinking alcohol. Men are up to six times more likely to develop cluster headaches than women.9
It’s best to consult a physician if you think you might be experiencing cluster headaches. To ease the pain during an attack or cycle of attacks, your doctor may administer the following:
- Nasal spray
- Prescription medication
Your health-care professional will be able to determine which treatment options are best for you.10
Pain from sinus headaches most often develops in the cheekbones, forehead, and/or bridge of the nose.
Sinus headache pain is characterized by deep, constant pain that usually intensifies with sudden head movements or straining. Other sinus symptoms include:
- Thick, discolored nasal discharge
- Feeling of fullness in the cheeks, forehead and brow
Sinus headaches are caused by an inflammation of the sinuses, which are air-filled cavities located in the forehead, cheekbones, and behind the bridge of the nose that produce a thin mucus that drains out of the nose.12 Allergies can also inflame the sinuses, causing pain and leading to sinus headaches.13
Possible treatment approaches for sinus headaches include:
- Pain relievers
- Nasal vasoconstrictors
- Corticosteroids may be prescribed by a physician to further decrease inflammation14
If you have questions or concerns about your sinus headache pain, talk with your doctor.
7 Headache Locations and Their Causes | What Headache Locations Mean
Headaches are one of the most common ailments in the world, and where your pain is located can sometimes tell you something about the cause and how to stop the pain. There are more than 150 types of headaches, but most often they are primary headaches which don’t have an underlying cause like high blood pressure. Only about 1% of headaches are caused by tumors. Here are some of the most common headaches, where they hurt, what their location means, and what you can do about them.
1. Headache on both sides of your head
If you feel a dull pain on both sides of your head, accompanied by a feeling of pressure, it is likely a tension headache. It may also be felt in the neck and shoulders because tension headaches develop when the scalp and neck muscles tense up, oftentimes due to stress. Tension headaches can also be due to alcohol, caffeine, eye strain, and tiredness, among other causes. Over-the-counter pain relievers can help, but they can have side effects or lead to rebound headaches if used too often. Try to avoid triggers and consider relaxation techniques, such as massage or biofeedback.
2. Headache on one side of your head
Migraine headaches, which are a neurological disease, affect up to 12% of the population. Slightly more than half of them occur on only one side of the head, but they can also develop in the neck, forehead, cheeks, behind the eyes, or along the hairline. They often come on within an hour of an aura, which is visual or sensory symptoms like seeing flashing lights. The pain is a severe throbbing sensation and you may feel nauseous or sensitive to light and sound. There are many prescription medications for migraines, and it may help to lie in a dark, cool room.
3. Headache behind one eye
Cluster headaches are severe headaches that usually develop behind one eye or on one side of the head. They’re more common in men than women and occur in groups over a couple of weeks to a few months. You can have as many as eight headaches a day, lasting from several minutes to a few hours. Cluster headaches can be painful enough that they can wake you up. Your eye may tear or your eyelid droop and you may feel restless. Inhaling oxygen can provide relief, and there are medications to relieve them, usually administered by injection. There are also medications to help prevent cluster headaches.
4. Headache around your eyes, forehead and cheeks
You may have a sinus headache. The pain may become more severe if you lie down or lean over and your teeth may ache. Migraines can be confused with sinus headaches, but sinus headaches don’t typically cause nausea or sensitivity to light. If your doctor diagnoses a sinus headache rather than a migraine or tension headache, you can try a decongestant, antihistamine, or steam to relieve the pressure. If you have a bacterial sinus infection, your doctor may prescribe antibiotics.
5. Headache on both sides that doesn’t go away
If you don’t usually get headaches, and then develop one that doesn’t go away, it may be a new daily persistent headache, or NDPH. It can feel similar to a migraine, in that you may be sensitive to light or feel nauseous. Most people can identify the date or circumstance their NDPH began, and it can last for months or longer. The pain may vary at the beginning, but becomes continuous within a day or so. It may throb, stab, ache or burn. NDPH can be difficult to treat, and treatment will depend on your symptoms.
6. Pain around your forehead or temple after trauma
Following a concussion, which is a mild but traumatic brain injury, you can develop a headache in your forehead or temple that may be pounding or throbbing. Like migraine, it may cause nausea and sensitivity to noise or light. A headache from trauma can feel like a tight band around the head, or an intense feeling of expanding pressure. Seek medical care if you have hit your head and you are in pain or feel dizzy or foggy (confusion or thinking problems). Rest is important after a concussion and you should follow your doctor’s advice carefully.
7. Sudden pain in head, neck and back
If a headache comes on suddenly in your head, neck or back, causing severe pain and perhaps accompanied by vomiting or nausea, it may be a “thunderclap headache.” The pain lasts only a few minutes, but it can be caused by bleeding in the brain. If you have these symptoms, get medical help immediately by calling 911 or going to an emergency room (only if someone can drive you). These headaches are rare, but in some situations they can be life-threatening.
What to Know About Low-Pressure Headaches
Dr. Deborah Friedman, MD, MPH, FAHS, shares her insights on the connection between Spontaneous Intracranial Hypotension (SIH) and headache.
What is Spontaneous Intracranial Hypotension (SIH)?
In the simplest of terms, SIH is a low-pressure headache. Intracranial hypotension literally means that there is low spinal fluid pressure in the brain. In SIH, there is a leak of spinal fluid from the spine, either in the neck (cervical) or mid-back (thoracic) area. Spinal fluid bathes the brain, cushioning it from impact against the skull when the head moves. The brain makes spinal fluid continuously, and absorbs it at the same rate, creating a delicate balance that keeps the spinal fluid volume and pressure normal.
What are the Symptoms of SIH?
The most common symptom of SIH is a “typical” headache, located in the back of the head, often with neck pain. It is worse when standing or sitting and improves or goes away within 20-30 minutes of lying down, called “orthostatic” or “postural” headache. The pain is often very severe. The next most common variation is a headache that is not present (or mild) upon awakening but develops in the late morning or afternoon and worsens throughout the day.
The location of the headache varies – it may be in the front, affect the entire head or be one-sided. It may resemble migraine with sensitivity to light and noise, nausea or vomiting. There is no specific character of the pain, which may be aching, pounding, throbbing, stabbing, or pressure-like, as examples.
Another common feature of the headache is marked worsening with coughing, sneezing, straining (lifting, bearing down during a bowel movement), exercise, bending over and sexual activity. Other symptoms include hearing changes (muffled hearing, ringing in the ears, hearing loss), dizziness, impaired concentration, back or chest pain, and double vision. Rarely loss of consciousness, coma, or a Parkinson-like state may occur.
