What research when you often have a headache. Headache: diagnosis and treatment

To confirm the diagnosis of primary headache, it is not necessary to detect any changes during examination. This does not mean at all that the headache is “not real” or has no cause. The simple fact is that headaches in most cases are a paroxysmal (occurring periodically for a short time) condition. Therefore, usually when a patient comes to the doctor (outside the attack period), upon examination, nothing except some tension in the pericranial muscles or a slight increase in reflexes can be detected (see reasons for more details). However, a general and neurological examination is mandatory to exclude secondary, sometimes dangerous reasons headache.

Naturally, each doctor has his own diagnostic techniques that he uses to examine the patient. However, there are a number of parameters that you should definitely pay attention to. As an example, we present the examination protocol adopted at the Center (treatment/Center) for Headache at the Department of Nervous Diseases of the Faculty of Medical Sciences of the Faculty of Medical Sciences named after I.M. Sechenov (head of the department, Professor V.L. Golubev).

Pulse, blood pressure and, in some cases, respiratory rate and temperature.
Head size and shape.
Changes in the eyes, including increased intraocular pressure (typical of glaucoma).
The condition of the temporomandibular joint - is there pain, are movements difficult, are there any clicks or unpleasant sensations when opening the mouth.
Scalp, neck, shoulders, spine - pay attention primarily to muscle tension.
Whiskey - the state of the temporal artery (does it protrude, is there swelling), is there pain or tension in this area.
Arteries of the neck - the doctor listens to see if there is any noise in them and feels the pulsation.
The thyroid gland - by feeling it (located on the front surface of the neck), determine if there is an enlargement of the gland.
Cranial nerves - their function is very important to evaluate in order to exclude organic causes of headache (i.e. structural, not biochemical disorders).
Sensitivity - the sensitivity of the skin (over the whole body) to irritants such as cold, pin prick, vibration.
Muscles - tone and strength; It is especially important to notice muscle tremors (may occur with hyperthyroidism, Parkinson's disease, multiple sclerosis, anxiety, and also as a side effect of certain medications).
The cerebellum is the part of the brain located at the back. The safety of its functions is assessed, the main of which is coordination of movements. For example, one of the tests is to close your eyes and get index finger an outstretched arm to the nose.
Reflexes, including pupillary (reaction to light, etc.) and tendon (for example, knee).
Mental condition- signs of depression and anxiety, including anxiety attacks and intrusive thoughts. With post-traumatic headache, there is an inability to concentrate and memory impairment.

In addition to searching for the cause of the headache, a general examination of patients is necessary to diagnose other diseases (bronchial asthma, hypertension, ischemic disease hearts, etc.). Information about concomitant diseases is important, if only because when choosing a method of treating headaches, you need to take into account what medications the patient is already taking. In addition, some medications may be contraindicated for the listed pathologies.

The first question that a neurologist faces when a patient comes to him is what kind of pain is he dealing with? - from the secondary or from the primary (in that order). And first of all, it is important to exclude such serious causes of headache development as a tumor process, inflammatory changes, and vascular disorders.

In the arsenal modern medicine There is a wide variety of research methods nervous system, evaluation of her work anywhere and at any level.

In addition to the instrumental examination, during the examination the neurologist examines facial expressions, eye movements, muscle function, range of motion, muscle strength and tone, and the ability for normal coordination of movements.

The information obtained during the examination helps to determine the primary or secondary nature of the headache, confirm the diagnosis, and identify contraindications to the prescription of certain medications.

It should be borne in mind that at the first consultation with a specialist, a lot will depend on the patient. The patient, if possible, needs to formulate his complaints as detailed and accurately as possible and tell the history of the disease, as well as answer some questions.

In particular, it will be important for the doctor to find out the age of the patient, when the headache appeared, heredity, the course of the disease (attack-like or non-attack-like headache, etc.), the frequency of attacks and episodes of headache at the beginning of its onset and in subsequent years, is there a connection between the increase in attacks and external circumstances, the time of attacks during the day, the duration of attacks of pain, the “pattern” of pain (localization, irradiation, the nature of the painful sensation, intensity).

