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HEADACHE

HEADACHE. HEADACHE. Headache is probable the most common type of pain experienced by humans. Headache is a common symptom of many neurologic condition and is also a separate disease process. MEANING. HEADACHE IS PAIN IN ANY REGION OF THE HEAD

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HEADACHE

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  1. HEADACHE

  2. HEADACHE • Headache is probable the most common type of pain experienced by humans. Headache is a common symptom of many neurologic condition and is also a separate disease process.

  3. MEANING • HEADACHE IS PAIN IN ANY REGION OF THE HEAD • A HEADACHE MAY APPEAR AS A SHARP PAIN, A THROBBING SENSATION OR A DULL ACHE. HEADACHES CAN DEVELOP GRADUALLY OR SUDDENLY, AND MAY LAST FROM LESS THAN AN HOUR TO SEVERAL DAYS.

  4. CLASSIFICATION • Headache are classified by international society on primary and secondary. • Primary headaches are not associated with any other known pathological cause. Ex: migraine, tension and cluster headaches. • Secondary headaches are caused by known pathology such as meningities, tumors or subarachnoid haemorrhage.

  5. ETIOLOGY ORGANIC DISEASE (NEUROLOGIC OR OTHER DISEASES) EX: BRAIN TUMOR OR AN ANEURYSM A STRESS RESPONSE VASODILATION (MIGRAINE) SKELETAL MUSCLE TENSION(TENSION HEADACHE) CRANIAL ARTERITIS SUBARACHNOID HEMORRHAGE STROKE SEVERE HYPERTENSION HEAD INJURIES MENINGITIS ENVIRONMENTAL FACTORS: SUNLIGHT, WEATHER CHANGES FOOD

  6. CONTINU… • EMOTIONAL FACTORS: STRESS • SLEEP PATTERN • APPETITE • EXPOSURE TO TOXIC SUBSTANCE • FAMILY HISTORY

  7. PATHOPHYSIOLOGY PAIN CAUSED BY TRACTION, STRETCHING OF MOVEMENT OF STRUCTURES OR BY VASODILATION OF BLOOD VESSELS OR VASOCONSTRICTION INFLAMMATION OF BLOOD VESSELS RELEASE OF SEROTININ CAUSES HEADACHE

  8. CLINICAL MANIFESTATIONS • PAIN OVER : FRONTAL HEAD, TEMPORAL REGIONS, PERIETAL REGION AND NECK • RADIATING OTHER PARTS OF BODY • PAIN MAY BE TIGHT, SQUEEZING AND BANDLINE PRESSURE. • PAIN MAY BE SUSTAINED, CHRONIC, DULL AND PERSISTENT • “AURAE” – THE AURA OCCURS BEFORE THE ACUTE ATTACK AND MAY INCLUDE VISUAL FIELD DEFECTS SUCH AS “FLASHING LIGHTS” PHOTOPHOBIA, CONFUTION OR PARESTHSIS. AURAE TYPICALLY LAST FOR AN HOUR OR MORE • NAUSEA, VOMITING, CHILLS, FATIGUE, IRRITABILITY, SWEATING AND EDEMA. • FLUSHING, TEARING OF EYES, NASAL STUFFINESS AND SWELLING OF TEMPORAL VESSELS. • “PRODROME”- DEPRESSION, IRRITABILITY, FEELING COLD, FOOD CRAVINGS, ANOREXIA, CHANGE IN ACTIVITY LEVEL, INCREASED URINATION, DIARRHEA OR CONSTIPATION.

  9. DIAGNOSTIC EVALUATIONS • HISTORY COLLECTION • PHYSICAL ASSESSMET: HEAD AND NECK • COMPLETE NEUROLOGICAL EXAMINATION • CT • CEREBRAL ANGIOGRAPHY • MRI: TO DETECT UNDERLYING CAUSES SUCH AS TUMOR OR ANEURYSM • ELECTROMYOGRAPHY (EMG): MAY REVEAL A SUSTAINED CONTRACTION OF THE NECK, SCALP OR FACIAL MUSCLES. • BLOOD TEST: CBC, ESR, ELECTROLYTES, GLUCOSE, CREATININE AND THYROID HORMONE LEVELS.

  10. MANAGEMENT- MEDICAL • NON-NARCOTIC ANALGESISCS (ASPIRIN, ACETAMINOPHEN, AND IBUPROFEN) • ANALGESIC COMBINATIONS (BUTALBITAL) • MUSCLE RELAXANTS • SEROTONIN RECEPTOR AGONISTS (SUMATRIPTAN, NARATRIPTAN, RIZATRIPTAN) • ALPHA ADRENERGIC BLOCKERS (ERGATRAMINE TARTRATE) • VASOCONSTRICTORS (ISOMETHEPTONE- MIDRIN) • CORTICOSTEROIDS (DEXAMETHOSONE) • TRICYCLIC ANTIDEPRESSANTS (AMITRIPTYLINE)

  11. CONTINU… • BETA-ADRENERGIC BLOCKERS (PROPRANOL-INDERAL) • ALPHA-ADRENALINE BLOCKERS • LITHIUM • SEROTONIN ANTAGONISTS • CALCIUM CHANNEL BLOCKERS (ISOPTIN) • YOGA • MUSCLE RELAXATION TRAINING • PSYCHOTHERAPY

  12. MANAGEMENT- NURSING • DIETARY COUNSELING: AVOID FOOD VINEGAR, CHOCOLATE, ONIONS, ALCOHOL (RED WINE), EXCESSIVE COFFEINE, CHEESE, FERMENTED OR MARINATED FOOD, NICOTINE, ICE-CREAM. • AVOID SMOKING • AVOID EXPOSURE TO TRIGGERS SUCH AS STRONG PERFUMES • AVOID STRESS • RELAXATION TECHNIQUES • REGULAR EXERCISE • MEDICATIONS • REST AND SLEEP

  13. THANK YOU…

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