SIH is one cause of New Daily Persistent Headache, which is a headache that starts “out of the blue” one day and never goes away.
Who Gets SIH?
Although anyone can get SIH, it seems to occur more often in people who have a weak “connective tissue matrix”. These people are often tall and thin, have a slender neck, are double-jointed or unusually flexible. Their dura is probably thinner and prone to tearing than in most people.
How is SIH Diagnosed?
If you think that have the symptoms of SIH, it’s important to consult your doctor to conduct a series of tests. From the Trendelenburg test, where the patient lies flat and the exam is tilted to lower the head, imaging studies such as an MRI scan, CT scan or cisternogram, can help to determine if SIH is the cause of the headaches. Still, even through diagnostic testing, a substantial minority of patients may have normal results.
How is SIH Treated?
Many patients with long-standing SIH discover that virtually all of the standard medications used for headache treatment are ineffective. The medical management is similar to what is used for the headache that occurs immediately after a spinal tap, including caffeine, hydration and lying flat. Sometimes an abdominal binder or a medication called theophylline (which acts similar to caffeine) are helpful but rarely make the headache go away permanently.
Because epidural blood patches are usually successful, they are often the first line of treatment. The patient’s own blood is drawn from the arm and injected in the low spine into the epidural space, which is the space immediately outside the dura. The procedure is performed under fluoroscopy (x-ray) or CT as an outpatient. The most common complication is lower back pain that generally resolves within a week. Occasionally, the back pain lasts weeks or months; rarely there may be scarring (arachnoiditis) causing persistent back pain, or a rebound high pressure state which usually resolves on its own. There is a potential risk of infection. The blood patch often brings instant relief. Sometimes the effect wears off and additional blood patches are needed.
Why Not Just Fix the Leak?
It sounds easy but the site of the leak may be VERY difficult to find. The tests that are most helpful to locate the leak are special MRI images (which are not part of the standard MRI software package and not readily available), as well as MR and CT myelography. Even with these techniques, there may be “false positive” results that are misleading because the abnormality on the image is not really the site of the leak. The most difficult leaks to find and treat are in front of the spinal cord. Directed blood patches and surgery may ultimately be needed.
Deborah I. Friedman, MD, MPH, FAHS
Director, Headache and Facial Pain Program
Professor of Neurology and Neurotherapeutics and Ophthalmology
When to Worry About a Headache: Location, Duration, and Type
Relief for primary headaches
For a more comprehensive guide, please also check out “How to Stop a Headache: 23 Methods for Fast Headache Relief”.
Tension headache relief
Q: How are tension headaches treated?
A: Tension-type headaches are often treated with over-the-counter (OTC) medications so Tylenol, Acetaminophen, Aspirin, and nonsteroidal anti-inflammatories such as Ibuprofen or Naproxen are all helpful for tension-type headaches. These are given as needed when the headaches actually occurs. It’s rare that when someone with tension type headache needs to be on chronic medication but there are prescription medicines they will sometimes use for tension-type headaches that are often frequent or disabling.
Q: How are migraines treated?
A: Migraine headaches are more complicated, but we can break it into different categories. There are certain complementary and alternative physical strategies which can help some patients- acupuncture or chiropractic medication can help mitigate migraines. Medications for migraine is broken into two treatments taken at the onset of the headache to shorten its duration or severity, or chronic daily medications to decrease someone’s overall for a month for example. The two treatments would be among the same ones you can use for tension headaches such as NSAIDs or Aspirin. Acetaminophen does not usually work for migraines.
There are prescription medications that are specific to migraines that can be used when those medicines are not effective. The prescription medicines would be ones that are specific to migraine, most commonly used ones are so called triptans which there are about a half dozen out and can be given in different formulations including a pill, a wafer that someone puts on their tongues and dissolves, a nasal spray and an injection someone would administer themselves at home.
There’s also something called Ergotamine, which is another treatment for migraine that is used less commonly these days. For some patients whose migraines are typically disruptive or disabling or don’t respond well to those two treatments which are very frequent, we can use a different number of options to decrease the total number of migraines which would long discussion with the provider to determine which would be the best option for different persons. Drug classes would include beta blockers, which are also used to treat other conditions besides migraine. Divalproex sodium which is an anti-seizure medicine which also prevents migraines and Topiramate which is another anti-seizure medicine that helps to prevent migraine and daily preventive use. There’s a number of other medicines which are used less frequently.
Patients with very disabling and chronic headaches like migraine – more than 15 days per month- use try botulinum toxin injections in the muscles around the scalp and intracranial muscles. An injection would be 12 weeks to reduce the total number of migraines, but it’s only effective for chronic migraines and since it’s expensive it usually requires prior authorization to get insurance to cover it.
Those are some of the pharmacological strategies and in addition we talk to all patients with migraine about lifestyle modifications. There are certain healthy lifestyle modifications which can improve the course of migraines which include regular sleep schedules, regular meal schedules for example not skipping a meal, limiting caffeine to no more than two caffeinated drinks per day, and some patients, not all, know there are certain food triggers like red wine and chocolate. Those can be triggers and produce migraine, which is a very complicated discussion. There’s a lot to go through in terms of how frequently they occur and how well patients respond to first steps of treatment.
Cluster headache relief
Q: How are cluster headaches treated?
A: The treatments for cluster headache are quite different since it’s a different mechanism for migraine or tension-type headache. The same medicines that work for headache are among those used for migraine but there’s a difference. Most effective acute treatment for cluster headache given at the onset of headache is actually oxygen. A 100% oxygen given by facemask will abort cluster headache in a majority of patients with cluster. That’s not always practical because someone cannot have it with them at work or when they are travelling, but if they have one at home, then that can be an acute treatment. Triptan which we talked about for migraines are also effective as an acute treatment when cluster headache occurs. Also the Ergots which I only briefly mentioned for migraines can be used as acute treatment for cluster headaches.
The maintenance treatments for cluster are quite different than those for migraine. We do know that for some patients, corticosteroids, strong NSAIDs usually prednisone can be given in a burst at moderate to high dose with a taper of over 10-14 days at the onset of a cluster and will shorten the duration of a cluster. For maintenance therapy, that is chronic daily treatment in patients whose clusters occur frequently, patients can use two drugs which would be Topiramate and Divalproex sodium but other drugs can be used including: Verapamil which is a blood pressure medicine is also helpful here, and lithium, which is rarely used for bipolar disorder but can be used as a preventative treatment for cluster headache. It’s a very different repertoire of treatments.
