Long-term recurrent headaches, and the examination is normal, so it is considered primary headache. Today I will talk about the three most common primary headaches, tension headache , migraine and cluster headache .
Your headache is probably not something cervical spondylosis , not sinusitis , and not cerebral ischemia.
Tension headache
It is the most common headache in our lives. WHO Global disease burden research speculates that in 2017, 2.33 billion people worldwide suffered from tension headaches. Each of us may have had tension headaches at a certain point in our life. The pain is generally bilateral. The pain is mild to moderate. Some people describe it as swelling, dull pain, pressure, feeling big head or tight head and neck. It is more typical to feel like "wearing a hat or neck brace".
Headache generally has little impact on daily activities, and running and jumping will not aggravate the headache. Sometimes a little activity can be relieved. Headache is generally not accompanied by nausea, vomiting, fear of light, fear of noise, etc. It is dryness, which is headache. The duration of the headache varies. half an hour shorter, and it can last for a week. Tension headache is the kind of headache we usually think is normal, so not many people with tension headache come to the hospital for treatment.
Its relevant scientific research is the least corresponding among these three types of headaches. The pathogenesis is not particularly clear. It may be related to the activation of nociceptors in the fascia of the head and neck muscles or sensitization of .
When the repeated pain signals are continuously uploaded, it will cause a sensitization of the brain center and aggravate the headache.
It is worth mentioning that the tension here mainly refers to muscle tension, not emotional tension, although emotions are indeed a cause of headaches.
migraine
migraine is also very common, second only to the nervous headache mentioned earlier. The prevalence of migraine in Chinese is 9.3%, and almost one in ten people suffers from migraine, and the prevalence rate of women is about three times that of men.
When hearing the name migraine, many people take it for granted to equate unilateral headaches with migraines. In fact, migraines may not be unilateral, but can also be bilateral. Unilateral headaches may not be migraines.
Migraine is not just a headache, but a headache is just one of its most prominent manifestations. The pain of blood vessels is moderate to severe. It will cause nausea and vomiting when it hurts. It is sensitive to some smells, and is afraid of light and noise, so you want to rest in a dark and quiet place.
If you do some physical activities at this time, such as going up and downstairs, running and jumping, and shaking your head, the headache will worsen. The headache lasts for more than four hours at a time. A small number of people will have very "strange" aura symptoms before the headache, and more than 90% of the auras are visual symptoms.
Before a headache, you may see water ripples, bright spots, mosaics, C-shaped halos, black and hazy black, etc. These may sound abstract, but friends with these signs will definitely understand it, and these patterns will gradually change over time.
In addition to visual symptoms, some people also experience numbness and weakness in one limb, clumsy speech, and unclear speech. The aura symptoms will last for several minutes to an hour, and then there will be headaches. For many patients with aura migraine, these cardiac symptoms will feel more fearful.
Once a migraine is sick, you cannot work, study, live normally, etc., it is very painful.
questions can be used to initially screen if you have migraines:
Have you been affected by work, study or daily activities due to headaches at least one day?
Are you nausea or stomach upset during headache?
Is the three headaches accompanied by fear of light?
If you answered yes on two or three of them, then the migraine screening is positive. Don’t look at it simply. The positive predictive value of this table is as high as 93%, which means that it is positive means that you have a 93% chance of having migraine.
cluster headache
Its attack is actually very distinctive, but because it is rare, it is almost one in a thousand. There are obviously more men than women and they will always be misdiagnosed.
Clusters in cluster headaches refer to the fact that the attack has obvious periodicity and does not occur for a long time, such as one year, and then once the attack occurs, it will occur for a period of time. This attack period is called the cluster period, which can usually last about two months.
During this cluster period, it may hurt once every two days, or it may hurt eight times a day. A single headache lasts for 15 minutes to 180 minutes, which is shorter than the time of migraine. It may occur at a fixed time every day, such as in the evening or early morning, as if an alarm clock is set, so some people call it "alarm clock-type headache".
It is an absolute unilateral headache, which is more true than migraine. In the same cluster period, only one side is painful. In the next cycle, a few people can switch to the other side. This time, the left and the next time, the right, but no matter what, there will be no bilateral pain at the same time. The bilateral cluster headache only exists in a very small number of medical case reports and does not have clinical guidance.
It is a severe pain around the eye socket on one side or temple . From a 2020 study, 1,604 people used a ten-column system to evaluate the degree of various pain. They were all cluster headache patients. At the same time, they also combined certain other pain conditions. The higher the score, the heavier the pain. Cluster headache ranks first (9.7 points), which is even more painful than having a child.
cluster headaches, in addition to pain, there will also be tears, runny nose, red nose congestion on this side of the headache. A few people also have eyelid sagging , pupil shrinkage, etc.
Some people mistakenly think of glaucoma and sinusitis because of these. These accompanying symptoms are related to a physiological reflex, called trigeminal autonomic reflex, which is a protective reflex of our human body.
Overall, when cluster headache occurs, the person is very dry, restless, walking around the room, and a very small number even tend to commit suicide, so some people call it "suicide headache".
diagnoses a disease. Although it is important to understand its diagnostic criteria, it cannot be copied. What is the pain of three hours is cluster headache, and it is not a migraine after less than four hours. It needs to be considered comprehensively.
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