title: headache during dialysis this lecture is about the headache an acute complication during dialysis. it will cover all the aspects of headache like its prevention management and causes.

1. HEADACHE
Aniqa Atta
BS: Renal Dialysis Technology
Mphil: Molecular Biology and Genetics

2. What is Headache?
Headache is a pain or discomfort in the head scalp or neck

4. Types of Headache
 Primary headache
 Secondary headache

5. Types of Headache
Primary headache
No structural or metabolic
abnormality
 Tension headache
 Migraine headache
 Cluster headache
 Hormonal headache
 Sinus headache
Secondary headache
Structural or metabolic abnormality
 S …. Systemic problems
 N….. Neurological symptoms
 O…. Onset is new
 O…. Other associated conditions
 P…. Previous headache history and
progression in progression of headache

6. Primary Headache
1. Tension headache:
 Most ubiquitous headache
 Location: Bilateral
 Character : pressure or tightness that waxes and wanes
 Duration: variable
 Associated symptoms: none
 Treatment: simple analgesics OTC drugs (paracetamol)

7. Primary Headache
2. Migraine headache:
 Disorder of recurrent attack
 Location: unilateral(70%)
 Character: gradual onset, crescendo pattern, moderate to severe in pain
 Duration: 4-72 hours roughly
 Associated symptoms: nausea, vomiting, photophobia, phono-phobia, aura
 Treatment : NSAIDS/ aspirin, antiemetic and hydration

8. Primary Headache
Aura: A sensation perceived by a patient that precedes a condition affecting the
brain
An aura often occurs before a migraine or seizure. It may consist of flashing lights, a
gleam of light, blurred vision, an odor, the feeling of a breeze, numbness, weakness,
or difficulty in speaking

9. Primary Headache
3. Cluster headache:
 Group of idiopathic headache entities and trigeminal nerve neuralgia
 Location: always unilateral (around eye)
 Character: pain begins quickly deep continuous pain, excruciating and expulsive
in quality
 Duration: 30min-3hr
 Symptoms associated: pain, Horner's syndrome, lacrimation, nasal discharge
 Treatment: subcutaneous sumatriptian, oxygen is given, triptans are
contraindicated in patients with cardio artery disease, pulmonary vascular disease
and cerebrovascular disease

10. Cluster Headache

11. Primary Headache
4. Hormonal headache:
 Low estrogen concertation
 Beginning of the menstrual cycle
 With drawl of hormonal therapy

12. Primary Headache
5. Sinusitis headache:
 Associated with sinusitis
 Supportive therapy analgesics/antipyretic OM and antibiotics

13. Pathophysiology of Primary Headache

14. Headache During Dialysis
Causes of headache:
 Occurs in 70% of patients
 Due to disequilibrium syndrome
 Coffee drinker (caffeine with drawl acutely during dialysis)
 Migraine headache
 Neurologic causes

15. Headache During Dialysis
Management of hypotension:
 Acetaminophen can be given during dialysis

16. Headache During Dialysis
Prevention:
 Decreasing dialysis solution sodium levels
 A cup of coffee
 Magnesium supplement can be given in case of hypomagnesemia( keeping in
mind the risk of magnesium in renal failure patients)