90,000 how they differ and what they say
Headache can become chronic and significantly spoil life, affecting a person’s performance and normal functioning in society. Few people know, but there are different types of headaches , which differ from each other both in the causes of occurrence and in the methods of treatment. About what types of headaches are and their causes , as well as signs of headache , we will tell in the article.
Why is headache so dangerous?
Almost all types of headaches activate the same pain receptors. This can make it difficult to know if your headache is a sign of a serious condition or not. The most serious causes of headaches are:
- Hemorrhagic (bleeding) stroke. A hemorrhagic stroke happens when a blood vessel in your brain ruptures and bleeds;
- aneurysm.Bulge or distention of a blood vessel in the brain;
- meningitis. A bacterial or viral infection that causes swelling of the protective lining of the brain;
- brain tumor. A “primary” brain tumor begins in the brain and can be malignant or benign.
To understand if your headache is dangerous, it is important to understand what types of headaches exist, their causes and how to get rid of the headache.
Types of headaches
Headache is caused by signals that interact between the brain, blood vessels, and surrounding nerves. During a headache, an unknown mechanism activates certain nerves that act on muscles and blood vessels. These nerves send pain signals to the brain.
What types of headaches are there? Headaches can be more complex than most people think. Different types of headaches can have their own set of symptoms, arise for unique reasons, and require different treatments.
Once you know what type of headache you have, your doctor will be able to choose a treatment that will help relieve and prevent them.
Types of headaches by location:
- migraine – severe and throbbing pain in one side of the head.
- Hypertension – Severe throbbing pain, usually in the back of the head.
- Stress – prolonged pain “squeezing” the head like a hoop.
- influenza, acute respiratory infections – pain in the browbones, forehead and temples.
- osteochondrosis – sharp pain in the back of the head and at the temples.
We will talk about the types of headaches and headaches by zones further.
The most common type of headache is tension headache, which does not recur very often and only in 3% of cases become chronic. It occurs due to injuries to the muscles of the neck and head, as well as due to severe stress. When diagnosed, most often the source of pain is not determined.
Signs: Tightness or pressure is felt around the top of the head, and the muscles in the eye sockets and forehead may seem very tense and cannot be relaxed.The intensity of the pain usually increases in the evening. The duration of such pain can be either half an hour or a week.
Treatment: with an irregular nature of tension pain, it is better to use simple painkillers, and also try to be outdoors more often, do light exercise, stretch your neck and shoulders. Chronic pain should be treated with medication as directed by your doctor.
Attention! Self-medication can be harmful to your health, be sure to check with your doctor before taking any medication.
Cluster pains affect about 1% of the world’s population. Interestingly, in 80% of cases, cluster pain bothers men. Its reasons are unknown.
Signs: intense throbbing pain on one side of the head, usually near the eye. It lasts 15-60 minutes and is accompanied by lachrymation, redness of the eyes, rush of blood to the head, and a runny nose. Sometimes it can become so acute that the person cannot even speak. Cluster pain occurs at regular intervals at the same time of day – once a month, week.
Treatment: difficult to treat due to the fact that they arise and disappear unpredictably. For prolonged attacks, drug injections and oxygen therapy are used.
A possible cause of migraine is a dysfunction of the brain, but what exactly is currently unknown. There is evidence that when a migraine occurs, blood vessels greatly expand, and an abnormal electrical activity occurs on the cerebral cortex.
Signs: migraine is a type of headache on one side of the head that lasts from 4 hours to 3 days. A migraine is often described as a stabbing, throbbing pain. Migraine episodes tend to recur and often result in nausea, dizziness, and sensitivity to light and odors.
Treatment: it is impossible to completely cure a migraine, however, medications prescribed by a doctor will help relieve some of the unpleasant symptoms.
Attention! Self-medication can be harmful to your health, be sure to check with your doctor before taking any medication.
It manifests itself in the form of increasing, sudden pain in any part of the head after an injury (sometimes symptoms appear after a few hours).
Signs: accompanied by impaired speech skills, vision, coordination, nausea, personality disorders. Symptoms worsen over time, after which the person may pass out.
Treatment: it is necessary to see a doctor who will remove the accumulated blood from the cranium so that the hematoma does not press on the brain, thus damaging it.After this, it is important to find out the cause of the hemorrhage by examining the vessels of the brain.
Temporal arteritis is common in patients over 50 years of age and can lead to blindness if left untreated. It occurs due to hypothermia, alcoholism, various injuries, uncontrolled intake of drugs, an attack of viral infections on the immune system.
Signs: severe headaches occur against the background of insomnia, weight loss, depression, neck and shoulder may also hurt.
Treatment: Steroid medications are used to stop the inflammation of the blood vessels. With the development of concomitant health problems, it is also necessary to consult with doctors of other specialties. For example, if the lens is clouded, go to an ophthalmologist.
If the headache is associated with a brain tumor, which occurs in about 4% of cases, it will appear in the morning and be accompanied by vomiting. Such episodes are repeated periodically and each time it gets worse and worse.“The brain doesn’t feel pain. There are no pain receptors in the brain. They are present only in the meninges and blood vessels. For example, when a person experiences a headache, it is not the brain itself that hurts, but the tissues surrounding it, ”said neurosurgeon Alexei Eroshkin in an interview for Doc.ua.
Signs: seizures, sudden weight loss, personality change in such cases become a reason to undergo a brain examination.
Treatment: depends on the size, location and type of education.
Pain in the head during a hangover develops due to the fact that alcohol leads to dehydration, which is one of the reasons for the development of migraines. In addition, alcohol dilates the vessels of the brain and disrupts the functioning of serotonin (the substance through which electrical signals are transmitted from one nerve cell to another).
Signs: Alcohol makes people want to urinate because it suppresses the production of a hormone called vasopressin.This hormone affects the body in different ways, affecting the ability of the kidneys to reabsorb water. Sweating, vomiting, and diarrhea are also hangover symptoms. All of these symptoms can lead to further dehydration.
Treatment: The best hangover headache cure is a pain reliever pill and sleep.
Attention! Self-medication can be harmful to your health, be sure to check with your doctor before taking any medication.
Help Doc.ua: you can make an appointment with a neurologist on the website.
90,000 7 types of headaches: how they differ and what they talk about | Healthy life | Health
In the meantime, headaches can turn into chronic and significantly spoil your life. Which headache indicates a serious illness? And which one is itself a disease? Let’s try to figure out how to distinguish between headaches and how to treat them.
