It is believed that everyone has experienced headache in his or her life. Due to certain misconceptions, some people do not take their headache seriously and do not think that headache and brain fever are not serious illnesses, thus delaying the diagnosis and treatment; while some people are so nervous about their headache that they cannot sleep or eat and seek medical help from all directions. As a clinical practitioner, I deeply feel the responsibility to let people out of the misunderstanding and help them alleviate their pain. Myth 1: The heavier the headache, the heavier the disease Not long ago, I was on duty in the emergency room, and at about two o’clock in the middle of the night, several people sent a young patient in. Before the patient entered the door, I heard him moaning from a distance. Before I could quickly go over to check the patient, the few people who sent him in shouted: “Doctor, hurry up and give him a painkilling injection, his headache is so bad that if he doesn’t stop the pain quickly, people will die of pain …… “But I did not rush to give him a painkilling injection, but carefully gave him a detailed and comprehensive examination before doing the corresponding treatment. Comment: Headache itself is not a disease, it is just a clinical manifestation. There are many diseases that can cause headache, and sometimes headache can occur even without disease (such as poor rest and mental tension). Just like fever, we feel hot in summer, we feel hot when we wear too many clothes, we feel hot when we have a fever, and we feel hot when we are nervous. Heat is only one clinical manifestation, and many factors can cause the sensation of heat. Headaches can also be caused by many diseases. The mechanism of headache production is complex. For the general public, it is enough to see a headache as a sign to remind oneself to go to the doctor. The severity of a headache is not necessarily related to the severity of the disease, but depends on the cause of the headache and the speed of development of the intracranial disease. In addition, the severity of the sensation of headache also depends on the individual’s feelings. Generally speaking, the headaches caused by trigeminal neuralgia, migraine, meningeal irritation are the most severe, and sometimes the headaches of neurosis are also quite severe; systemic infectious diseases such as influenza, typhoid, malaria, leptospirosis, heat stroke, etc. can also cause severe headaches. Conversely, headaches from brain tumors may be mild or only moderate over a longer period of time. Thus, a headache that some people feel is mild may have a serious disease lurking. Conversely, while some people feel a severe headache, they may not find anything wrong. For example, some patients with the above-mentioned brain tumors face life-threatening conditions, yet they have only mild headaches, and some can even still work as usual. However, some patients with neurological disorders are incapacitated by headaches and go around to seek medical help, but nothing can be found. Therefore, for those headaches that have simple causes, even if they are severe, if we handle them correctly, sometimes they may be cured even if we do not use medicine (such as heat stroke). On the contrary, for those headaches that do have serious diseases lurking, even if the degree is very mild (such as brain tumor), we should treat them seriously and never be paralyzed or careless, so as not to cause a big mistake and make people regret for life. Myth 2: Headache is not heavy, blood pressure is not high My beloved unit’s Ma Lao-Be was recently hospitalized due to sudden brain hemorrhage. The colleagues all know that Ma Bo is a bit hypertensive, because he has a characteristic of this person’s hypertension, that is, once he heard him say that he has a headache, we do not need to say that Ma Bo’s hypertension has worsened again, headache has almost become his hypertension “weather forecast”. As soon as the headache, Ma Bo began to take antihypertensive drugs. After a few days of blood pressure stability, the headache will be reduced or even disappear, he will not take antihypertensive drugs. He believes he is the best “physician” and knows how to deal with the headache. Therefore, although he had high blood pressure and his doctor told him to take antihypertensive medication, he did not take the doctor’s words seriously at all, and unless he felt uncomfortable with the headache, he would not take antihypertensive medication at all. And this time, how come he was suddenly hospitalized? In the hospital, colleagues listened to his family and the doctor’s explanation, and finally understood why Ma Laobao had a sudden brain hemorrhage. Comment: Hypertension is a very common disease. According to the World Health Organization, adults with systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg can be diagnosed as hypertensive. Headaches can occur because hypertension can cause spasm of intracranial arteries and affect the blood supply to the brain. Especially in some diseases that can cause great fluctuations in blood pressure, such as hypertensive encephalopathy, the blood pressure of these patients often suddenly rises very high, causing severe headache, and the degree of headache is related to the degree of increase in blood pressure, and lowering blood pressure can reduce the headache. However, some