To make their story more specific, the patient can prepare a written description of the headache in advance on a sheet and take it with them to the doctor. You can make notes about the nature of your pain immediately after a painful attack. This will help the doctor make a more accurate diagnosis. After all, the assessment of a headache directly depends on the psycho-emotional state of a person. And over time and under the influence of external circumstances, the description of pain may differ from reality.

Dopplerography

Dopplerography is one of the main examination methods in neurological practice, thanks to which the work of blood vessels is assessed.

Encephalography

An electroencephalogram, or EEG for short, records through an intact skin covering skull activity of a huge number of neurons in the brain.

Magnetic resonance imaging of the brain

Magnetic resonance imaging (MRI) provides images of the brain and spine in various planes and with a high degree of resolution.

Blood tests - why take them?

In a comprehensive examination of the patient and identifying the causes of headaches, various blood tests may be prescribed. Headache may be a sign of some infectious diseases. Blood tests can reveal signs of infection and inflammation. In particular, a general blood test shows the number of leukocytes. They protect the body from viruses and infections.

If your head hurts several times a week, this is already a reason to consult a doctor. So, let's look at the main causes of headaches and the specialists you should contact.

The first doctor you should visit is a general practitioner. He will conduct an initial examination and give directions for tests.

Headache due to overwork

It’s as if your head is being squeezed by a hoop. The pain is monotonous and seems to be spread all over the head. With chronic fatigue, your head will hurt more than 15 days a month for several months.

First aid:, breathing exercises, hot bath with aromatic oils and salt. For severe pain, it is recommended to place a wrung-out hot towel on your forehead. Drink freshly brewed green tea and get more sleep.

Headache "due to blood vessels"

The pain is intense. My head feels like it's splitting. There is a strong knocking in the temples. I want to lie down and not get out of bed. The face may become puffy. One of the signs of problems with the vascular system is the onset of a headache during sudden weather changes and a few days before menstruation.

First aid: for intense pain - wet compresses. If the face turns red during an attack, use a hot compress, if it turns pale - a cold one.

Traditional medicine advises drinking herbal preparations based on hawthorn, lemon balm and cudweed. Smoking and drinking coffee are strictly not recommended.

Migraine headache

Very hard to bear. As a rule, only one half of the head hurts, but migraines can be accompanied by nausea and vomiting. In acute attacks, loss of consciousness is possible.

The pain may last from several hours to several days. Migraines are more common in women than in men, and this may be due to the hormonal background.

First aid: do not waste time on self-medication, rather go to a therapist (and do not be alarmed if he gives a referral to a psychotherapist, this is a feature of the disease).

Tablets, teas and cold compresses are ineffective for migraines. It is important not to aggravate existing pain. Try to create silence. Dim the lights. Take a warm bath with essential oils lavender, lemon, mint.

Headache due to poisoning

Intoxication of the body often leads not only to disorder digestive system, but also to headaches. The pain will continue until the toxins are eliminated from the body.

But, paradoxically, it may also be due to a lack of toxins. Those who use nicotine, alcohol, caffeine and other substances that are not the most beneficial for the body know well that without receiving a “dose”, the body begins to “be capricious”.

First aid: in case of poisoning, consult a doctor. Gastric lavage followed by diet may be required. For headaches that accompany a lack of a particular substance in the body, only time will help if the decision is made not to return to bad habit. To relieve pain, you can drink green tea and give yourself a head massage.

Which doctors will help with headaches?

For severe and frequent headaches, first consult a therapist. Next, be prepared for the fact that you will have to undergo an examination, take tests and visit one of the specialized specialists.

Content

Cephalgia, or headache, is a pathological condition that has various causes and is often a symptom of serious diseases. If it is temporary, you can limit yourself to taking analgesics to get rid of suffering. Pain that occurs constantly indicates the presence of pathology and requires treatment.

What is a headache

This pathological condition, familiar to every person, arises as a reaction of the body to physiological or psychophysiological changes occurring in it. The pathological condition is associated with one of three physiological disorders:

irritation of nerve fibers in bone tissue and skull;
violation of the tone of the cerebral vessels of the head, caused by changes blood pressure;
damage to the muscles of the skull and neck.

