Tension Headache Causes and Treatment
What is tension headache
Most important and common for vascular headache: the pulse of the same show with the pulsating pain or cramping. Bow, heat, strength, coughing or headaches, etc. will increase. Examination showed temporal artery uplift, pulsatility enhanced compression can reduce headaches.
Most of the causes of tension or anxiety induced, but also secondary to vascular headache or facial lesions headache, sometimes for head and neck myositis, or cervical muscle strain caused by cervical spondylosis.
The result of the head and neck muscles due to the continued contraction, mostly former head, or the whole head and neck pillow continuing Duntong.
Inspection should give prominence to key points, according to history-taking materials to the maximum extent possible to consider one or more of certain kinds of disease, first of all, be inspected as soon as possible, certain positive or negative diagnosis.
After a clear cause headache, and sometimes also need further examination, which is due to:
① headache may be more than one cause, such as migraine patients susceptible to hypertension; headache after traumatic brain injury in addition to neurasthenia performance, but also there are other types of mergers or intracranial complications of a headache.
② a headache can be the cause of secondary causes another headache. If sinusitis can be induced supraorbital neuralgia, may be secondary to otitis media, such as intracranial abscess. Clinical should be vigilant.
How to treat:
First of all, is to actively prevent and treat the disease. In addition to symptomatic treatment can be used outside of morphine analgesia drugs, such as various antipyretic analgesics, under clothes or short-term illness Dayton 2-3 times / d taking it seriously, in low doses can be codeine, or Rotundine Dihydroetorphine such. Can be used, as appropriate, increase or stability of various tranquilizers, anxiety, irritability Youyi. Depression performance, plus antidepressants. Psychiatry reference can be more than handouts. In the treatment, can also be a headache for the mechanism, for example:
① correct intracranial pressure: high intracranial pressure, such as giving dehydration, diuretics low intracranial pressure, such as intravenous fluid given low.
② vascular contraction and expansion: If migraine attack, the use of lysergic early preparations. Category of non-vascular migraine headache, common compound containing caffeine antipyretic analgesics, such as the APC, Suomi-Mig-to-ling, etc. to improve vascular tone.
③ relaxation of the muscle contraction: apply to muscle contraction headache, such as massage, heat, pain points novocaine closed, and so on, or use of weak stability and efficiency such as stability, tranquility, and so on, not only help relax the muscles and also help to lift the spirit tension.
④ suffering from the closure of the cranial nerve table: Table for cranial neuralgia. ⑤ “update” of the disease cerebrospinal fluid: after subarachnoid hemorrhage as severe headache can be stable condition after the situation is not high intracranial pressure, as appropriate, released bloody cerebrospinal fluid 5 ~ 10 ml, or oxygen injection contour, in an effort to CSF Absorption “update”, and often can quickly ease the headache. This method also applies to serous meningitis headache.
Several more common headache again on the specific control methods:
1. Migraine: an early attack one of the following methods used analgesics: Oral ergotamine 0.1 to 0.2 g of caffeine, such as null and void after the half-hour service can be further 0.1 g day total of not more than 0.6 g. Intramuscularly lysergic new base 0.2-0.5 mg, null and void when one hour after the repeat. Intramuscular anisodine pH 4-5 mg or slow intravenous 2-6 mg (50% glucose Add 40 ml). 0.5% novocaine subcutaneous closed around the expansion of the temporal artery, and so on. Arteriosclerosis, heart and brain or peripheral vascular disease, as well as pregnancy Jiyong ergot preparation. Intermittent period can be used to prevent the onset of Oryzanol (20-30 mg), propranolol (10-20 mg), anisodine pH (1-4 mg) or Mefenacef-啶(0.5-1 mg), three / d. Also taking ergotamine butanol amide (0.5 mg first dose, and gradually increased to 1-2 mg, 2 times / d, not more than six months, with the taboo of ergotamine), anisodine pH (1-4 mg), Mefenacef-啶(0.5-1mg), three / d. Puerarin films, Chuanxiong injection, Effects of Chinese Herbal Medicine, intravenous 0.5% novocaine (10 ml each, a total of 20-30), but also have a certain effect. On the longer course, frequent seizures, drug therapy ineffective and temporal artery dilated serious patients, as appropriate, may also try superficial temporal artery ligation.
2. Custer headache: attack can be used ergot preparation. Intermittent period for the drug can be tested, or prednisone 30 mg Leighton served for three consecutive days to 5-20 mg, once a day or every other day, three times to stop.
3. Neck migraine: cervical traction, expansion at the same time taking drugs or Blood Circulation vascular medicine and the treatment of carotid the coexistence of thoracic nerve root inflammation. Stellate ganglion trial can be closed. Conservative treatment fails and serious symptoms, can be considered for removal of the vertebral joints hooks.
4. Muscle contraction headache: massage, heat, electricity, as well as taking therapy excited stability, and meprobamate, such as muscle relaxants and sedatives. Tenderness in the muscles can also point to 2% novocaine 1-2 ml closed. Acute cervical muscle strain injuries can be caused cortisone acetate, 1 ml (plus 1% increase due to slavery Dover 1-2 ml) closed. Hyperplasia due to cervical spine injury caused or should increase cervical traction, plus neck and entrusted to consolidate traction effect.
5. Neuritis headache: the principle of the state neuritis treatment, in the supraorbital notch, “wind pools” Point and other places several times with 2% increases for Merino Dover 0.5-1 ml (or accession Vi.t B1 50mg or Vit.B12 100 μ g) closed, or with a 0.5 ml ethanol closed. Oral phenytoin or carbamazepine also an effective analgesic. Hyperplasia of the cervical spine caused by the greater occipital neuralgia should be used cervical traction.
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