Citha Nafasa Tallesang

1561050109
Learning Objective
• Definition and Epidemiology Of Headache
• Pathophysiology of Headache

• Clinical Symptoms And Classification of Headache

• Diagnostic of Headache

• Management of Headache
• Prognosis and Education of Headache
 What Is Headache ?
• Headache: is pain anywhere in the
region of the head or neck.

• Pain in the head and neck may easily

overlap.

• So they should be thought of ( as a unit)

when considering complaints of
headache.
Emergency Medicine Approach to Acute Convertion, 2015
Epidemiology Of Headache

Global Year Against Headache 2011-2012

Epidemilogy Of Headache

Global Year Against Headache 2011-2012

Classification of Headache

Migraine Cluster
Headache Headache

Tension –
Trigeminal
Type
Headache
Neuralgia
Migraine Headache

UNM, Health Science Center 2013

Cluster Headache

UNM, Health Science Center 2013

Tension Type- Headache

UNM, Health Science Center 2013

 Trigeminal neuralgia
• Paroxysmal pain in distribution of CNV

• Pain often triggered by trivial sensory

stimulus (light touch,wind)

• Each attack is short-lived (seconds) but

tends to occurrepetitively, with
lingering facial pain

UNM, Health Science Center 2013

 Pathophysiology Of Headache
* Two Suggested Theories For The
Pathophysiology Of Headaches / Migraines :
• Old : The Vascular Theory :

• Intracranial vasoconstriction is responsible for

the aura of the migraine.

• Headache is results from the subsequent

rebound dilatation which leads to the activation
of the perivascular nociceptive nerves.
Emergency Medicine Approach to Acute Convertion, 2015
 Pathophysiology Of Headache
• New : The Neurological Theory :

• Headaches/ Migraines are triggered by a

complex series of neural and vascular events ,
due to Neuronal hyper-excitability in the
cerebral cortex, especially in the occipital
cortex.

Emergency Medicine Approach to Acute Convertion, 2015

 How to Diagnose ?
• Evaluate the prevalence of primary and
secondary headache disorders in the general
population and clinical practice
• Identify warning signs of serious secondary
headaches
• Review the clinical features, diagnostic
criteria, and differential diagnosis of
migraine
• Assess the value of diagnostic testing in
primary and secondary headache disorders
Headache Classification Subcommittee of the International Headache Society.
The InternationalClassification of Headache Disorders
 How to Diagnose?
• EEG
• CT- Scan
• MRI

Headache Classification Subcommittee of the International Headache Society.

The InternationalClassification of Headache Disorders
 How to Treat?
• Migraine and Cluster Headache :
 Ergot alkaloids Dihydroergomtamin
Ergotamine
 OAINS
Opioid analgesics

• Tension Type- Headache :

Muscle relaxant
Anti-depressant
OAINS

UNM, Health Science Center 2013

 How to Treat ?
• Trigeminus Neuralgia
 anti-konvulsant

Successful treatment usually includes strong emphasis on non-

pharmacologic management :
 Physical therapy for neck
 Stretching
 Relaxation techniques
 Posture correction
 Heat to neck affected by muscle spasm

UNM, Health Science Center 2013

 Prognosis and How to Educate ?
• Depending on the type of headache

• Avoid trigger factors

 Reference
• International Association for the Study of Pain.
2011. Global Year Against Headache.