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| | __NOTOC__ |
| | {| class="infobox" style="float:right;" |
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| | | [[File:Siren.gif|30px|link=Headache resident survival guide]]|| <br> || <br> |
| | | [[Headache resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] |
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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| {{Infobox_Disease | | | {{Headache}} |
| Name = Headache |
| | '''Editor-In-Chief:''' [[User:Bobby Schwartz|Robert G. Schwartz, M.D.]] [mailto:RGSHEAL@aol.com], [http://www.piedmontpmr.com Piedmont Physical Medicine and Rehabilitation, P.A.]; '''Associate Editor-In-Chief''':{{NE}} {{CZ}} |
| ICD10 = {{ICD10|R|51||r|50}} |
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| ICD9 = {{ICD9|784.0}} |
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| }}
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| {{SI}}
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| '''Editor-In-Chief:''' [[User:Bobby Schwartz|Robert G. Schwartz, M.D.]] [mailto:RGSHEAL@aol.com], [http://www.piedmontpmr.com Piedmont Physical Medicine and Rehabilitation, P.A.]; '''Associate Editor-In-Chief''': {{CZ}} | |
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| ==Overview== | | {{SK}} Cephalgia |
| A '''headache''' ('''cephalgia''' in medical terminology) is a condition of pain in the [[head]]; sometimes [[neck]] or upper back pain may also be interpreted as a headache. It ranks amongst the most common local pain complaints.
| | ==[[Headache overview|Overview]]== |
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| The vast majority of headaches are benign and self-limiting. Common causes are [[tension headache|tension]],[[Neck pain]], [[migraine]], eye strain, [[dehydration|dehydration]], low blood sugar, and [[sinusitis]]. Much rarer are headaches due to life-threatening conditions such as [[meningitis]], [[encephalitis]], [[cerebral aneurysm]]s, [[hypertensive emergency|extremely high blood pressure]], and [[brain tumor]]s. When the headache occurs in conjunction with a [[head injury]] the cause is usually quite evident. A large percentage of headaches among females are caused by ever-fluctuating [[estrogen]] during [[menstruation|menstrual]] years. This can occur prior to, during or even midcycle menstruation.
| | ==[[Headache historical perspective|Historical Perspective]]== |
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| Treatment of uncomplicated headache is usually symptomatic with [[Over-the-counter drug|over-the-counter]] [[analgesic|painkillers]] such as [[aspirin]], [[paracetamol]] (acetaminophen), or [[ibuprofen]], although some specific forms of headaches (e.g., [[migraines]], [[Barre lieou]]) may demand other, more suitable treatment. It may be possible to relate the occurrence of a headache to other particular triggers (such as stress or particular foods), which can then be avoided.
| | ==[[Headache pathophysiology|Pathophysiology]]== |
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| == Pathophysiology == | | ==[[Headache causes|Causes]]== |
| The [[brain]] in itself is not sensitive to [[Pain and nociception|pain]], because it lacks pain-sensitive nerve fibers. Several areas of the head can hurt, including a network of nerves which extend over the scalp and certain nerves in the face, mouth, and throat. The [[meninges]] and the blood vessels do have pain perception. Headaches often result from traction to or irritation of the meninges and blood vessels. The muscles of the head may similarly be sensitive to pain.
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| == Types == | | ==[[Headache differential diagnosis|Differentiating Headache from other Diseases]]== |
| There are five types of headache: vascular, myogenic (muscle tension), cervicogenic, traction, and inflammatory.
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| === Vascular === | | ==[[Headache epidemiology and demographics|Epidemiology and Demographics]]== |
| The most common type of vascular headache is ''[[migraine]]''. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and, for some people, disturbed vision. It is more common in women. While vascular changes are evident during a migraine, the cause of the headache is [[neurologic]], not vascular. Barre-Lieou is an excellent example [http://www.piedmontpmr.com/diagnose-treat-barre-lieou-neck-pain-blurred-vision-nausea-vertigo-tinnitus-2]. After migraine, the most common type of vascular headache is the [[Toxic headache|"toxic" headache]] produced by fever.
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| Other kinds of vascular headaches include ''[[cluster headache]]s'', which cause repeated episodes of intense pain, and headaches resulting from ''[[hypertension|high blood pressure]]'' (rare).
| | ==[[Headache risk factors|Risk Factors]]== |
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| === Muscular/myogenic === | | ==[[Headache natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| Muscular (or myogenic) headaches appear to involve the tightening or tensing of facial and neck muscles; they may radiate to the forehead. [[Tension headache]] is the most common form of myogenic headache. Myofascial pain [http://www.piedmontpmr.com/myofascial-syndrome-diagnsosis-and-treatment-2] is a common cause of muscular headache.
