Type of headaches

type of headaches

 

We have all experienced headaches throughout our lives. Headaches can be acute or chronic. Recurrent and intermittent headaches can disable the person and interfere with his or her daily activities. It is interesting to know that the parenchymal tissue of the brain has no receptors for pain. In fact, what we feel as a headache is not the pain related to the brain parenchyma, but stimulations or damage of pain-sensitive tissues such as the meninges (layers that cover the brain and spinal cord). The stimulations and inflammations of the cerebral arteries is usually perceived by the person as a headache. What we will read:

 

Pain-sensitive tissues in the skull

what is the mechanism of pain in different headaches?

Classification of headaches

Migraine

Tension headaches

Trigeminal autonomic cephalgia

Paroxysmal hemicrania

Unilateral and short-term neuralgia attacks

Which headaches are high risk and need attention?

 

Pain-sensitive tissues in the skull:

Tissues that are sensitive to pain inside the skull include:

  • Skin and subcutaneous tissue
  • Muscles
  • The walls of the arteries
  • Periosteum of the cranial bones
  • Wall of venous sinuses
  • Parts of the bottom of the brain
  • Fifth, ninth and tenth cranial nerves and the first three roots of the cervical nerves
  • Sensitive tissues in the ears, eyes and nasal cavities

It is interesting to know that the cranial bones, brain and cerebellum tissues, etc. do not have pain receptors at all.

 

what is the mechanism of pain in different headaches?

Migraine pain:

The effect of serotonin, prostaglandins and dilation of cerebral arteries is perceived as pain.

Pain in meningitis around the brain and spinal cord:

Inflammatory reactions are responsible for causing pain.

Pain in intracranial hemorrhage:

Stretching of the receptors and their stimulation is perceived as pain.

Pain in cerebral aneurysm:

The artery inside the brain dilates locally, and this dilation causes the receptors on the vessel wall to be stretched and perceived as pain.

 

Types of headaches:

The International Association of Headaches (IHS) in its latest classification divides the types of headaches into two main categories:

Primary headaches:

Headaches are caused by changes and inflammation in the tissues around the brain and have nothing to do with conditions outside the brain. Types of primary headaches are:

Secondary headaches:

There are headaches that are secondary to an important event and secondary stimulation of pain receptors. Types of secondary headaches are:

  • secondary Headaches due to injury or trauma to the head and/or neck
  • Headaches associated with cranial or cervical vascular disorders
  • Headaches associated with intracranial non-vascular disorders
  • Headaches related to the use of materials or Withdrawal
  • Headaches associated with infections
  • Headaches associated with homeostasis disorders
  • Headaches related to disorders of the eyes, ears, nose, sinuses, teeth, etc.
  • Psychiatric disorders and diseases

The following is a brief description of each type of headaches:

 

Migraine:

Migraines are caused by changes in the arteries and blood flow to the brain, nerves and neurotransmitters such as serotonin. Migraine is a unilateral or bilateral headache. Migraines are usually throbbing. Sometimes it is accompanied by aura. Auras are symptoms that the patient feels before the onset of the headache attack. For example:

  • Visual aura: seeing light sparks
  • Sensory aura: tingling and numbness in the hands and feet
  • Linguistic aura: The patient stuttered before the onset of the headache attack 
  • Motor aura: causes paralysis of part of the body

Most migraine attacks last four to seventy-two hours, but sometimes people have migraine headaches for multiple days. Migraines are found in both sexes, but are two and a half to three times more common in women than men. Interesting to know that even infants can get migraine attacks. Finally, it is a known fact that genetics play a role in the development of migraines.

Types of migraines:

  • Migraines without aura 
  • Migraines with aura 
    • Migraines with typical aura
    • Migraines with brainstem auras
  • Hemiplegic migraines
    • Sporadic hemiplegic migraines
    • Retinal migraine
    • Chronic migraine
    • Probable (probably) migraines

The patient may also have the following syndromes during a migraine attack:

  • Gastrointestinal disorders
  • Cyclic vomiting syndrome
  • Abdominal migraine
  • Benign Paroxysmal vertigo
  • Benign Paroxysmal torticollis

 

 Tension-type headaches:

  • It is the most common type of headache.
  • It is a bilateral and compressive headache.
  • Fatigue, stress and problems in the muscles and joints of the head and neck can be the cause of the onset of tension headache. It can last from thirty minutes to a week.
  • There is no nausea and vomiting but anorexia may be accompanied by tension headaches.
  • Photophobia and phonophobia (unlike migraine) do not have a throbbing headache. The intensity of tension is low to moderate.

 

Trigeminal autonomic cephalgia:

There are three types:  

  • Cluster headache
  • Episodic cluster headache
  • Chronic cluster headache

 

 Paroxysmal hemicrania:

  • Episodic paroxysmal hemicrania
  • Chronic paroxysmal hemicranias

 

Unilateral and short-term neuralgia attacks such as:

  • Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT)

  • Short-lasting unilateral headache with cranial autonomic (SUNA)

  • Types of secondary headaches:

    • Trauma and injury to the skull
    • Increased intracranial pressure: spatial lesions like tumors as well as intracranial hemorrhage, etc. can increase intracranial pressure and stimulate pain-sensitive receptors.
    • Infections and Inflammations:
      • Meningitis
      • Brain abscess
      • Cerebral tuberculosis
    • Pseudotumor cerebri:
      • Consumption of substances and drugs
      • Material Withdrawal course
      • Temporal arthritis

 

High risk headaches:

  • High-risk headaches are headaches that start suddenly 
  • Headaches that the patient describes as having the most severe and worst headaches of his or her life (subarachnoid hemorrhage) or (rupture of cranial artery aneurysms)
  • Headaches with fever, nausea and vomiting, anorexia and neck stiffness
  • Headaches with high blood pressure (intracranial hemorrhage)
  • Headache with any degree of consciousness level fluctuation and confusion
  • Headaches with jumping vomit (tumors and other factors that increase intracranial pressure)
  • New onset of headache in a person over fifty years old who has never had a similar headache
  • Temporal headaches with tenderness in the temporal region and visual disturbances (temporal arthritis or giant cell arthritis)

In the above cases, an emergency visit to an equipped medical center is necessary!

 

 

 

 

 

 

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