Headaches and other pain syndromes. Most recurrent headaches are symptoms of a chronic primary headache disorder, but headache can be the consequence of ophthalmologic problems, sinusitis, dental disorders, infection, brain tumour, cerebral haemorrhage, meningitis, stress, sleep disorder and starving. Headache pain of benign origin may be intense; meanwhile headache pain caused by malignant disease could be mild.
Main reason of patients with headaches to see a doctor is the fear of serious disease. Primary motivation of patients is the endorsement of not having a subacute thyroiditis headache tumour or any other serious disease, the alleviation of pain is secondary.
The presentation of how to classify, make diagnosis and treat different forms of headache is the goal of this chapter. Taking accurate history is essential of headache diagnosis. There are no specific clinical markers or precise clinical tests to prove the diagnoses of essential headache.
So it is very important to discuss the importance of appropriate history taking.
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Patient térdízület duzzanata mit kell tenni are primarily subacute thyroiditis headache examinations, MRI scans etc. Another important point of view should be considered during taking history is that our memories regarding pain could be inaccurate.
This could be proved by another interesting phenomenon: patients during or after a headache attack are usually more motivated to see a headache specialist, even in a case of recurrent headache.
Meanwhile a few weeks after the headache attack or in a pain free period, patients do not have the same motivation to visit a specialist.
As a matter of fact it is difficult to distinguish among real headache pain, malingering, somatization. In cases of frustration and stress we can often see that people grasp their head indicating their hopeless situation. The meaning of this posture is the pain of powerlessness and fear, and it is same in every culture. This may be one explanation why emotional problems might provoke headache.
All the above facts could shape the doctor-patient relationship: Beforedoctors followed different rules for description and subacute thyroiditis headache thyroiditis headache of headache they even used several conflicting definitions of headache sub types as well.
In and in the International Headache Society IHS created a classification system which became a word-wide accepted standard for diagnostic work and clinical research. It divides headaches into two major categories: First of all the groups of primary headaches groups Then the secondary headache disorders were divided into groups The classification includes more than types of headache and it gives a great help in exact labeling of type of headache.
Thanks to HIS classification epidemiological and clinical researches related to the headaches became much more reliable. Patients often have more than one type of headache or a change in headache pattern over time.
We begin with the headache that is the greatest concern to the patient, the one that motivated the person to seek care. We then explore other headache patterns. InIHS classification was revised, so it became even easier to use.
The diagnosis of primary headaches is based on the patient's statements of the previous attacks. The correct diagnosis is based on the presence or absence of necessary symptoms required by specified rules.
The fourth group of the classification includes various types of headaches that have no detectable background of structural damage, for example subacute thyroiditis headache headache associated with sexual activity, or hemicrania continua.
The diagnosis of headache The first step in the diagnosis of headache is to determine whether the actual headache is accompanied by some other symptoms of an illness secondary headacheor do we face with primary headache.
In the latter case, the headache is the disease itself. We base our diagnosis on the recorded patient history, on the neurological examination and we also check the patients general-medical state too. Further instrumental studies are needed only in the cases of physical alteration referring to any disease. During the questioning of a headache patient, it is useful to keep the list of the "warning signs of headaches" in mind, which will help the isolation of primary-secondary headaches.
Headache can be a symptom of many metabolic diseases, especially in cases subacute thyroiditis headache the disease can lead to cognitive impairment as well. These include hypernatremia, hyponatremia, acidosis, liver and kidney failure. In these cases a mild headache is only a symptom of a disease, which may result irritation, confusion, disorientation, or coma.
When the cortical function is grievously affected, then the headache is no longer considered as a primary complaint, except in the following cases: Hipercapnia: In addition to hypercapnia, severe headache, expressed vasodilation and papilledema may occur.
Acidosis: Acidosis subacute thyroiditis headache often associated with headache.
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This also caused by vasodilation, which is due to impaired function of the cerebrovascular autoregulation developed by acidosis. Thyroid disease: especially hypothyroidism is accompanied by headache. The mechanism is unknown, but it usually disappears when the metabolic function is corrected. Parathyroid disease: In the case of intensive chronic headaches caused by hypothyroidism, there is bilateral pain sometimes accompanied by csípő prolaps kezelés tenderness.
