Headache is one of the most common complaints in society. The rate of those with headache complaints reaches 90 percent in the society. Migraine and tension-type headaches make up 90 percent of all headaches.
Bone Structure of the Head
Main Nerves Causing Headache
The International Headache Society has classified headaches into 14 main groups and hundreds of subgroups. Headaches that occur directly with a headache picture and are not related to another disease PRIMARY HEADACHES . These are migraine, tension-type and cluster headaches. SECONDARY HEADACHESOn the other hand, 10 percent of them are headaches that occur during the course of diseases such as cerebrovascular diseases, nervous system diseases, brain tumors, eye diseases, sinusitis, and meningitis due to a certain disease.
Usually the pain is on one side of the head
The pain is throbbing, moderate or severe
Nausea, vomiting occurs
Comes in crises (attack)
Pain lasts 4 to 72 hours
Visual disturbances occur at the onset of pain (with aura type)
Pain increases with head movements and physical activity
Don’t be bothered by light and sound
How many types of migraine are there?
It is generally divided into two groups. ‘Migraine with and without Aura. Only 10 percent of migraines have auras.
What is the aura of migraine?
aura are the complaints encountered in migraine with pre-symptoms. Most of these symptoms are vision related. The patient reports seeing bright lights, zig-zag lines or blurred vision, loss of vision in one area or an area. In addition, numbness in the arms and legs, dizziness, and speech disorders are also seen. It takes 20-30 minutes and then the pain starts.
What are the factors that trigger migraine?
air pollution, cigarette smoke
bright light or flickering light
Loud and continuous noise
Fragrance fragrance, other strong odors and chemicals
Changes in weather (pressure, temperature and humidity change, southwestern)
Seasonal changes (autumn and spring are the worst times)
hunger, skipping meals
Sleeping too much or little, disturbances in sleep patterns
birth control pills
Hormonal changes in women (menstrual period)
Some foods and beverages (chocolate, nuts, red wine, etc.)
Many foods are held responsible among the factors that trigger migraine. However, the food that increases migraine pain in each patient may be different. The important thing is that the person finds and discovers the substance that triggers the pain.
Why is migraine more common in women?
This is a case of women’s hormonal regimen. Migraine attacks become rare in menopausal women. Migraine attacks decrease between the 3rd and 9th months of pregnancy.
Tension Type Headache
Tension headaches are the most common type of headache. It is a severe headache that occurs with the constant stretching of the face, head and neck muscles as a result of important changes in human life such as changes in environmental factors, overloading of responsibilities, disappointments, familial and economic problems. The contraction of the muscles in the head or neck may be due to stress or restlessness, sitting in the same position for a long time, a blow or depression such as a traffic accident. Often the patient diagnoses migraine on his own. However, tension headache is handled very differently from migraine in terms of both mechanism and treatment. While patients with migraine seek a quiet place, patients suffering from tension headaches, on the contrary, want to wander around. Unlike migraine, tension headache does not involve a single area. It shows a more widespread course. It gets worse as the day progresses. It goes on for hours. Visual impairment and other symptoms that may precede the pain in migraine are absent in tension headaches. It is an important finding in tension headaches that trigger points that cause the appearance of reflected pain by applying pressure on the muscles of the head, neck and shoulder region. The most important feature of tension headache is that it usually starts from the neck region and rises to the top and progresses as a compressive pain. Patients often describe this condition as a compression of the head as if it were being squeezed. Headache; It can be triggered by sleeping less or more than necessary, eating less or more than necessary, consuming too much alcohol, exposure to excessive noise, overwork and other health problems. In addition to headache, many patients experience symptoms such as burning sensation, felting, and sensitivity to touch. In addition, complaints such as difficulty in concentration and insomnia may accompany the pain. Nausea or vomiting may occur. However, it is often not as severe as in migraine. Another important point is that migraine and tension-type headache can sometimes be seen together. In fact, a patient suffering from migraine headaches may develop tension-type headaches over time, and the symptoms of tension-type headache may become more prominent. In this case, patients state that the shape, duration and frequency of headaches have changed.
Patients are taught how to relax. This method is particularly effective in the treatment of muscle contraction headaches. In pain that is resistant to drug therapy and relaxation training, various injections are made to the trigger points detected in the head, neck and shoulder region to relax the muscles and thus control the pain.
