Focus on Headache

Focus on Headache

Headache

* Probably the most common type of pain experienced by humans
* Majority of people have functional headaches
o Migraine or tension-type headaches
* Not all cranium tissues are sensitive to pain
* Pain-sensitive structures include venous sinuses, dura, cranial blood vessels, divisions of the trigeminal nerve, facial nerve, glossopharyngeal nerve, vagus nerve, and the first three cervical nerves
* Classification from the International Headache Society diagnostic criteria
* Primary classifications
o Tension-type
o Migraine
o Cluster


Tension-Type Headache

* Most common type
* Bilateral, band-like feeling of pressure around the head
* Constant, squeezing tightness
* Not aggravated by physical activity
* Usually mild or moderate
* Often subcategorized into
o Infrequent episodic
o Frequent episodic
o Chronic

Tension-Type Headache Etiology and Pathophysiology

* Mechanism in all patients with tension-type headaches has neurovascular factors similar to those involved in migraine headaches

Tension-Type Headache Clinical Manifestations
* No nausea or vomiting
* May involve sensitivity to light and sound
* May occur intermittently
* Can have combination of migraine and tension-type headaches
* Careful history taking
* Electromyography may be performed
o May reveal sustained contraction of neck, scalp, or facial muscles
o May not show increased tension even when test is done during headache

Tension-Type Headache Diagnostic Studies

Migraine Headache
* Recurring
* Characterized by unilateral or bilateral throbbing pain
* Triggering event or factor
* Strong family history
* Manifestations associated with neurologic and autoimmune nervous system function
* More common in females than males
* In United States, prevalence highest in those of lower socioeconomic status

Migraine Headache Etiology and Pathophysiology

* Evidence suggests vascular, muscular, and biochemical factors are involved
* Exact cause is unknown
* Can be preceded by an aura and prodrome
o May precede by days or hours
o Aura associated with wave of oligemia beginning at occipital lobe and spreading forward
* May be precipitated or triggered by
o Food
o Hormonal fluctuations
o Head trauma
o Physical exertion
o Fatigue
o Stress
o Pharmacologic agents

Migraine Headache Clinical Manifestations
Migraine Headache Diagnostic Studies
Cluster Headache Etiology and Pathophysiology
Cluster Headache Diagnostic Studies
Headache Other Types
Headache Collaborative Care
Headache Nursing Management

Focus on Headache.ppt
from South Texas College
(Relates to Chapter 59,“Nursing Management: Chronic Neurologic Problems,” in the textbook Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved. )