More than six months after settlement of the disease, may be required to improve or eliminate the headache. The subacute thyroiditis headache of history As previously stated, we would not find any signs of neurological diseases during a neurological examination of most of the headache patients. In these cases, the diagnosis must rely on the patient's referral. A specialist who starts headache treatment, is expected to establish a long term relationship with the patient.
Therefore, the detailed interview is important, because it subacute thyroiditis headache an appropriate therapeutic relationship between patient and doctor.
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It is common that a patient is suffering from more than one type of headache. Before asking any questions about headaches, be sure to clarify that how many types of headache does the patient have. If this is not clear, we would not get appropriate answers. This may lead several errors, misunderstanding and also to subacute thyroiditis headache diagnosis. The most frequent headaches are tension-type, migraine, hunger caused and fever provoked headaches.
The second common headaches are headaches accompanying nose, teeth, sinus disorders and eye problems. The most intense headaches occur in subarachnoid hemorrhage, meningitis, brain tumor, and brain abscess. Fortunately, these are less common headaches. Age at Onset Primary subacute thyroiditis headache can begin in childhood, during puberty or in young adulthood. A headache beginning above the age of 50 raises the suspicion of organic disease temporal arteritis, tumor, metastasis, cerebrovascular disease.
Migraine usually disappears after the menopause, except in some rare cases. Tension headaches can start omega shark krem any age. Headaches induced by sleep disorders begin among the elderly.
Localization Cluster headaches are strictly unilateral. In cluster headache pain develops around and behind one the eyes, and often radiates towards the neck. Migraine can cause pain anywhere on the head or on the face, but typically in most of the cases the temporal location of pain.
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Dental, eye and sinus diseases can cause frontal headache, but pain can also radiate to the nape, to the neck and to the back. Headaches caused by parasellar processes are typically bitemporal. Pain strictly localized around the eyes can refer to ocular origin. Trigeminal neuralgia can cause pain on any area of the face.
Posterior fossa processes mostly cause pain localized occipitally. Patients complain about frontal and vertical localized pain during space-occupying processes associated with dislocation. Space occupying processes may cause pain on the tumor site before the major dislocation. Subdural hemorrhages cause pain in the localization of the bleeding next to the side of the damage, mainly fronto-parietal.
Larger hypophysis tumors cause pain on the top subacute thyroiditis headache the head. The maximum pain of tension type headache can be occipital, on the neck and on the shoulders, but frequently the frontal region is also involved.
The majority of the tension type headaches are bilateral, but it can be unilateral as well. Diseases affecting diaphragm can cause pain radiating to the shoulders and neck.
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Cardiac ischemia can cause occipital region and jaw pain. Frequency The frequency of headaches and the patterns of occurrence contribute greatly to the accurate diagnosis. Episodic tension-type headache occurs less than 15 times per month, if it is more frequent, it should be diagnosed as chronic tension type headache. The daily fluctuation of tension-type headache could be characteristic, the pain is more pronounced in the morning and in the evening, but it decreases after going to bed and it rarely interferes with sleeping.
The occurrence of cluster headaches may have a seasonal nature, in this case periods start subacute thyroiditis headache fall and in spring, which can last for months, during a period, the patients usually reports headaches a day with typical duration of minutes. It is not uncommon that the attacks occur exactly at the same period of the day. The patterns of the appearance of headache can lead to the choice of a useful preventive strategy.
For example in subacute thyroiditis headache case of menstrual migraine, non-steroidal anti-inflammatory drugs NSAIDs applied in premenstrual periods can be effective.
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Ergot products applied in the evening may prevent overnight cluster headaches. Almost in all patients with primary headache there is a specific frequency pattern which could not be detected in symptomatic headaches. However it is typical that the frequency and severity increases with time in the case of symptomatic headache.
In such cases, clarifying diagnostic tests of the cause are needed.
- The pattern of supratentorial WMH appearance differs between the two groups; however, accurate differential diagnosis of WMH by conventional MRI is probably not possible in individual patients.
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If yes, headache with many years of existence are surely benign. Intensity The intensity of pain is specific to each type of headache. It can be measured by a visual analog scale or by a verbal analogue scale.