Signs

Any signs of cephalalgia are behavioral characteristics of a person suffering from this condition. Infants, deaf-mutes, and sick elderly people are unable to explain what is bothering them. Signs of cephalalgia are:

crying, moaning;
frequent blinking, squinting of eyes;
pressing with palms, fingers on the bridge of the nose, back of the head, crown, eyebrows, temples;
unreasonable rotation of the head or neck;
unusual facial expressions.

Symptoms

Cephalgia can be clearly localized (when a person is able to say exactly where he has unpleasant sensations), or it can “radiate” to other parts of the body, and then the patient says that his “eyes hurt”, “his temples ache”, “ puts pressure on the neck,” etc. The following symptoms of cephalalgia are distinguished:

a feeling of tightness in the head and neck area;
painful reaction to light;
temperature increase;
dizziness;
cardiopalmus;
visual disturbances, attacks of blurred vision;
nausea, vomiting.

Causes of headaches

Head pain occurs for the following reasons:

excessive consumption of alcohol, coffee or smoking - caffeine and nicotine cause vascular spasms and impaired blood circulation in the brain;
chronic stress, depression and psychosomatic disorders (phobias, nervousness);
respiratory tract infections, internal organs;
poisoning with chemicals, harmful gases;
excessive physical activity, head and neck injuries;
damage or curvature of the spine;
diseases of the cardiovascular system, previous strokes;
osteochondrosis cervical spine spine, radiculitis.

Severe headaches

Often severe sharp pains, accompanied by nausea, fever and a feeling of “pressure” on the eyes, often indicate the onset of meningitis - inflammation of the membranes of the brain. Periodically occurring radial pain radiating to the temples is a common symptom of migraine. The disease is accompanied by dizziness, vomiting, and temporary loss of vision. The nature of the pain is unilateral and intensifies with sudden movements. The pathology of migraine is unknown, but young women are most susceptible to this disease.

Headache often

Hypotension, a disease characterized by low pressure in the arterial vessels, is almost always accompanied by periodic cephalgia, which occurs early in the morning or in the evenings after a working day. The pain is localized temporally, has a pulsating or aching character and goes away after eating, a cup of black tea, rest, and healthy sleep.

It is necessary to conduct laboratory tests and examinations if cephalgia occurs during the day, does not go away for a long time, affects vision, or is dull and permanent. These symptoms may indicate:

hormonal disorders;
metabolic problems;
inflammatory processes in internal organs;
development of malignant intracranial tumors.

Aching headache

With increased pressure, a long-lasting aching pain occurs in the back of the head. To relieve discomfort, it is recommended to take a pain reliever, go out into the fresh air or open a window. Aching frontal cephalgia can be the result of complications of tonsillitis, otitis, sinusitis (see video at the end of the article). In this case, you should immediately consult a doctor who will prescribe antibiotics to prevent meningitis.

Bursting pain

The feeling when the head “splits”, as if something is bursting from the inside in both directions, occurs in the following pathological conditions:

Depression, nervousness. Mental imbalance affects the functioning of absolutely all body systems, including the nervous system. Cephalgia is caused by a disruption of blood flow to the brain and its normal circulation.
Strong emotional stress. In this case, pain does not appear immediately, but after a certain time after the disorder has been experienced as a protective reaction of the body - a signal for immediate rest.
Hormonal imbalances cause disturbances in blood circulation and normal regeneration. Cephalgia appears as a result of these changes.
Increased intracranial pressure, which occurs as a result of injuries, taking an uncomfortable position during sleep, squeezing the neck muscles, wearing heavy hair clips, hoops, and uncomfortable hats.
Brain tumors. Cephalgia in cancer is in most cases sharp, pulsating, but bursting pain can also occur.
Infectious diseases, intoxication resulting from inhalation of harmful substances, food poisoning, drinking alcohol (hangover).

