Headache is never a small disease.
It is so severe that it can make a man bang his head against a wall; it is extremely common, being the most common disease in neurology clinics; and it is so complex that most patients cannot find a clear cause. Headache, despite the many unknowns, is gradually being demystified by doctors through extensive research and curbed by standardized diagnosis and treatment.
The results of epidemiological surveys conducted from 2008 to 2010 show that, not counting headaches caused by colds and alcohol, the total prevalence of headaches in China is 28.5%; 4.8% of people experience headaches in any given day; and one out of 100 people is suffering from headaches every moment of every day.
Headache is divided into two categories, one can find a clear cause, including intracranial tumors, hemorrhage, meningitis, hypertension and other organic lesions; the other is the one that cannot find a clear cause, also called “primary headache”, which is the majority of patients, accounting for 83.5%. Yu Shengyuan said, in order to treat headaches, the first step is to screen out headaches that originate from organic lesions and treat them from the “source”; after excluding organic lesions, then classify primary headaches and then crack each one.
There are three types of primary headache. The first one is migraine, which has an annual prevalence of 9.3% in the population, with women predominating twice as much as men. The characteristics of the headache include: lateralized, throbbing, moderately severe, aggravated by activity, often accompanied by nausea and vomiting, fear of light and sound, etc. The diagnosis is usually made by meeting two of these criteria. The second type of headache is tension-type headache, which affects 10.8% of the population in a year. Its pain characteristics are: bilateral, non-pulsatile, not aggravated by activity, generally mild to moderate, and the patient often has hat-like swelling pain, accompanied by head muscle spasms, not accompanied by nausea and vomiting. The third type is called “cluster headache”, as the name implies, the patient’s headache is very frequent and severe for a period of time, often accompanied by unilateral lacrimation, sweating and other autonomic symptoms, this is the most serious type of headache, the majority of men, some patients even choose to die because of unbearable.
After the diagnostic typing of headache is clarified, doctors can give the appropriate treatment accordingly. After researching and summarizing tens of thousands of clinical cases, Yu Shengyuan and his team have found a way to “divide and conquer”. It is now believed that migraine is related to trigeminal vascular reflexes, and its treatment principle is: when it attacks, NSAIDs or tritans are used; when it does not attack, calcium antagonists (flunarizine), antiepileptics, beta-blockers, antidepressants, etc. can be used for prevention. For tension-type headache, current research suggests that it is related to central nerve hypersensitivity to pain. For treatment, if the headache is mild, use general painkillers; for patients with muscle spasms, use muscle relaxants, and in addition, use antidepressants. Yu Shengyuan explained that antidepressants are not used only for headache patients with depression, because the drug itself has a blocking effect on the transmission of pain sensation. In the case of cluster headache, the cause is thought to be related to the biological clock in the hypothalamus, and treatment requires hormones, isoptin and other drugs. The accuracy of the diagnosis depends on the detailed description of the patient’s medical history, and careful questioning is often more valuable than laboratory tests. “Patients with headaches must usually keep a pain diary, which will help the doctor characterize the headache as soon as possible, and then carry out targeted treatment”.
Adopt 4 habits
Each headache patient has his or her own pattern of attacks, so it’s best to keep a diary to help the doctor’s diagnosis and to find his or her own patterns and triggers, so that they can be avoided in life. Professor Yu Shengyuan said, in addition to keeping a diary, patients should usually pay attention to the following points.
1, less head down, more exercises that require head tilting. It is recommended to participate in more activities such as badminton, swimming and kite flying to help prevent headaches.
2.Perform psychological adjustment and improve sleep. Studies have shown that poor sleep and emotional tension can trigger headaches.
3.Drink less coffee and cola. These drinks contain caffeine. A small amount of caffeine can relieve pain, but a large intake can trigger headaches instead.
Sixty percent of patients are abusing drugs
When headache comes, patients often hold two extreme attitudes, one is to carry on without medication, lest painkillers hurt the body; the other is to abuse painkillers. Yu Shengyuan told reporters that the cumulative use of painkillers for more than 10 days in a month is considered abuse, which is very common among chronic headache patients, accounting for 60 percent. Some patients, when visiting the outpatient clinic, even grabbed a large amount of medicine and sent it to their mouths in front of the doctor.
The painkillers that patients use on their own are generally non-steroidal antipyretic analgesics, such as aspirin, paracetamol, ibuprofen, etc. These drugs are mostly over-the-counter, and patients can buy them from pharmacies. Experts stress that these drugs are another major cause of headaches, in addition to adverse effects such as digestive tract damage and kidney damage. In other words, improper use of painkillers causes headaches instead, and it is quite common.
Among chronic headache patients who have headaches for more than 15 days a month, a significant number of them need to quit the medication first. These patients have been taking large amounts of medication for a long time and have become dependent on painkillers, and when they stop using them, they develop withdrawal symptoms, for which their doctor will provide help. When they get through this period, they can then undergo targeted treatment, and the headache can be controlled.
8 conditions to be alerted
More than 80% of headache patients have primary headaches for which no exact cause can be found, and a few have organic lesions. Those organic lesions that cause headaches are often more serious diseases, so headache patients need to rule out such conditions first and treat them as soon as they are detected. There are several conditions that require vigilance.
1. Headaches that have just occurred. Compared with long-term chronic headache, sudden onset of headache should be more alert.
2.Headache in the elderly.
3. Headache that gradually worsens.
4.With hemiplegia and aphasia, be alert to acute cerebrovascular disease.
5.With fever and skin rash, be alert to brain infection.
6.With stiff neck and jet vomiting, suggesting an increase in cranial pressure.
7.Lying down without pain, but standing up with headache is often a sign of low cranial pressure.
8.Patients with headache themselves have underlying diseases, such as immune diseases, etc.