This is the most common type of headache in the world – each of us has experienced it at least once in our lives.They are not often repeated; they acquire a chronic form in 3% of cases.
Features . Feels like pressure or tightness around the top of the head. The muscles in your forehead and eye sockets may seem too tense, but you cannot relax them. The duration of such pains varies from half an hour to a week, the intensity usually increases in the evening.
Possible causes . Tension pain can be associated with excessive stress or injury to the muscles of the head and neck.However, when diagnosed, the source of pain is usually “undefined.”
How to treat . Since pain is rarely regular, simple pain relievers such as ibuprofen or paracetamol are the best remedies for pain. If the pain does not go away for more than a week, you can try to do light exercise, regularly stretch your shoulders and neck, and be outdoors more in order to neutralize stress. Chronic tension pains are treated with medication as prescribed by a physician.
Features . Migraine is a recurrent pain on one side of the head that lasts about 4 hours or longer. Typically, migraine episodes recur and can lead to dizziness, nausea, and photophobia (photophobia). Sometimes, before the onset of an attack, patients experience visual abnormalities – they see bright colored rings and stripes – or feel a slight tingling sensation throughout the body.
Possible causes . The mechanism of migraine headaches has long been a subject of controversy in scientific circles.Now doctors are sure that this is definitely not a mental illness. It is associated with a dysfunction of the brain, but with what, it is not known for certain. It is noted that during the onset of pain, the blood vessels of the head greatly expand, and abnormal electrical activity occurs on the cerebral cortex.
How to treat . Approximately 20% of people suffering from migraines experience pain after a certain external influence – a pungent smell, a loud monotonous sound, cigarette smoke, etc.e. Doctors simply advise such patients to avoid “risk factors”, while the rest are left to take medications as prescribed (triptans are most effective, but they act almost like a drug – the more you drink, the worse it cures). Unfortunately, it is impossible to completely cure migraines, and simple painkillers will hardly help you.
These pains affect approximately 1% of the total population of the planet, and in 80% of cases they are men.
Features .This is intense throbbing pain on one side of the head, usually in the front of the head, near the eye. It lasts from 15 minutes to an hour and is accompanied by redness of the eyes, tearing, runny nose, rush of blood to the head. It usually occurs at the same time of the day with regular time intervals – once a week, a month, two, and so on. Sometimes it reaches such an acuteness that a person cannot not only function normally – even move and talk.
Possible causes .Unknown.
How to treat . This type of pain is difficult to treat because it occurs sporadically and can disappear as unpredictably as it appeared. For prolonged seizures, oxygen therapy is used (the patient breathes through a mask) and medicinal injections as prescribed by the doctor.
Features . Are obvious.
Possible causes . There are many conjectures about exactly how alcohol contributes to the onset of headaches.One of them says that alcohol dilates the blood vessels of the brain and disrupts the work of the neurotransmitter serotonin, a substance through which electrical signals are transmitted from one nerve cell to another. Both of these symptoms are observed with migraine pains. In addition, alcohol dries out the body, and dehydration is also known to trigger migraine attacks.
How to treat . The best remedy is a paracetamol tablet and good sleep. But you shouldn’t be joking about a hangover.If your head hurts even after a small dose of alcohol, it is possible that you are suffering from migraines, and alcohol simply pushes the attacks.
Hypochondriacs and simply worried patients often associate headaches with brain cancer. We hasten to reassure you: in fact, only 4% of tumor formations appear in this way.
Features . If the pain is still associated with a tumor, it usually appears in the morning and is accompanied by vomiting.The episodes are repeated periodically and get worse and worse over time. If, against this background, there is a sharp weight loss, personality changes and seizures, this is a reason to undergo a brain examination.
Possible causes . When a tumor grows to a certain size, an increase in brain volume leads to an increase in intracranial pressure. Hence the initial symptoms.
How to treat . Depends on the location, size and type of education.
Having received an injury to the head vessels, a person may not immediately understand this. Sometimes hemorrhage appears several hours after the rupture of the vessel, but it is potentially very dangerous.
Features . Sudden, growing pain anywhere in the head. It is accompanied by visual impairments, speech skills, coordination, personality disorders, nausea. Symptoms come on in succession and get worse over time. Eventually, the person may lose consciousness.
Possible reasons . The rupture of the vessel can occur as a result of injury (strong blow) or due to excessive thinning of its walls.
How to treat . First of all, the doctor will need to remove the accumulated blood from the cranium, since the hematoma will press on the brain, damaging it. Then it is extremely important to find out the cause of the hemorrhage: if it was not preceded by an obvious trauma, the ruptures may recur. Such patients need an examination of the vessels of the brain.
The disease, as a rule, occurs in people 50 and older and without treatment can lead to complete blindness.
Features . Severe headaches occur with weight loss, insomnia, depression, sometimes fever and redness of the scalp. The shoulder and neck can also hurt.
Possible causes . Many different factors can push the disease, including viral infections. A strong attack on the immune system causes it to malfunction and causes the immune system to attack the walls of the blood vessels.Other “provocateurs” of arteritis include uncontrolled medication, intense exposure to sunlight, alcoholism, hypothermia and various injuries.
How to treat . The most commonly used drugs are steroids to stop the inflammation of the blood vessels. If you have concomitant vision problems (for example, lens opacity), an ophthalmologist should be treated.
90,000 The expert told when a headache requires an urgent visit to a doctor
MOSCOW, October 28 – PRIME. There are some warning signs when to worry about headaches. Such signs can be a strong “thunder-like” headache; a sharp change in the nature of the headache; headaches that appear for the first time after 50 years; headache that worsens with coughing or movement; constantly increasing headaches. Headaches that are associated with fever, neck stiffness, confusion, decreased attention and memory, or neurological symptoms such as blurred vision, slurred speech, weakness and numbness in the limbs, or seizures can also be dangerous.Izeta Yeloeva, the head of the department of the Medsi na Solyanka CDC, a neurologist, tells the Prime agency about this.
The doctor gave advice to Russians on what to refuse on non-working days
Headaches, accompanied by painful redness of the eyes, should not be ignored either; headaches after head injuries.
If the habitual nature of the headache has changed, for example, from a “dull” pain to “acute”, from a short-term – prolonged or has changed its location, you should seek the help of a doctor.
“Headaches as a result of a sharp jump in blood pressure or the so-called hypertensive crisis pose a great danger to health. To minimize the risks of complications such as stroke and heart attack, with these symptoms, a person needs to stop any physical activity and work and rest,” says doctor.