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| === Cervicogenic === | | ==Diagnosis== |
| Cervicogenic headaches originate from disorders of the neck [[Neck pain]],[http://www.piedmontpmr.com/neck-pain-relief-2] including the anatomical structures innervated by the cervical roots C1–C3. Cervical headache is often precipitated by neck movement and/or sustained awkward head positioning. It is often accompanied by restricted cervical range of motion, ipsilateral neck, shoulder, or arm pain of a rather vague non-radicular nature or, occasionally, arm pain of a radicular nature.
| | [[Headache history and symptoms|History and Symptoms]] | [[Headache physical examination|Physical Examination]] | [[Headache laboratory findings|Laboratory Findings]] | | [[Headache CT|CT]] | [[Headache MRI|MRI]] | [[Headache ultrasound|Ultrasound]] | [[Headache other imaging findings|Other Imaging Findings]] | [[Headache other diagnostic studies|Other Diagnostic Studies]] |
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| === Traction/inflammatory === | | ==Treatment== |
| Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection.
| | [[Headache medical therapy|Medical Therapy]] | [[Headache surgery|Surgery]] | [[Headache primary prevention|Primary Prevention]] | [[Headache secondary prevention|Secondary Prevention]] | [[Headache cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Headache future or investigational therapies|Future or Investigational Therapies]] |
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| Specific types of headaches include:
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| *[[Tension headache]]
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| *[[Migraine]],[http://www.piedmontpmr.com/migraine]
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| *[[Idiopathic intracranial hypertension]] (headache with visual symptoms due to raised [[intracranial pressure]])
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| *[[Ictal headache]]
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| *"[[Brain freeze]]" (also known as: ice cream headache)
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| *[[Thunderclap headache]]
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| *[[Vascular headache]]
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| *[[Toxic headache]]
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| *[[Coital cephalalgia]] (also known as: sex headache)
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| *[[Hemicrania continua]]
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| *[[Rebound headache]] (also called medication overuse headache, abbreviated MOH)
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| *[[Red wine headache]]
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| *"Spinal headache" (or: post-dural puncture headaches) after [[lumbar puncture]] or related procedure that will lower the [[intracranial pressure]]
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| *[[Hangover]] (caused by heavy alcohol consumption)
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| A headache may also be a symptom of [[sinusitis]].
| | == Case Studies == |
| | [[Headache case study one|Case #1]] |
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| Like other types of pain, headaches can serve as warning signals of more serious disorders. This is particularly true for headaches caused by [[inflammation]], including those related to [[meningitis]] as well as those resulting from diseases of the sinuses, spine, neck, ears, and teeth.
| | {{Symptoms and signs}} |
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| == Diagnosis ==
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| While, statistically, headaches are most likely to be harmless and self-limiting, some specific headache syndromes may demand specific treatment or may be warning signals of more serious disorders. Some headache subtypes are characterized by a specific pattern of symptoms, and no further testing may be necessary, while others may prompt further diagnostic tests.
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| Headache associated with specific symptoms may warrant urgent medical attention, particularly sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with [[fever]], [[convulsion]]s or accompanied by confusion or [[loss of consciousness]]; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person with no previous history of headaches; and recurring headache in children.
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| The most important step in diagnosing a headache is for the physician to take a careful history and to examine the patient. In the majority of cases the diagnosis will be tension headache or migraine, both of which can be managed on the basis of a clear-cut clinical picture. Where doubt remains, or if there are abnormalities detected on examination, further investigations are justified.<ref>Detsky ME, McDonald DR, Baerlocher MO, Tomlinson GA, McCrory DC, Booth CM. Does this patient with headache have a migraine or need neuroimaging? JAMA 2006;296:1274-83</ref> [[Computed tomography]] (CT/CAT) scans of the brain or sinuses are commonly performed, or [[magnetic resonance imaging]] (MRI) in specific settings. [[Blood test]]s may help narrow down the [[differential diagnosis]], but are rarely confirmatory of specific headache forms. For mixed headaches (headaches with several components) diagnostic testing that addresses each suspected aspect may be required. Examples include EMG/NCV [http://www.piedmontpmr.com/emg-ncvs-3], [[Diagnostic musculoskeletal ultrasonography]] and [[Thermography]].
