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Presentation on HEADACHE AND ITS PATHO-PHYSIOLOGY
- 1. HEADACHE AND ITSPATHO- PHYSIOLOGY DR. NAVYA
- 2. DEFINITION: A common symptomthat causes pain and discomfort in the head or neck region. Headache is not always related to an underlying condition. It may be caused by: • Stress • Emotional distress • Infections
- 3. There are morethan 150 types of headache. They fall into two main categories: Primary headaches: • Cluster headaches. • Migraine. • New daily persistent headaches (NDPH). • Tension headaches. Secondary headaches: • Disease of blood vessels in the brain. • Head injury. • High blood pressure (hypertension). • Infection. • Medication overuse. • Sinus congestion. • Trauma. • Tumor.
- 6. SYMPTOMS: • Excruciatingpain, generally situated in or around one eye, but may radiate to other areas of your face, head, neck and shoulders. • One-sided pain • Restlessness • Excessive tearing • Redness in your eye on the affected side • Stuffy or runny nose on the affected side • Forehead or facial sweating • Pale skin or flushing on your face • Swelling around your eye on the affected side • Drooping eyelid
- 7. SUICIDE HEADACHE: • Clusterheadache are a very specific type of headache that occurs at an exact time each day during a particular part of the year. The pain from these headache is described to be so intense that some patients become desperate for relief, thus earning them the nick name, suicide headaches. • Although the pathophysiology of cluster headaches is not well understood, researches believe that the trigeminal nerve, the hypothalamus and circadian rhythm may be involved.
- 8. TRIGRMINAL NERVE PATHWAYS: SOMATOSENSORYPATHWAY Pain in the orbital region Carried to brain by ophthalmic division of the trigeminal nerve In brainstem: the signal is organized by lower part of the spinal nucleus of trigeminal nerve Thalamus Pain is interpreted in brain Malfunction of trigeminal nerve Pain originates in the brain stem and is falsely interpreted by the brain as coming from the orbital region CAUSES
- 9. PARASYMPATHETIC PATHWAY Parasympathetic signalsare responsible for “rest and digest” behaviors such as mouth watering or slowing the heart rate. The signal that causes lacrimation originates from the facial nerve and is carried to the lacrimal gland by a branch of the trigeminal nerve. The signal for tearing dose not originate from the facial nerve, but from an unknown area of the brainstem or from the trigeminal nerve itself
- 10. HYPOTHALAMUS AND CIRCADIANRHYTHM • The hypothalamus is active during a cluster headache episode. • People who experience cluster headaches often have episodes that occur 1-3 times a day for a period of one week to several months. • This is called CLUSTER PERIOD • When not in cluster period, a patient will not experience cluster headaches. The highly cyclical nature of these headaches is somehow controlled or triggered by hypothalamus.
- 11. TENSION HEADACHE: • Atension-type headache (TTH) is generally a mild to moderate pain that's often described as feeling like a tight band around the head. Signs and symptoms of a tension-type headache include: • Dull, aching head pain • Sensation of tightness or pressure across the forehead or on the sides and back of the head • Tenderness in the scalp, neck and shoulder muscles
- 12. Tension-type headaches aredivided into two main categories. Episodic tension-type headaches • Episodic tension-type headaches can last from 30 minutes to a week. • Frequent episodic tension-type headaches occur less than 15 days a month for at least three months. • Frequent episodic tension-type headaches may become chronic. Chronic tension-type headaches • This type of tension-type headache lasts hours and may be continuous. • If your headaches occur 15 or more days a month for at least three months, they're considered chronic.
- 14. MIGRAINE HEADACHE: • Amigraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. • It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. • Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
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- 16. Triggering factors Hyper neuronalstimuli/ activity Stimulates adjourning vegetative centre VERTIGO/ IMBALANCE/ NAUSEA Stimulates autonomic centre of brain(blood flow area) Calcium influx in smooth muscles of arteries Vasospasm Cerebral hypoxia AURA AND VERTIGO Efferent neurons of 5th nuclei stimulated Release of serotonin, substance-P and neuropeptides Release and activation of prostaglandins Inflammation of extradural and extra cranial arteries HEADACHE PATHOPHYSIOLOGY OF MIGRAINE
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- 18. SINUS HEADACHE: • Sinusheadaches are headaches that may feel like an infection in the sinuses (sinusitis). You may feel pressure around the eyes, cheeks and forehead. Perhaps your head throbs.
- 19. • Pain inthe forehead may be a frontal or ethmoid sinus problem or a muscle contraction tension headache • Pain in the maxillary sinus may be located over the maxillary sinus or radiate to the canine teeth and into the temporal region.
- 20. • Ethmoid sinusitiscan produce pain most often in the medial canthal area, but also the pain can extend into the parietal and temporal areas and into the upper cervical area.
- 21. • Sphenoid sinusitiswill generally produce a retro-orbital headache, but it can extend to the temporal area, vertex, occiput, and even into the shoulder and canine teeth
- 22. HYPERTENSION HEADACHE: • Thepain caused by hypertension headaches may range from mild to severe depending on how high a person’s blood pressure is at the onset of the headache. • The headache itself is caused by a phenomenon called AUTOREGULATION. • This process allows the body to determine and control its own blood supply. • When a person’s blood pressure is elevated, autoregulation causes the blood vessels running through the tissue under the skull to constrict which is a common cause of headaches.
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