these slides are important for medical people mbbs students bds students paramedical staff and nurses as well can get knowledge regarding the topic headache

1. Somatic
Sensations:11.
Headache Sensations
DR: MUHAMMAD MUQEEM MANGI
MBBS. MPhil
Associate Professor Physiology
SULEMAN ROSHAN MEDICAL COLLEGE,
TANDO ADAM

2. LEARNING OBJECTIVES
AFTER LEARNING THESE SLIDES STUDENTS SHOULD
BE ABLE TO UNDERSTAND ABOUT THE DETAIL OF
HEADACHE
TYPES OF HEADACHE
TYPES OF REFERRED AREAS OF HEADACHE

3. HEADACHE
Headaches are a style of ache raised to the surface of the
head from deep head structures.
Some headaches result from pain stimuli arising inside the
cranium,
others arising outside the cranium, as from the nasal
sinuses.

4. Pain-Sensitive Areas in the Cranial Vault.
1. The brain themselves are totally insensitive to
Pain.
2. Rarely causes Pain on cutting or electrically
exciting the sensory areas of the cerebral cortex;
it just causes touchy types of paresthesia's on
the area of the body represented by the portion
of the sensory cortex stimulated.
3.Therefore,most of the pain of headache is not
caused by injury within the brain itself.
Headache of Intracranial
Origin

5. WHILE,
• Tugging ( Pulling or Pushing ) of venous sinuses around
the brain, Damaging the tentorium,
• Stretching the dura at the base of brain, can cause intense
headache.
• Brain operations carefully attempting in any type of
crushing traumatized injuries which causes headache.
• Neurosurgeons are alert more , when middle meningeal
artery will be damaged due to any reason , specially when
using local anesthesia

8. The cerebral vault including the upper
surface of the tentorium itself,
The cerebral portion of the Vth nerve
and, therefore, causes referred
headache to the front half of the head
in the surface areas supplied by this
somatosensory portion of the fifth
cranial nerve,
Areas of the Head to Which
Intracranial Headache Is Referred

9. Conversely, pain impulses from beneath
the tentorium enter the central nervous
system mainly through the
glossopharyngeal, vagal, and second
cervical nerves, which also supply the scalp
above, behind, and slightly below the ear.
Subtentorial pain stimuli cause “occipital
headache” referred to the posterior part of
the head.
Areas of the Head to Which Intracranial
Headache Is
Referred. (continue)

10. Areas of the Head to Which
Intracranial Headache Is Referred.
HEADACHE

12. Types of Intracranial
Headache
Headache Caused by Low
Cerebrospinal Fluid Pressure.
Just removing 20ml of fluid from the
spinal canal, particularly if the person
remains in an upright position, often
causes intense intracranial headache.
Due to reducing the flotation of the brain
that is normally provided by the
cerebrospinal fluid.
The weight of the brain stretches and
otherwise distorts the various dural
surfaces and thereby elicits the pain that
causes the headache.

13. Headache of Meningitis.
The most severe type of headaches of all
is inflammation of Meninges, due to any
reason may be including the sensitive
areas of the dura and the sensitive areas
around the venous sinuses.
Any such damage of Meninges known as
Meningitis can cause extreme headache,
pain referred in entire head.
Types of Intracranial Headache
(continue)

14. Migraine headache is a special type of
headache that may result from abnormal
vascular phenomena.
Migraine headaches often begin with various
prodromal sensations, such as
1.Nausea,
2.Loss of vision in part of the field of vision,
3.Visual aura,
4.and other types of sensory hallucinations.
Migraine
Headache.

15. Migraine
Headache.
The symptoms begin 30 minutes to1hour before the
beginning of the headache.
Any theory that explains migraine headache must
also explain the prodromal symptoms.

16. One theory
The migraine headaches is due to
prolonged emotion or tension causes (1.)
ischemia,
something happens to the vascular walls
perhaps (2.) exhaustion of smooth muscle
contraction
to allow the blood vessels to become (3.)
flaccid
and incapable of maintaining normal
(4.) vascular tone for 24 to 48 hours.

17. Other theories of the cause of migraine
headaches
Include:
Spreading cortical depression,
Psychological abnormalities.
The blood pressure in the vessels
causes them to dilate and pulsate
intensely, and the excessive
stretching of the walls of the
arteries—including some
extracranial arteries, as the
temporal artery—causes the actual
pain of migraine headaches.

18. Increase local potassium in the
cerebral extracellular fluid
may cause vasospasm .
A positive family history for
migraine genetic predisposition
headaches reported in 65 to 90% of
cases.
Migraine headaches also occur
about twice as frequently in women
as in men

19. Alcoholic Headache..
Many people have practiced, a headache often
follows excessive alcohol consumption.
because it is toxic to tissues, directly irritates
the meninges and causes the intracranial pain.
Dehydration may also play a role in the
“hang over”that follows an alcoholic binge;
hydration usually attenuates but does not
abolish headache and other symptoms of
hangover.

20. Extracranial Types of
Headache
Headache Resulting
1.From Muscle Spasm.
2.Emotional Tension
3.Intracranial lesions
4.Nasal and Accessory Nasal
Structures.
Headache Caused by Eye
Disorders.
A second type of headache that
originates in the eyes
occurs when the eyes are exposed to
excessive irradiation by light rays,
especially ultraviolet light, welder
exposing light

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