Often due to common causes, the headache can often be solved by using hygienic measures of an elemental nature.
Headache or headache can respond to many types, many of which escape a causal definition. Even so, there are situations in which it is relatively easy to recognize their origin and therefore intervene in a timely and effective manner.
However, it is necessary to remember that if it is true that most of the time headache is a minor consequence of a particularly hard work day, an intense emotional state or an excess of food, so it is not too few Sometimes the headache can be an expression of severe general illness or suffering from some organ of the head, sometimes due to absolutely despicable causes.
Therefore, once the acute episode of a headache has passed, if it persists or has traits of special intensity, it is advisable to perform a deeper study and to clarify the nature of that state.
Pain-sensitive tissues (the major artery segments, pericranial soft tissues, periosteum) and insensitive tissues (bone skeleton, brain substance, and arterial fragments that deepen the brain substance) are located in the head. The pain that originates then runs through the cranial nerves. The mechanisms by which the pain appears include the dilation of the sensitive arterial segments, the traction or compression of the epicranial and nuchal muscles and the spread of localized painful stimuli.
Headache is a common symptom of a large number of diseases. The majority of patients complaining of headache as the main symptom do not present any disease; there is however a minority, which nevertheless constitutes an important group, suffering disorders of some relevance and requiring immediate medical action.
The diagnosis of headache associated with an endocranial or general pathology, or diseases of the eyes, teeth or nose, is based mainly on clinical signs and laboratory findings, whereas the diagnosis of recurrent headaches of a more chronic character important, such as hemicrania and headache due to muscular tension, are based mainly on anamnestic data.
The first step in establishing a diagnosis and a therapeutic program is to carry out a careful family and pathological anamnesis. The following are important questions:
When did the first headache attack occur?
– was it associated with any head trauma or neck region, behavioral changes, infection, neurological signs, glaucoma, hypertension or a special emotional reaction?
– what drugs was the patient taking for headache or in any case before the onset of headache, especially considering the use of narcotics, tranquilizers, oral contraceptives, anticoagulants and antibiotics?
The entity of the headache is not always a valid data to assess the severity of the disease: some of the strongest headaches are secondary to a subarachnoid hemorrhage, a hemicranial attack or a situation of emotional stress, whereas the pain referred to by a patient with an endocranial tumor may be relatively modest. Sometimes the location of pain may have some significance: unilateral or localized pain may be indicative of a well-defined disease, including an endocranial mass; the location of the hemicranial attack may instead vary depending on the different accesses. Headache secondary to an endocranial disease may be diffuse or localized at any point in the head, depending on the nature of the disease and an increase in endocranial pressure. On the other hand, both the quality and the signs of the onset of headache should be described.
In the study of headache it is also very important to establish the temporal relationships of their appearance, their duration, etc.
A headache that lasts one hour, although sharp and very intense, will probably be less severe than one that lasts several hours or days.
A recurrent chronic headache, the only symptom for the patient, should alarm much less than the appearance of headaches as a new symptom. The headache that wakes the patient from sleep and that appears as soon as the patient wakes up in the morning may be more worrying than a pain that starts at midmorning, when the patient is working, and increasing throughout the day.
The first type is typical of patients with endocranial or endocranial hypertension.
The signs and symptoms that accompany the headache can be indicative when determining the causes. The presence of seizures is a common symptom of an organic disease of the nervous system and requires further studies, especially if it has just appeared.
The presentation of a progressive neurological symptomatology, with memory disorders in relation to recent things or changes in personality, may be secondary to the presence of an endocranial mass.
In the elderly, the specific conditions associated with headache, such as temporal arteritis, glaucoma, cerebral circulation insufficiency syndromes, and hypertension should also be considered. Physical and neurological examination are critical. It is important to examine the fundus of the eye and the state of the pupils and to perform examinations of the cervical spine and skull. Neurological examination should also include an assessment of the psychic conditions, cranial nerve state, motor system, superficial and deep reflexes, sensory system and cerebellar function.