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| ==Complete Differential Diagnosis of Causes of Headache==
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| Causes include <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
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| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiac'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | • [[Hypotension]] • [[Hypertension]] • [[Malignant hypertension]] •
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| | '''Chemical / Poisoning'''
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| |bgcolor="Beige"| • [[Amnesic shellfish poisoning]] • [[Anadenanthera peregrina]] • [[Antimony]] • [[Arsenic poisoning]] • [[Artemisia afra]] • [[Carbon monoxide]] • [[Copper]] • [[Cyanide]] • [[Heavy metal ingestion]] • [[Hemlock]] • [[Hydrogen sulfide]] • [[Lead poisoning]] • [[Manganese]] • [[Marine toxins]] • [[Monocrotophos]] • [[Nicotine poisoning]] • [[Radiation poisoning]] • [[Soil contamination]] • [[Thallium]] • [[Toxic headache]] • [[Water intoxication]] •
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| | '''Dermatologic'''
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| |bgcolor="Beige"| • [[Linear immunoglobulin A dermatosis]] •
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| • [[Acamprosate]] • [[Acyclovir]] • [[Alatrofloxacin Injection]] • [[Alosetron]] • [[Amantadine]] • [[Ambrisentan]] • [[Aminophylline]] • [[Amiodarone]] • [[Amlodipine]] • [[Amphotericin B]] • [[Anagrelide]] • [[Armodafinil]] • [[Atorvastatin]] • [[Benazepril]] • [[Bepridil]] • [[Bexarotene]] • [[Bisoprolol]] • [[Bosentan]] • [[Bromocriptine]] • [[Butabarbital]] • [[Butorphanol]] • [[Cabergoline]] • [[Caffeine]] • [[Candesartan]] • [[Capecitabine]] • [[Carbamazepine]] • [[Carbimazole]] • [[Carmustine]] • [[Carteolol]] • [[Carvedilol]] • [[Caspofungin]] • [[Cilansetron]] • [[Cilostazol]] • [[Clomethiazole]] • [[Combined oral contraceptive pill]] • [[Cycloserine]] • [[Cyclosporin]] • [[Cefaclor]] • [[Cefamandole Nafate Injection]] • [[Cefotetan]] • [[Cefdinir]] • [[Cefoperazone Sodium Injection]] • [[Calcitriol]] • [[Chelation therapy]] • [[Chlorothiazide]] • [[Chlorthalidone]] • [[Cilostazol]] • [[Cimetidine]] • [[Clopidogrel]] • [[Cyclosporine Injection]] • [[Deferasirox]] • [[Dextroamphetamine|Dexamfetamine]] • [[Digoxin]] • [[Diltiazem]] • [[Dimercaprol]] • [[Dinoprostone]] • [[Dipivefrine]] • [[Dipyridamole]] • [[Disopyramide]] • [[Docosanol]] • [[Dolasetron]] • [[Dofetilide]] • [[Doxazosin]] • [[Enalapril]] • [[Epinephrine]] • [[Eplerenone]] • [[Epoprostenol]] • [[Ergotamine]] • [[Etanercept Injection]] • [[Ethacrynic Acid]] • [[Ethanol]] • [[Ethosuximide]] • [[Ezetimibe]] • [[Felodipine]] • [[Fenofibrate]] • [[Fenoldopam]] • [[Flu vaccine]] • [[Fluorouracil]] • [[Fluoxetine]] • [[Fluvastatin]] • [[Epinephrine]] • [[Fosinopril]] • [[Furosemide]] • [[Ganciclovir]] • [[Gemeprost]] • [[Glyceryl trinitrate]] • [[Granisetron]] • [[Griseofulvin]] • [[Gyromitrin]] • [[Indomethacin]] • [[Insulin lispro]] • [[Influenza vaccine]] • [[Imatinib mesylate]] • [[Interleukin 2]] • [[Isosorbide dinitrate]] • [[Isosorbide mononitrate]] • Lerisetron • [[Levosimendan]] • [[Lofepramine]] • [[Lomotil]] • [[Lisuride]] • [[Mefloquine]] [[Memantine]] • [[Methimazole]] • [[Metronidazole]] • [[Methyprylon]] • [[Modafinil]]• [[Monosodium glutamate]] • [[Moricizine]] • [[Nicorandil]] • [[Nifedipine]] • [[Nitrendipine]] • [[Nitroglycerine]] • [[Non-steroidal anti-inflammatory drugs]] • [[Oxtriphylline]] • [[Oxytocin injection]] • [[Omalizumab]] • [[Ondansetron]] • [[Palonosetron]] • Pemirolast • [[Pergolide]] • [[Pimecrolimus]] • [[Piribedil]] • [[Propylthiouracil]] • [[Quinidine]] • [[Quinine]] • [[Rasagiline]] • Reproterol • [[Roflumilast]] • [[Ropinirole]] • [[Salbutamol]] • [[Selective serotonin reuptake inhibitor]] • [[Sildenafil]] • [[Sodium nitrite]] • Sulprostone • [[Tadalafil]] • [[Trabectedin]] • [[Trimeprazine]] • [[Trimethobenzamide]] • Tribavirin • [[Trimethadione]] • [[Tropisetron]] • [[Vardenafil]] • [[Vitamin A]] • [[Zafirlukast]] • [[Zileuton]] • [[Zomepirac]] •