Classification

By degree and nature pain The following types of pain are distinguished:

“Pain of tension” – has a compressive, aching character, appears after heavy physical and mental stress.
Cluster - very strong unilateral acute cephalgia. With cluster headaches, lacrimation occurs, a runny nose, the eyes turn red, and it is very difficult to tolerate this condition. Men suffer from these pains more often than women.
Migraine is also intense pain on one side of the head, but migraine, unlike cluster cephalgia, is pulsating in nature.
Burning – affects the entire area of the head, appears at the onset of multiple sclerosis, osteochondrosis. Non-localized burning may be the result of mental disorders.

What examination should you undergo for headaches?

You should start the examination by contacting a therapist, who, after listening to your complaints, will refer you to a neurologist, otolaryngologist, orthopedist, osteopath or ophthalmologist. After a general examination, a diagnosis is prescribed, the methods of which depend on the specific symptoms. The patient is prescribed:

blood test for antibodies: provides information about the presence of inflammation;
ophthalmoscopy: allows you to determine whether there are changes in the fundus;
encephalogram: performed if osteochondrosis or hypertension is suspected;
angiography: helps to track changes in the functioning of cerebral vessels;
Lumbar puncture - sampling of fluid from bone tissue: prescribed if meningitis is suspected.

MRI

Magnetic resonance imaging (MRI) is a medical examination method used to identify diseases of the central nervous, musculoskeletal, circulatory systems. Using MRI, the doctor receives a three-dimensional image of an organ or part of the body (in this case, the brain), which helps to see any changes in its functioning. The MRI procedure almost completely eliminates the possibility of an erroneous diagnosis.

The MRI is preceded by a consultation with a doctor, during which the doctor will find out whether the patient has had head injuries, what the severity of the injury was, whether there have been surgeries, and whether he has dental implants. In some cases, additional tests are prescribed. Immediately before the procedure, you need to remove all metal objects from yourself, put coins out of your pocket, remove brooches, pins, cufflinks, and remove devices that transmit data: phones, tablets, players.

Progress of the procedure:

The patient lies down, the doctor fixes his head with a special pillow.
The couch on which the patient lies is rolled into the MRI room, where the tomograph is located.
An MRI takes only 15-30 minutes. The diagnosis is painless, but for people suffering from hypersensitivity or claustrophobia, the doctor gives a sedative injection.

Treatment

The first thing the doctor does is look for the reason why the headache attack occurs. Treatment for headaches is always comprehensive. Before making a diagnosis you need:

blood and urine tests;
conducting MRI;
eyesight check;
Sometimes vascular drugs are prescribed before diagnosis.

First aid

For cluster cephalgia and migraine, it is necessary to take pain medication. Sudden attack headaches, especially if caused by overwork and stress, you can try to ease without using medicines:

open the window, ventilate the room;
relax, take a comfortable position (it is better to sit in a chair or lie down);
close your eyes;
Lightly massage your temples and eyes;
drink herbal tincture (for example, chamomile), green tea.

Medications

The use of any strong painkiller is contraindicated for liver and kidney diseases, serious disorders of the gastrointestinal tract and heart disease. Most analgesics are prohibited during pregnancy and lactation. The table below presents a list of medications that effectively relieve an attack of cephalgia:

Medicine name	Purpose
Painkillers
Citramon	General pain reliever
Sumatriptan	Exclusively for the fight against migraines
Tempalgin	For any acute pain
Anti-inflammatory
Analgin	Sharp throbbing symptomatic pain
	Aching or impulsive pain
Paracetamol	Pain accompanied by increased body temperature
Solpadeine	Paroxysmal pain

Home Remedies

If you have a headache, a cup of coffee, cocoa or tea, or a piece of dark chocolate will not hurt people with low blood pressure. Those who suffer from hypertension need to go out into the fresh air and do breathing exercises. However, it should be remembered that if attacks of cephalalgia recur regularly, you should consult a doctor.

You can treat a headache at home only when it is symptomatic and the cause is well known. Among traditional methods offer:

Relaxation: take a warm bath, turn on relaxing music, try to meditate.
Do an eye massage: lightly press your fingers on the area of the eyeballs, perform rotational movements, first in one direction, then in the other direction.
Conduct breathing exercises: Go out into the fresh air, take a deep breath, hold your breath for a few seconds, exhale slowly.

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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