HEADACHE

DEFINITION

is the symptom of pain anywhere in the

region of the head or neck
also known as Cephalgia.

Clasification
1. Primary headache
Unknown causes
Such as
a) Migraine.
b) Tension Headache.
c) Cluster (Atypical Migraine).

Clasification
2. Secondary headache
a)
b)
c)
d)

cause by pathological problem.

Such as;
Vaskular Nonmigrainous headache.
Headache cause by intracranial
traction.
Cranium infection.
Headache cause by referred pain
not in the nervous system.

PATHOPHYSIOLOGY
Vascular headache
Vasokonstriction followed by
vasodilatation& distension of
extracranial artery and external
carotid.
Migrain
Dilatation of the extracranial, temporal
& intracranial artery.

PATHOPHYSIOLOGY
Headache cause by fever & hpt
Distension and extension of the
intracranial artery.
Tension headache
Spasm on the muscle of the neck.
depression.

PATHOPHYSIOLOGY
(Eye)
Eye muscle imbalance
Intracranial lesion
Changes of the blood vessel & the
structure on the surface of the
brain
Traction on the blood vessel of the
brain.

PATHOPHYSIOLOGY
Irritation if the mininges
ICP .
Inflamation of the blood vessel and
congestion of the blood supply to
the brain

ETIOLOGY
1. Migrain
2. Tension Headache.
3. Diseases that involve blood vessel
such as an intracerebral
hemorrhage, cerebral thrombosis /
embolism, Berry aneurysm, HPT
encephalopathy etc.
4. ICP ; tumor, abscess, encephalitis,
trauma, subdural hematoma etc.

ETIOLOGY
5. meningitis,subarachnoid
bleeding.
6. Post ictal.
7. Post concussion.
8. sinusitis, #, mastoiditis, paget
disease.
9. otitis media.

ETIOLOGY
10.glaucoma, iritis, tumor.
11.hypoxia, hipoglisemia.
12.anaemia & policythaemia.
13.Coital cephalgia.
14.Psikogenik.

TENSION HEADACHE

Mostly occurs.
Pain especially during the day.
Dull ache, feels like being grip.
Usually occurs in - occipital or
frontal.
Bilateral headache.
Onset gradual & usually come
with nausea, anxiety or dizziness.

TENSION HEADACHE

Spasm on the back of the neck.

Not disturbing on sleeping.
Pt can do ADL.
Analgesic not effective.
Will decrease after resting.
Can be caused by stress.

CLUSTER headache
Also known as paroxismal nocturnal
cephalalgia, migrainous neuralgia.
causes - vascular, either
constriction or dilatation.
Usually on old people.
Sudden onset after 2-3 hours of
sleep.
Pt awaken cause of orbitotemporal
headache.
Ass. with rhinorrhea, ptosis,
unilateral or bilateral. Flushing,
sweating.

CLUSTER headache
duration 30 min to 3 hours then
relieves.
Cluster means frequently occurs,
every week or month.
Will occurs on the same side.

CLUSTER headache
treatment;
stop or reduce consuming
alcohol
NSAID Mefenamic Acid.
Prevention Prednisolone 525mg od/divided dosage or
ergotamine.