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Diagnostic presentation Headache United States University Introduction Headache is the most common pain in the united states. Headache means pain or discomfort in the head, face, or neck. Headache can be caused by inflammation or spasm related to cranial vessels, nerves, or muscles Headache can be primary or secondary. (Dlugasch & Story, 2021) Classification of headache Primary headache Most common, not a symptom of underlying an underlying disease Benign Can be recurrent It mainly occurs early in an individual Decrease after ages 40 to 50 Migraine Tension-type headache Trigeminal autonomic cephalgia Other primary headache disorders (Rizzoli & Mullally, 2018). Secondary headache Caused by an underlying condition Trauma or injury to the head or neck Cranial or cervical vascular disease Nonvascular intracranial disorder A substance or its withdrawal Infection Affliction of homeostasis Illness of the skull, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cervical structure Psychiatric disorder (Rizzoli & Mullally, 2018). The red flag of headache If an older patient complaint of New headache Abnormal neurologic examination such as mental status changes and papilledema If there is any New change in the headache pattern Intensifying headache New headache if in case of HIV risk factors, cancer, or an immunocompromised status Systemic illness signs (e.g., fever, stiff neck, rash) If precipitate by cough, exertion, Valsalva maneuver If the Headache in pregnancy or postpartum period If a patient says it is the First or worst headache of my life (Rizzoli & Mullally, 2018). Pathophysiology of headache Stimulation of primary nociceptors Lesions in the pain-producing pathway of PNS and CNS Pain producing structure Scalp Middle meningeal artery Dural sinuses Flax cerebri Proximal segment of the large pial arteries (Dlugasch & Story, 2020) Pathophysiology of headache continue There are no nociceptors in the brain parenchyma So the pain originates from surrounding structures, such as blood vessels, meninges, muscle fibers, facial structures, and cranial or spinal nerves. Any stretching, dilatation, constriction, or any nociceptor when they stimulate stimulation structures can cause the perception of headache. The secondary headache depends on the cause and diseases ( Rosenthal & Burchum, 2021) migraine headache Migraine headache is a headache associated with systemic complaints. The person feels a severe throbbing pain or a pulsing sensation, usually on one side of the head, along with nausea, vomiting, and extreme sensitivity to light and sound. The attacks can last for hours to days, and the pain can be severe that it interferes with daily activities (Dlugasch & Story, 2020). Triggers to migraine headache Emotional stress Hormonal change during menstruation Alcohol intake Change in weather Odors Disturbance in sleep or not getting enough sleep migraine heada ...
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