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 percent of the onset is associated with migraine. A statistic combining 14 studies found a twofold increase in the risk of stroke in migraine. Recent studies have also found an association between headaches, especially migraines, 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, lesions such as bleeding and thrombosis in the brain can irritate the meninges and pull on blood vessels or nerves, causing 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”. 1.Headache caused by high blood pressure: headache caused by high blood pressure is mainly distension and pain, which is continuous and the pain site is not fixed, either left or right or top of the head. It is easy to attack when the temperature drops, because in the cold season the human body vasoconstriction, blood pressure is higher than usual, and patients with a history of hypertension often have headache attacks 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. 2.Headache caused by spasm of vertebrobasilar 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, and the pain is persistent and distension is the main cause. The pain is mostly caused by spasm of the vertebrobasilar artery after degenerative lesions of the cervical spine, which increases or decreases the blood flow of the internal carotid artery. See orthopedics or acupuncture and massage department. 3.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 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. If there is no bleeding or the bleeding is not serious, see craniocerebral medicine; if the bleeding is serious, see craniocerebral surgery. 4.Cold can cause headache: headache caused by cold may be due to the invasion of the cold virus into the nervous system, the headache is mainly swelling and pain with a feeling of heavy fall. This kind of headache is mostly 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 the respiratory medicine department for cold and headache. 5.Infection can cause headache: This kind of headache is caused by the invasion of bacteria, viruses and other microorganisms into the human body, with lung, urinary tract and oral infection, mostly heavy cramping pain, and accompanied by 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 the general internal medicine department first, and then see the corresponding department according to the doctor’s diagnosis. 6.Nervous headache: also called tension headache, headache attack will appear paroxysmal tightness of the head, local pressure pain points, characterized by pressure-like boring pain, swelling pain, dull pain, mostly seen in people who use the brain too much, poor rest or insomnia. Patients with this type of headache usually do not have fever symptoms. 7.Migraine headache: It is a migraine headache, with a few patients having repeated attacks bilaterally or alternately left and right, with pulsating throbbing pain behind the orbit (eye orbit) or frontal temporal 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. It can be seen in neurology. 8.Trigeminal neuralgia: This kind of headache is the most intense, lightning or electrocution-like, may be accompanied by tears, the headache is paroxysmal and intermittent attacks, lasting from a few seconds to a few minutes, after a period of time and again. 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 ear, nose and throat inflammation, especially otitis media, after recovery. 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. 9. 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 waist, buttocks and upper limbs, causing nerve segmental damage, and if it invades the head and face, it will cause headache. It can be seen in neurology. 10.Headache caused by eye lesion: glaucoma, high myopia, retinopathy can cause headache, which needs to be examined and treated under the guidance of ophthalmologist. 11.Headache caused by head tumor: including brain, ear, nose and throat tumors such as nasopharyngeal carcinoma can cause headache, and the mechanism is that the tumor compresses the central nerve and the pressure inside the skull increases, resulting in severe headache. It should be seen in brain and oncology department. 12.Headache caused by other factors: In addition to the above-mentioned diseases that can cause headache symptoms, other diseases such as epidemic disease and leukemia can also cause headache if the symptoms are transferred to the brain.