Dangerous to health, according to the neurologist, may be prolonged headaches, for example, daily for a month. If drugs cannot cope with them, then this may indicate a violation in the bloodstream of the brain, one of the reasons for which is oncology, notes Eloeva.
The most severe headache attacks can occur with inflammation of the trigeminal nerve, which “is most likely to occur after walking in a cold wind or being in a draft.” A person has an exhausting pain that does not allow not only to do business, but even to sleep.
The doctor spoke about dangerous products
Another type of intense headache called cluster headache. This disease quickly turns into a chronic one – according to the expert, those who have a throbbing pain in the head are of a seasonal nature should be wary.
If you have had such headache attacks, then in order to exclude any dangerous diseases and choose the correct drug therapy, you must consult a doctor. Sometimes such attacks of pain can be symptoms of serious diseases – brain tumors, lesions of the cerebral vessels (aneurysms), the neurologist explained. 90 017 90 000 Applications: The latest news from Russia and the world – Kommersant Health (117794)
For Professor Jürgen Beck, Chief Physician of the Department of Neurosurgery at the University Hospital in St.Freiburg, the most significant joy in the treatment of CSF loss syndrome is the final moment – when the patient’s long suffering comes to an end and the headache that sometimes haunted him for years goes away.
– We often hear that even young and active people suffer from headaches. What are the reasons for this phenomenon?
– Headache most often manifests itself in the form of migraine, however, it is often caused by overexertion. Young people most often suffer from just such pain.However, a few years ago we learned that a form of headache occurs as a result of loss of cerebrospinal fluid (CSF). It is from her that young, dynamic, able-bodied people often suffer.
– CSF Loss Syndrome – what is this disease? What are her symptoms?
– With loss of cerebrospinal fluid, the headache occurs when the patient is in an upright position – in other words, stands. This pain is severe, pulling, tearing and often radiates to the occipital region.Sometimes it is accompanied by tinnitus or eye pain. As soon as the patient takes a horizontal position, the pain instantly subside. This is a characteristic feature of the disease. These pains come on suddenly and are different from an overexertion headache or migraine. Most people remember exactly the day this pain started.
– Is it a rare disease or does a lot of people suffer from it?
– According to scientific research, about 5 people per 100 thousand suffer from it.citizens. That is, the disease is considered quite rare. However, since it is little known, and the correct diagnosis is not always made, this figure is definitely greatly underestimated. Young, able-bodied people aged 30 to 50 are more likely to get sick. The disease occurs in both men and women, but based on our experience and observations, CSF loss syndrome occurs in women twice as often as in men.
– What is the cause of CSF Loss Syndrome?
– In recent years, there have been studies in which we also took part.Studies have shown that the cause of the disease is a small hole in the dura in the spine through which cerebrospinal fluid leaks. When a person gets up, the brain sinks somewhat due to a lack of cerebrospinal fluid, and this terrible headache arises.
– How does this hole appear?
– In the course of the aforementioned studies, it was discovered that the cause is a tiny calcareous spur formed in the dura mater, which under certain circumstances pierces it like a miniature dagger.The result is an opening through which cerebrospinal fluid flows out of the spine.
– How is CSF Loss Syndrome diagnosed?
– At first, you need to listen carefully to the patient’s complaints in order to recognize the nature of his headaches. Almost always, with a loss of cerebrospinal fluid, the patient says that a severe headache appears when he is standing, and in the lying position he gets better. It is at this point that you need to pay special attention.
In addition, now there is a special hardware diagnostics, which also helps to make the diagnosis correctly. First of all, it is necessary to do an MRI of the patient’s head and back.
We, the specialists of the Freiburg clinic, are looking for this very small hole in the dura mater in the spine. Specially trained, qualified doctors perform myelography, CT myelography, infusion test, and ultrasound. To successfully conduct such special studies, doctors, of course, need to have experience and skills, and the specialists of our clinic have them.
– What are the difficulties in making a diagnosis?
– This diagnosis is still frequently overlooked in many clinics that have little experience with CSF Loss Syndrome. However, it is not the diagnosis, but the treatment of this disease that requires even more experience.
– How is CSF Loss Syndrome treated in your clinic?
– The first stage of treatment of the syndrome is the imposition of the so-called epidural blood patch.This procedure is carried out in our clinic by invasive neuroradiologists. The application of such a patch is carried out very often, and thanks to the high level of experts from the department of neuroradiology, in particular Professor Urbach, this, as a rule, is enough for a complete cure.
However, if one or more of the blood patches fails, surgery may be necessary. An experienced neurosurgeon is needed to perform this type of intervention. There are few centers with extensive experience in conducting such operations.In Europe, these are Freiburg in Germany and Bern in Switzerland. Freiburg neurosurgeons have developed highly accurate, patient-specific surgical procedures for the treatment of CSF leakage with access from the dorsal side (i.e. from the back). With the help of an operating microscope, we can precisely close this small hole. This method, Liquorlex, was developed by me personally. This approach eliminates the need for major surgeries such as vertebra replacement or surgery through the chest or abdomen.
– What difficulties can arise in the treatment of the disease?
– Difficulties mainly arise if the patient’s headaches persist after applying one or more blood patches. In such a situation, as I have already said, it is necessary to locate the CSF fistula as accurately as possible and to perform an operation. The hardest question is where is this little hole. After all, it is only 3-7 mm in size.
– How long does the patient need to stay in the hospital?
– I would distinguish two stages: the first is the stage of diagnosis and blood patching, it lasts two to three days.The second stage, if the complaints persist and the patient cannot get rid of a severe headache, usually lasts from five to seven days, including surgery.
– What is the success rate for surgical treatment?
– If we have advanced so far that we could find a hole in the dura mater, then the probability that the headaches will disappear after the operation is 90%. This is a very high cure rate.
– Can complications arise after treatment?
– Complications, of course, as with any surgical intervention, may arise.But, fortunately, such cases are very rare. We have had no cases of long-term neurological complications.
In the first days, headaches may appear due to severe pressure, especially in cases where the disease lasted several weeks, months or even years. The body needs to adapt first. But the improvement comes very quickly.
– How quickly do patients recover from surgery and how soon can they return to their daily activities?
– The majority of patients, fortunately, recover very quickly, and this is very gratifying.Among other things, it depends on how long the patients suffered from the headache. If the disease has not been identified for a long time, then the recovery lasts longer. If we managed to diagnose the disease in the first three months and start treatment, then we almost always discharge patients completely healthy.
– There must have been an unusual incident in your practice. Tell us.
