Headache

Headache is a symptom. In particular, sudden, intense pain can signal a serious, life-threatening illness.

Headaches are divided into:


 * primary (pain is one of the manifestations of non-life-threatening, chronic, paroxysmal disease);
 * secondary (arises as a symptom of another disease).

The most important task in examining a patient with a headache is to identify severe secondary headache that can be life-threatening.

It is always alarming :


 * first headache in a patient over 40 years of age;
 * sudden, intense headache;
 * gradually developing atypical headache unresponsive to conventional treatment;
 * headache in a patient with cancer or HIV infection ;
 * the presence of any focal neurological finding or impaired consciousness.

The reason for a visit to the doctor is most often a sudden or severe headache.

Personal history
We detect the presence of diseases that are accompanied by headaches. For example


 * circulatory system disorders;
 * kidney disease ;
 * general infections;
 * cancer;
 * ENT affections;
 * eye diseases;
 * teeth and jaw infections.

Differential diagnosis
In the differential diagnosis of headaches, the most important thing is careful taking of the anamnesis and neurological examination.

We are finding out:


 * cancer the nature of the pain (dull, pulsating, whipping);
 * cancer localisation of pain (hemicrania, diffuse, behind the eye);
 * cancer pain intensity and duration (seconds, hours, days, daily pain);
 * cancer frequency of pain (several times a day, monthly);
 * cancer other accompanying symptoms (phonophobia, photophobia, odorophobia, lacrimation, nasal secretion, cerebral nerve palsy, hemiparesis, cerebellar symptoms , impaired consciousness) and inducing factors (physical activity, defecation, head tilt , stress , menstruation , medication, alcohol);
 * cancer we ask about the current treatment and its effect.

Primary headaches
Primary headaches have a normal neurological finding. These include:


 * migraine ;
 * tension headaches ;
 * trigeminal autonomic cephalgia
 * cluster headache ;
 * chronic paroxysmal hemicrania ;
 * continuum hemicrania ;
 * SUNCT syndrome ;
 * headaches during sexual and physical activity.

Complications: chronic daily headache.

Secondary headaches
Headaches are often associated with other neurological symptoms. As a secondary symptom, headaches are accompanied by the following serious diseases and conditions:


 * subarachnoid hemorrhage ;
 * meningitis and meningoencephalitis ;
 * intracranial expansion ;
 * strokes, especially hemorrhagic strokes ;
 * carotid artery dissection ;
 * cerebral venous thrombosis ;
 * strokes cranial neuralgia;
 * trigeminal neuralgia ;
 * sinusitis ;
 * glaucoma attack ;
 * hypertension ;
 * intracranial hypertension
 * temporal artery ;
 * head injury ;
 * strokes stp. regime error, including alcohol excess;
 * sleep apnea syndrome (SAS);
 * cervicocranial syndrome.

Související články

 * Bolest hlavy (pediatrie)
 * Bolesti hlavy – článek pro postgraduální studium
 * Bolesti hlavy/PGS (VPL)
 * Chronická každodenní bolest hlavy