Protection from Migraine Attacks
It is very important to identify situations that increase stress and stay away from them. For this, if necessary, relaxation techniques should be learned by taking psychological counseling service. Exercising regularly and getting enough and regular sleep will regress the complaints. Another important point is to eat regular meals. Tension-type headaches are less common in people who maintain a sense of humor and have a positive outlook on life.
Cluster headache is a very severe unilateral headache that occurs around or behind the eyes. Cluster headaches have typical features. Pain comes in attacks. It usually starts 3-5 hours after going to sleep or at a specific time in the morning, almost every day, as if set by an alarm clock. The pain is unilateral and very severe. It is most felt around the eye, behind the eye, and at the temple. Along with headache, redness of the eye, bloodshot, tearing, nasal discharge and congestion, sweating on the forehead and face, swelling of the eyelid and drooping of the eyelid may be present. These attacks of pain, which are very severe, last between 15 minutes and 3 hours. After that, the patient starts to relax again within minutes. These attacks can be seen once or many times a day, or they can be every other day. Cluster headaches are in the form of attacks that can last from a few weeks to months. In between, there is a crisis-free period that lasts for several months. Crises often last 4-8 weeks. It can vary from 1 week to 12 months. In patients suffering from cluster headaches, there are some indications of excessive dilatation of the vessels in the head. However, the cause of these pains is not known exactly. It is known that alcohol and cigarette consumption can increase the frequency and severity of cluster headache attacks. In addition, it is seen that patients with cluster headache suffer more pain during seasonal changes. Stress also threatens patients as a triggering factor for pain. Cluster headaches are more common in men over the age of 30. Its incidence has also increased in those who have had a previous head injury or operation. It has been found to be more common in men with gastric ulcer and cardiovascular disease and in women with previous migraine. The shape of the headache will help the doctor make a diagnosis. The type and timing of attacks is very important, so a headache diary should be kept. Someone who is with the patient during the attack can also help the doctor by telling the doctor how the patient looks and behaves during the attack. The patient should not hesitate to tell the doctor what he did to relieve the pain during the attack (such as banging his head on the walls or furniture). Behaviors like these are common, and telling the doctor about them helps to understand how severe the pain is.
In its treatment, various drugs are used to reduce the severity of pain during attacks and prevent attacks from occurring. Various nerve blocks such as sphenopalatine ganglion blockade and stellar ganglion blockade can also be applied in patients who are resistant to drug therapy. During cluster periods, bright light, alcohol, irritability, stressful behaviors and excitement should be avoided. These can exacerbate attacks. Smoking should be avoided, tobacco may prevent cluster headaches from responding to drug treatment. Patients should avoid activities that will harm themselves during an attack.
Headaches of Neck
Contrary to popular belief, headaches are not always caused by the brain or other structures in the head. It was thought long ago that headaches could also be caused by the neck, it was discussed for years, and in 1983 the term cervicogenic (neck origin) headache was introduced into medicine. Various disorders of structures such as nerve root, bone, muscle, joint and disc located in the neck or back of the head give symptoms in the form of headache. Pain is unilateral. However, depending on the location and degree of neck disorders, pain may occur on both sides. There may be limitation of movement in various directions in neck movements, headache can be revealed by various neck movements. A history of strenuous sports, head and neck trauma (for example, traffic accident) is common in patients suffering from neck-related headaches. Even a simple crash in the form of a traffic accident can cause damage that will later cause neck-related headaches. In such a situation, rapid back and forth movement of the head in the form of a whip can cause damage. The severity and duration of pain varies from patient to patient. The pain usually starts in the neck and is throbbing and non-prickling.
It is known that physiotherapy provides benefits by providing relaxation of neck movements and relieving muscle contractions in the neck. In cases where physical therapy and rehabilitation are ineffective, interventional methods are used. Sources of pain in the neck are disabled by radiofrequency or other methods.
Tension-Related Headache: In general, pain is seen mainly in the nape part. It is associated with an increase in blood pressure.
Headache Due to Medication: Even if very intense painkillers are used, the drugs cause pain. Pain medication should be discontinued under the control of a doctor.
Exercise headache:Pain that occurs after exercise and exertion