– I am reminded of a young woman, a physician by profession, who suffered from these sudden headaches while standing upright.She was treated for months in different clinics, but no one could help her. Diagnostic difficulties resulted in the patient developing symptoms of depression. She lost her job. In such cases, frustration appears, incorrect diagnoses are made. The doctors and the patient begin to doubt themselves. These are very emotional moments. The patient falls out of normal life. In the end, we still managed to find the exact location of this CSF fistula and, with the help of a small, targeted operation, close the opening.And the end of this obsession has come! After the patient’s long suffering, it was a great joy for her and for us. And also a great example of a successful cure.
Unfortunately, we often witness similar stories with which patients from different parts of Europe come to us.
Photo: Courtesy of Universitatsklinikum Freiburg
– In case of headache, exactly in the standing position, where and how should the patient be examined?
– First of all, you need to contact neurology or for advice about a headache.That is, you need to understand its causes. In order to prescribe treatment, it is important to understand whether the cause is migraine or CSF loss syndrome.
Patients can contact us via our website www.ims.uniklinik-freiburg.de or write to the clinic’s email address [email protected]
– What advice can you give to patients?
– Try to find the right cause of the headache, do not lose courage and perseverance. And all the best!
Interviewed by Olesya Oschepkova
* Contraindications are possible, specialist consultation is required
University HospitalFreiburg is one of the largest medical institutions in the world. It was founded on the basis of the Faculty of Medicine of the Albert and Ludwig University of Freiburg, which celebrated its 560th anniversary in 2017. The university clinic includes numerous departments, institutes and centers, employing about 13 thousand employees. Over the years, many outstanding doctors worked and taught in it, some of them became Nobel Prize winners. About 92 thousand people undergo treatment here every year.inpatients and 880 thousand outpatients. The clinic is one of the three largest in Germany.
The Department of General Neurosurgery at the University Hospital Freiburg is one of the most respected centers in Germany. Patients are offered a wide selection of the latest diagnostic and treatment methods. The specialists of the department have developed algorithms for the treatment of various diseases. Including nervous diseases, spine, brain and spinal cord. The operating departments are equipped with high-class equipment, including neuronavigation, their own intensive care unit and eight hospitals.In addition to providing medical care and conducting scientific research, the team pays special attention to training young doctors. This is why the European Society for Neurosurgery has awarded the Freiburg neurosurgery department the title of Training Center of Excellence.
90,000 Pain in the crown of the head, pain in the parietal part of the head, causes of pain
Depending on the cause, the headache can be localized in a specific area or cover the entire head.The nature of sensations can also be different, as well as their frequency. One of the most debilitating is the headache in the crown of the head. The crown is the part of the surface of the head located between the back of the head and the forehead, that is, from above.
It is worth noting that no one is insured against headaches in the region of the crown. It can even appear in a child. If the crown hurts, then the nature of the pain may be different. There may be a squeezing sensation, bursting from the inside, sometimes even a tingling sensation.Often, pain symptoms can be pulsating or radiate to the ears or optic nerve.
The reasons why the parietal part of the head hurts can be very different. Increased intracranial pressure is considered the most common, but it is not the only one.
Causes of pain in the parietal part of the head
As already mentioned, the causes of headache in the region of the crown can be different, but some of them are more common and have similar manifestations.
Pain in the vertex due to exertion
If the crown of the head hurts, then the reason may lie in the tension that occurs due to a long stay in an uncomfortable position, without the necessary movement and with insufficient lighting. Occupational pain in the crown of the head occurs due to the fact that the workplace does not meet ergonomic standards.
Painful sensations have a dull, oppressive, compressive character. With them, it feels like a tight helmet is put on your head.
Pain in the vertex due to neuroses
More than 50% of complaints of pain in the parietal region belong to patients with neuroses. They can be either permanent or periodic, differ in intensity and are accompanied by:
90,023 90,024 panic attacks;
If the pain symptoms are complemented by dizziness and numbness of the arms and legs, it is necessary to urgently seek medical help.
Pain in the vertex after trauma
Even minor craniocerebral trauma can cause pain in the crown of the head. It can be caused by the following:
- violation of the movement of cerebrospinal fluid;
- pinched nerve roots;
- damage to the meninges.
“Companions” of pain symptoms in this case are:
- decreased performance;
- memory impairment;
- Difficulty concentrating
Pain in the vertex due to vascular diseases
Diseases such as hyper- and hypotension, vegetative-vascular dystonia are also factors leading to the appearance of pain in the vertex.Due to the increased or decreased vascular tone, they are not able to provide the required blood pressure, which leads to spasms or compression of nerve cells.
More about vegetative-vascular dystonia
Do not postpone a visit to a specialist if, along with severe pain in the vertex, the following clinical manifestations are observed:
- increased pain;
- deterioration in general health;
- memory disorder;
- nausea, vomiting.
90,024 visual impairment;
90,024 increase in overall temperature;
You can contact the CELT clinic, and our specialists will help you get rid of not only pain, but also the reasons that caused them.
In order to determine the cause of pain, our specialists carry out:
If necessary, an examination by an ophthalmologist or surgeon can be ordered.
Analgesics are one of the most effective remedies for headache control.However, do not forget that they do not eliminate the main cause that caused such a reaction, but only eliminate clinical manifestations, and after a while the pain will again remind of itself.
90,000 Modern local anesthetics in anesthesiology
Local anesthetic toxicity
Toxicity of local anesthetics can cause complications , with the most affected cardiovascular and central nervous system . Today the frequency of systemic toxic reactions with epidural anesthesia is 1: 10000, with blockade of peripheral nerve plexuses – 1: 1000. Basic systemic toxic effects local anesthetics manifest as negative effects on the heart (blockade of the atrioventricular node, arrhythmias, myocardial depression, cardiac arrest) and the brain (agitation, depression of consciousness, convulsions, coma). Hypoxemia and acidosis increase the toxicity of local anesthetics.It should be noted that resuscitation after an overdose of bupivacaine can be difficult, therefore, intravascular administration of drugs and even more overdose of local anesthetics should be avoided. Nerve blocks should be performed slowly with fractional administration of local anesthetics.
Clinic for systemic toxicity of local anesthetics may be mild , which is manifested by tingling, itching, numbness in the lips and tongue, tinnitus, metallic taste in the mouth, anxiety, tremors, fear, muscle fasciculation , vomiting, disorientation. With moderate severity , speech impairment, numbness, nausea, vomiting, dizziness, drowsiness, confusion, tremors, motor agitation, tonic-clonic convulsions, wide pupils, rapid breathing are noted. In severe intoxication – vomiting, sphincter paralysis, decreased muscle tone, loss of consciousness, periodic breathing, respiratory arrest, coma, death.