patients with long-term hypertension have already adapted to a high level of blood pressure, so unless the blood pressure rises very high for a short period of time for some reason (such as excessive stress), they do not necessarily have headaches even though their blood pressure is very high. On the contrary, when the blood pressure of such patients is lowered to the level of normal people with drugs, they may have headache, headache, dizziness and other symptoms. Some hypertensive patients, for various reasons, tend to judge the level of blood pressure according to their headache feelings and even adjust the dose of antihypertensive drugs according to it. When the headache is heavy, they feel that their blood pressure is high and increase the medication, and when the headache does not hurt, they reduce the medication or even stop it. In fact, this is very unscientific and very dangerous. For the treatment of hypertension and its headache, the key is to make the blood pressure stable and not to fluctuate too much. Although under normal circumstances, human blood pressure also has certain physiological fluctuations, but the magnitude is generally not so large as to cause headaches. Irregular medication or short-acting antihypertensive drugs (such as cardiac painkillers) may increase the fluctuation of blood pressure, and too high or too low blood pressure is not good for the blood supply to the brain, which can cause headache. In other words, headache is not necessarily due to high blood pressure, but low blood pressure can also cause headache. The risk of cerebral hemorrhage or cerebral infarction can be caused by either high or low blood pressure. For patients with hypertensive headaches, the key is to stabilize blood pressure. Misconception 3: female migraine, take medicine to the end Miss Zhang is 26 years old, is the company unanimously recognized female capable. She is at the age of marriage and in good condition, but she insists on celibacy. In fact, only her close friends know the hidden story. That is, before each menstruation, Miss Zhang will always have a pulsating headache in the left temple area, each time to last for several days, and often accompanied by nausea and vomiting, photophobia, fear of sound, etc., the more nervous work, the more obvious this headache. Although I went to the hospital many times for checkups, nothing abnormal was found. The doctor always said it was migraine and prescribed some medicine for headache treatment. But in recent months, due to the heavy workload, Miss Zhang’s migraines are getting heavier and heavier. And she has always been a strong personality, advocating independence, do not want too many people to know her privacy, more afraid to find a boyfriend. Therefore, she sought many doctors and ate countless medicines, and privately insisted that she would treat her headache to the end, and would never find a boyfriend until her migraine was cured. Comment: Migraine is a recurrent one-sided throbbing headache, which is a common primary headache in clinical practice, and most migraines develop in children and young adults (10-30 years old), with more women than men. In female patients, migraine attacks tend to occur during premenstruation or menstruation and decrease or stop after pregnancy or menopause. The exact mechanism of migraine is not known, but some studies reveal that this migraine may be related to estrogen levels in women. During the premenstrual period, estrogen in a woman’s body gradually rises to its highest peak. Estrogen has a water and sodium retention effect and is likely to cause disturbances in the central nervous system, water and electrolytes, resulting in various symptoms, of which headache is one of the main manifestations. The headache is reduced when the progesterone level increases and estrogen decreases during pregnancy. The reduction of migraine after menopause is also related to the decrease of estrogen level after menopause. A correct understanding of these changes is also very important for dealing with work, love, dating, marriage, family relationships and preventing migraine attacks. For the treatment of migraine, the aim of the attack period is to reduce or relieve the symptoms of acute headache attacks and relieve the accompanying symptoms. For mild and moderate headaches, quiet rest in a darkened room is appropriate. Most of them can be relieved by using aspirin and Valium. For moderate to severe headache, ergotamine is preferred, and codeine can be used in severe cases. As for the preventive treatment, the purpose is to prevent or reduce the recurrence of migraine as much as possible. If there are more than 2-3 migraine attacks per month, long-term preventive medication should be considered, which should be taken daily for at least two weeks after taking the medication. Medication is certainly a very important aspect of migraine treatment, but medication alone is not enough and efforts should be made to avoid various triggers based on a full understanding of the condition. These triggers include cheese-rich foods such as dairy products, chocolate, etc.; various alcoholic beverages such as liquor, wine, beer and caffeinated beverages, etc. Mental stress, sudden climatic changes, bright light stimulation, hot sun exposure, etc. Targeted avoidance of the above triggers is extremely important for the prevention of migraine attacks.