Headaches, I believe, have been encountered by everyone. Numerous studies have found that the incidence of stroke is significantly higher in people with a history of migraine than in controls, and among young patients with thromboembolic stroke, 5% to 25% of the onset is associated with migraine. A statistic that combined 14 studies found a twofold increased risk of stroke with migraine. Recent studies have also found an association between headache, especially migraine, and ischemic heart disease, hyperlipidemia, hypertension, and diabetes. Frequent or sudden onset of severe headaches can easily cause vasoconstriction, leading to fluctuations in blood pressure and compromised blood circulation. On the other hand, bleeding and thrombosis in the brain can irritate the meninges, pull the blood vessels or nerves, and cause pain. Clinically, 80% to 90% of patients with brain hemorrhage have headache as the first symptom. If there is a sudden more severe headache without a clear cold and fever or adjacent organ morbidity, attention should be paid to consider whether there is a more serious hidden disease, especially cerebrovascular accident and hypertensive emergency. Cerebrovascular accident is a common disease in middle-aged and elderly people, including two types of ischemic stroke and hemorrhagic stroke. Due to brain atrophy and decreased reactivity of the body, elderly people do not always have physical dysfunction or severe headache and nausea and vomiting when they have a cerebrovascular accident, but many elderly patients often first have a mild headache with a fixed or diffuse location and a persistent headache, which may sometimes increase progressively. In addition, for adolescents and young adults, headaches that occur frequently and are evident with exercise and emotional excitement should be promptly screened for cerebral vascularity in case it is an intracranial arterial or venous malformation. Therefore, in life, we should also pay attention to quit smoking as early as possible to avoid aggravating or triggering headaches; exercise reasonably, control weight, and actively prevent “three highs”; and reduce stress appropriately to avoid physical and mental “overdraft”. Headache caused by high blood pressure: Headache caused by high blood pressure is mainly distension and pain, which is persistent, and the pain site is not fixed, either left or right or top of the head. Patients with a history of hypertension often suffer from headaches because they do not take enough medication and their blood pressure does not come down. Patients with a history of hypertension often have headaches because they do not take enough medication to lower their blood pressure. Headache caused by spasm of vertebral-basilar artery: It is mostly pain in the posterior occipital region, which can go straight up to the top of the head and is accompanied by neck pain, which is persistent and dominated by distension. Most of the pain is caused by spasm of the vertebrobasilar artery due to increased or decreased blood flow in the internal carotid artery after degenerative lesions of the cervical spine. See orthopedics or acupuncture and massage department. Headache caused by cerebral infarction and cerebral hemorrhage: Headache caused by cerebral infarction and cerebral hemorrhage is called central headache, which is distended and dull pain-like during the attack. In addition to headache, there are also manifestations such as numbness, weakness and confusion in one or both limbs. In the case of cerebral hemorrhage, the above symptoms will be more severe due to increased intracranial pressure and the stimulation of stasis of blood. Cerebral infarction and cerebral hemorrhage can usually be diagnosed by CT scan. In contrast, subarachnoid (membranous tissue covering the brain tissue) hemorrhage causes a very severe headache along with vomiting and stiff neck, which may not be diagnosed by CT and is often confirmed by a lumbar puncture that reveals bloody fluid. The diagnosis may not be confirmed by CT, but is often confirmed by a lumbar puncture with blood. Cold can cause headache: headache caused by cold may be due to the invasion of the nervous system by the cold virus, and the headache is mainly swelling and pain with a feeling of heaviness. This kind of headache is often accompanied by chills, fever, nasal congestion and other symptoms. If it is a wind-heat cold, most of them will have fever, and the symptoms of fever are heavier than the symptoms of cold, dry throat and yellow sputum; wind-cold cold will be cold, and the symptoms of cold are heavier than the symptoms of fever, and there are also white sputum and white tongue with light coating. You should see a respiratory medicine doctor for a cold and headache. Infections can cause headaches: These headaches are caused by the invasion of bacteria, viruses and other microorganisms into the body, and are most common in lung, urinary tract and oral infections, mostly with heavy cramps and fever. In the case of Gram-positive bacterial infections, there is usually an increase in white blood cells in blood tests; in the case of Gram-negative bacterial and viral infections, there is no increase in white blood cells. During these headache attacks, patients should pay attention to abnormal reactions in various parts of the body and identify the site of infection for symptomatic treatment. You can see a general internist first, and then see the appropriate department according to the doctor’s diagnosis. Neuropathic headache: Also known as tension headache, headache attacks are characterized by paroxysmal tightness of the head and localized pressure points, with pressure-like dullness, swelling and dullness. Patients with this type of headache usually do not have fever symptoms. Migraine: It is a migraine with recurrent attacks bilaterally or alternately from left to right, with throbbing pain behind the orbit (eye orbit) or in the frontotemporal area (at the temple), which may extend to the whole head. In severe cases, nausea or vomiting, photophobia and phonophobia may occur, and the symptoms are aggravated when doing physical activities; migraine can be triggered by factors such as menstrual cycle, weather changes, noise, bright light and other stimuli. You can see a neurologist. Trigeminal neuralgia: These headaches are the most intense, lightning or electrocution-like, and may be accompanied by tears. The headaches are paroxysmal and intermittent, lasting from a few seconds to a few minutes, and then occur again after a period of time. It is caused by the stimulation of the buccal branch, ophthalmic branch and temporal branch nerves distributed in the head. There are various sources of stimulation, such as excessive cold, excessive heat, mental stimulation and other factors, as well as the sequelae of the healing of ear, nose and throat inflammation, especially otitis media. Contact with the nerve distribution area when brushing teeth or washing face can cause headache. In addition, the pain of the buccal branch nerve is easily misdiagnosed as toothache or gingivitis, and the headache cannot be relieved even after the tooth is extracted. This kind of pain is not treated with general painkillers. Western medicine usually adopts sedative pain relief methods, such as internal carbamazepine, phenytoin sodium or closed therapy, but it cannot be cured; Chinese medicine requires evidence-based treatment, and treatment with Chinese herbal medicine to dispel blood stasis and pass through the channels or acupuncture can effectively reduce the number of attacks, and some patients can even stop taking western medicine. You can see neurology or acupuncture department. Headache caused by herpes zoster: Herpes zoster virus usually invades the unilateral intercostal nerve in the chest or the trigeminal nerve distribution in the head and face, as well as the lower back, buttocks and upper extremities, causing segmental damage, and if it invades the head and face, it can cause headache. Neurology may be consulted. Headache caused by eye lesions: Glaucoma, high myopia, retinopathy can cause headache, which requires specialist examination and treatment under the guidance of an ophthalmologist. Headache caused by head tumor: Tumors of the brain, ear, nose and throat, such as nasopharyngeal carcinoma, can cause headache, and the mechanism is that the tumor compresses the central nerve and increases intracranial pressure, resulting in severe headache. The mechanism is that the tumor presses on the central nerve and the intracranial pressure increases, resulting in severe headache. Headache caused by other factors: In addition to the diseases mentioned above, other diseases such as epidemic disease and leukemia can also cause headache if the symptoms are transferred to the brain.