Central nervous system toxicity of local anesthetics
Local anesthetics can inhibit various receptors, increasing the release of glutamate and thereby suppressing the activity of some intracellular signaling pathways. Systemic administration of local anesthetics may affect the functioning of the heart muscle, skeletal muscle and smooth muscle tissue. The transmission of impulses can change not only in the central and peripheral nervous systems, but also in the conducting system of the heart. Local application of local anesthetics, their injection near peripheral nerves or main nerve trunks, as well as injection into the epidural or subarachnoid space lead to loss of sensitivity in various parts of the body. Toxic reactions can be not only local, but also systemic, which usually occur with accidental intravascular or intrathecal injection, as well as with the introduction of an excessive dose. Moreover, specific side effects may develop with the use of certain drugs, such as allergic reactions to amino ester anesthetics. Convulsions caused by inadvertent intravenous administration of a local anesthetic can be relieved by intravenous administration of a small dose of benzodiazepines (eg midazolam) or thiopental. High spinal or epidural block can lead to severe arterial hypotension. The review of lawsuits from patients with perioperative cardiac arrest confirmed reports of cardiac arrest in relatively healthy patients undergoing spinal or epidural anesthesia. These cases were associated with high block rates as well as overuse of sedatives. Cessation of blood circulation occurred after a period of hypotension and bradycardia; at the same time, there was often a delay in the recognition of a threatening condition, untimely respiratory support (especially in sedated patients), a delay in the use of direct adrenergic agonists, such as adrenaline.
Cardiovascular toxicity of local anesthetics
All local anesthetics, but especially bupivacaine , can lead to rapid and profound suppression of the function of the cardiovascular system. Cardiotoxic effects bupivacaine differ from lidocaine as follows:
- The ratio of the dose that causes irreversible acute cardiovascular failure to the dose that has a toxic effect on the central nervous system (convulsions) is lower for bupivacaine than for lidocaine;
- Ventricular arrhythmias and fatal ventricular fibrillation occur much more frequently after rapid intravenous high-dose bupivacaine than lidocaine;
- Pregnant women are more sensitive to cardiotoxic effects.In the United States, a 0.75% bupivacaine solution is banned for use in obstetric anesthesiology;
- Cardiopulmonary resuscitation is obstructed by bupivacaine-induced cardiac arrest, and acidosis and hypoxia further increase the cardiotoxicity of bupivacaine.
Treatment of complications of local anesthesia
Treatment of complications of local anesthesia is carried out immediately! Cardiopulmonary resuscitation after high-dose intravenous local anesthetic should include the following:
- There are no drugs , that improve outcome in cardiac arrest or severe ventricular tachycardia after bupivacaine administration (except for Intralipid recommendations).It should focus on the basic principles of cardiopulmonary resuscitation, which should include airway management, oxygenation and ventilation of the lungs and, if necessary, cardiac massage;
- In view of the fact that resuscitation in case of cardiac arrest caused by local anesthetics is difficult, measures aimed at n and prevention of intravenous administration of these drugs are of decisive importance ;
- Lack of blood in the syringe does not always preclude intravascular placement of the needle or catheter . Fractional administration of local anesthetics should be the rule , followed in all patients undergoing regional blockade. ECG changes are often precursors of circulatory arrest, therefore, careful observation of ECG changes (changes in QRS, heart rate, rhythm, extrasystoles) may allow the injection of the drug to be stopped before a lethal dose is administered;
- If a patient develops a pronounced depression of the cardiovascular system after the administration of bupivacaine, ropivacaine or other local anesthetics, in parallel with the protocol of cardiopulmonary resuscitation, it is recommended to use intralipid:
- A 20% fat emulsion solution is injected intravenously in a bolus over one minute at a dose of 1.5 ml / kg (100 ml for a patient weighing 70 kg).
- Then the intravenous infusion of a 20% fat emulsion solution is continued at a rate of 0.25 ml / kg × min.
- Continue resuscitation measures, including chest compressions to ensure the circulation of the fat emulsion in the vascular bed.
- Repeat a bolus injection of a 20% fat emulsion solution at a dose of up to 3 mg / kg every 3-5 minutes until the heart is fully restored.
- Continue continuous intravenous infusion of fat emulsion until hemodynamic stabilization is complete.If hypotension persists, increase the infusion rate to 0.5 ml / kg / min.
- The maximum recommended dose of a 20% fat emulsion solution is 8 ml / kg.
The main mechanisms of action of lipid emulsion in systemic toxicity of local anesthetics is the binding of anesthetic (intravascular) with metabolic (intracellular) and membrane (sodium) channels. Selection of a specific lipid emulsion (intralipid, liposin, lipofundin, celepid, etc.) as an antidote has no significant value, since there are no proven advantages of some fat emulsions over others.
90,000 Ice Discord Archipelago: Spitz and Bergen Now Writing Separately – Articles – Armies and War
In ancient times, the vast polar archipelago of Svalbard, the discovery of which in 1596 is attributed to the Dutch explorer and navigator Willem Barents , who called the islands “sharp mountains” (previously Russian Pomors settled there), had an exclusively economic character.There bowhead whales were hunted, from which blubber was extracted – the fat for lighting lamps. Then they discovered coal, potential deposits of other minerals, including gold.
The current importance of Svalbard, shared by Norway and Russia, is largely military in nature. The very geographical location of the islands allows you to control shipping and air traffic in the Arctic Ocean. In fact, it is a kind of gateway to the Arctic. On condition only that the necessary military infrastructure will be located here – naval bases, airfields, radar and hydroacoustic stations.Back in Soviet times, Moscow made attempts to negotiate the deployment of military bases on Svalbard, but was refused – the archipelago remained a demilitarized zone. There are no Russian military there, but Norway, a NATO member country, has intensified its activity in this region, which worried the Russian Foreign Ministry.
The reason was the recent call at the port of Longyearbyen on Spitsberg by the Norwegian naval frigate Thor Heyerdahl, which was perceived in Moscow as the next step of Oslo in a series of successive actions to include this territory in the sphere of national military development.”Such a demonstration of military force raises serious concern as inconsistent with the spirit of the 1920 Svalbard Treaty, which defined the purely peaceful status of the use of this archipelago, and also contradicts the Oslo declared goal of maintaining low tension in high latitudes,” said Russian Foreign Ministry spokesman Maria Zakharova .
She also recalled such decisions of the Norwegian side, such as the extension to Svalbard of the Norwegian Law on Ports and Fairways, which implies the use of the archipelago’s infrastructure in the military planning of the defense of Norway, including the reception of reinforcements from NATO allies.As noted by Zakharova, together with the Svalsat ground satellite tracking station operating in the archipelago, technically equipped to perform dual-purpose tasks, the practice of using the Longyear airport by Norwegian military transport aircraft, patrolling the waters of Svalbard by coast guard ships, indicates an increase militarization by the Norwegian side.
Note that so far the Minister of Defense of Russia has kept silent Sergei Shoigu , who has something to say about both the Russian and NATO presence in the Arctic region, which is being actively developed by the Armed Forces of the Russian Federation.”Main caliber guns” are still silent. So what will happen to Svalbard, the name of which should already be written separately – Spitz and Bergen?
– Only one bibliography on the topic “Grumant / Svalbard / Svalbard” has several thousand titles of books and articles in different languages: from “A” – “Arctic Archipelago of Svalbard” to “Z” – “Yagel on Svalbard,” says historian and political scientist Alexander Zimovsky . – Therefore, it is proposed to follow a simple logical path. The historical centuries-old presence of Russian pomors at
Grumant / Svalbard and their development of the archipelago has been proven by archaeological research.The archipelago has 75 places where archaeologists, both ours and Norwegian, have discovered 75 large settlements of the Pomors; we are, of course, talking about their archaeological traces, artifacts, remnants of buildings and the presence of a tangible cultural layer. In total, taking into account individual finds and burials, there are about four hundred such places associated with the Russian Pomors. For Russians, Svalbard has been their own for many centuries. That is why the archipelago has such a unique legal regime. With our indispensable participation and our, of course, interests.
Now, according to the already familiar practice, we will look at the sailing and see that the calendar of ice conditions around Svalbard gives us a period of clear water off the western coast of the archipelago from June to November. In December, the coastal strip is finally blocked by impassable ice, which begins to free the passage for ships and vessels not earlier than May. The polar night lasts 112 days on Svalbard.
This short period is used by the Norwegian Navy to call warships at Svalbard / Svalbard.
Such visits are made annually. At the same time, the Norwegians:
a) do not inform Russia, at least not this year for sure;
b) declare that the 1920 Treaty, to which our Foreign Ministry just referred, I quote, “grants Norway full and unlimited sovereignty over Svalbard.”
For us, this is “the organization of the visit of the Norwegian warship to Svalbard.” For the Norwegians, “the entry of a Norwegian warship into a Norwegian port in the territorial waters of the kingdom.”
The military significance, or, more precisely, the meaning of the development of Svalbard for military purposes, today, like 80 years ago, is seen in the control of the meteorological / climatic situation. You can learn about how the naval war for Svalbard in 1940-1945 was going on by reading about the raid of the German battleship “Tirpitz” at the head of a rather large squadron on Svalbard (Unternehmen Zitronella), about the English Operation Fritham, and about the fact that the Germans on Svalbard they surrendered only in September 1945.The Germans were just engaged in meteorological support for the actions of the German fleet, mainly submarine forces.
Today, the technical capabilities of meteorologists have increased many times over, but still these achievements pale in comparison to the capabilities of reconnaissance and tracking equipment installed at the right time in the right place. Even during the years of the USSR Northern Fleet’s domination in the Arctic seas and the North Atlantic, few gave our ships as much headache as the Norwegian electronic reconnaissance ship “Maryata”.Today, the Norwegians are using the fourth generation of this series of ocean-going ships-complexes of global naval espionage. In combination with a hypothetical stationary long-range electronic reconnaissance site in Svalbard, this could seriously affect the planning and conduct of Russia’s naval operations in the Arctic region.
There is an obstacle – Article 9 of the 1920 Svalbard Treaty. According to it, Norway undertakes not to create or allow the creation of any naval base and not to build any fortifications in the specified areas (between 10 and 35 degrees east longitude from Greenwich and between 74 and 81 degrees north latitude), which should never be used in military purposes.But what is considered a “base” and what is “strengthening” is already a debatable question today.
And three more knots of controversy around Svalbard that should be mentioned. This is a two-hundred-mile fishery protection zone, which Norway has been expanding for a hundred years. Now we are sharing quotas with the Norwegians, agreeing at the same time what will go to third countries. The question is not idle, because since 1997 in the waters of Spitsbergen the Norwegians have been “pressing” Russian fishermen, right up to the landing of armed inspection parties on Russian trawlers and the arrest of ships.
Then the development of the continental shelf. Russia’s position is that all parties to the 1920 Treaty have equal rights. Norway’s position is that the rights to the shelf around Spitsbergen are Norwegian, and it decides who and what will develop there.
The last but not least knot on the list is access to the Svalbard waters in principle. Russia believes that all parties to the 1920 Treaty have equal access, but not including fishing. Norway believes it has the sole right to decide who has access to the waters of Svalbard.At the same time, the Norwegians insist that they can arbitrarily, without asking anyone, establish not only unequal access, but generally establish a discriminatory access regime on the basis of “like it, don’t like it, sleep, my beauty”.
Now the Russian Foreign Ministry has reacted to the Norwegian “seizure” of Spitsbergen, Moscow has sent a “signal” to Oslo through diplomatic channels. The next word is for the military. And Shoigu has something to say about this. In addition to the fleets based in the North, aviation airfields and air defense systems, the Armed Forces of the Russian Federation have also settled in remote regions of the Arctic.Military camps and airfields were built in six districts – on Alexandra Land (Franz Josef Land archipelago), in the village of Rogachevo on Novaya Zemlya, on Sredny Island (Severnaya Zemlya), on Cape Otto Shidta, on Wrangel Island and Kotelny Island (Novosibirsk Islands ). On the latter, for example, the base “Northern Clover” was erected on the permafrost, where 250 people serve (in an autonomous mode, the base can exist for 18 months), there is a station for monitoring aircraft and the “Pantsir-C1” air defense complex.
The battle for the Arctic, in which the Russian military has firmly established itself, continues – a piece, though cold, but tasty. Interest in this region is extremely high for a number of reasons, among which, first of all, one can name natural resources and control over the Northern Sea Route, which, according to Russian President Vladimir Putin, has become “a truly global, competitive transport artery.” In the last decade, Russia returned to the Arctic (it seemed that after 1991 this region was practically forgotten) and not only indicated its presence, but made it clear that, they say, “this is ours, please do not touch it with your hands.”Queue for Spitsbergen? So far, NATO has not settled there.