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| • [[Angina tonsillaris]] • [[Nasal polyp]] • [[Otitis externa]] • [[Otitis media]] • [[Pharyngitis]] • [[Rhinolith]] • [[Peritonsillar abscess]] • [[Strep throat]] • [[Sinusitis]] • [[Trochleitis]] • [[Tonsillitis]] • [[Upper respiratory tract infection]] •
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| | '''Endocrine'''
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| |bgcolor="Beige"| • [[Acromegaly]] • [[Addison's disease]] • [[Conn syndrome]] • [[Diabetes mellitus|Diabetes mellitus]] • [[Hypoglycemia]] • [[Hyperaldosteronism]] • [[Hyperparathyroidism]] • [[Hyperpituitarism]] • [[Insulinoma]] • [[Menopause]] • [[Pituitary tumour]] (growth hormone secreting) • [[Polycystic Ovarian Syndrome]] •
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| | '''Environmental Conditions'''
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| |bgcolor="Beige"| • [[Airsickness]] • [[Altitude sickness]] • [[Brain freeze]] • [[Diesel particulate matter]] • [[Heat stroke]] • Ice cream headache • [[Multiple chemical sensitivity]] • [[Second-hand smoke]] •
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| • [[Crohn's disease]] • [[Inflammatory Bowel Disease]] •
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| | '''Genetic'''
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| |bgcolor="Beige"| • No underlying causes •
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| | '''Hematologic'''
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| |bgcolor="Beige"| • [[Anemia]] • [[Blood transfusion]] • [[Leukemia]] • [[Multiple myeloma]] •
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| [[Acute Disseminated Encephalomyelitis]] • [[Acute viral nasopharyngitis (common cold)]] • [[Adenoiditis]] • [[AIDS]] • [[Alkhurma virus]] • [[Anaplasmosis]] • [[Aseptic meningitis]] • [[Aspergillus clavatus]] • [[Astrovirus]] • [[Blastomycosis]] • [[Bolivian hemorrhagic fever]] • [[Byssinosis]] • [[Brucellosis]] • [[Bruxism]] • [[Boutonneuse fever]] • [[Campylobacteriosis]] • [[California encephalitis virus]] • [[Chagas disease]] • [[Chikungunya]] • [[Cladosporium]] • [[Cotton fever]] • [[Coxsackie B]] • [[Cryptococcosis]] • [[Cysticercosis]] • [[Dengue fever]] • Dental infection • [[Ebola]] • [[Encephalitis]] • [[Fever]] • [[Feverfew]] • [[Freshers' Flu]] • [[Giardia lamblia]] • [[Glioblastoma multiforme]] • [[Gradenigo's syndrome]] • [[Group A streptococcal infection]] • [[Haemophilus influenzae serotype B infection]] • [[Hangover]] • [[Hantavirus]] • [[Hay fever]] • [[Harvest mite]] • [[Henipavirus]] • [[Herpes zoster]] • [[Hepatitis]] • [[Herpesviridae]] • [[HIV]] • [[Japanese encephalitis]][ • [[Hymenolepis infection]] • [[Influenza]] • Intracranial abscess / granuloma • [[Lábrea fever]] • [[Legionellosis]] • [[Leptospirosis]] • [[Listeriosis]] • [[Lyme disease]] • [[Malaria]] • [[Marburg virus]] • [[Mansonelliasis]] • [[Meningococcemia]] • [[Meningoencephalitis]] • [[Metabolic acidosis]] • [[Metal fume fever]] • [[Mononucleosis]] • [[Micropolyspora faeni]] • [[Monkeypox virus]] • [[Mucormycosis]] • [[Mumps]] • [[Mycoplasma pneumoniae]] • [[Naegleria fowleri]] • [[Naegleria infection]] • [[Neisseria meningitidis]] • [[Nipah virus encephalitis]] • [[Nocardiosis]] • [[Norovirus]] • [[Oropouche fever]] • [[Pityriasis rosea]] • [[Psittacosis]] • [[Q fever]] • [[Ramsay Hunt syndromes]] • [[Rat-bite fever]] • [[Relapsing fever]] • [[Rhinovirus]] • [[Rickettsial infections]] • [[Rift valley fever]] • [[Ross River Fever]] • [[Rocky Mountain spotted fever]] • [[Rubella]] • [[Saccharopolyspora rectivirgula]] • [[Snakebite]] • [[Scarlet fever]] • [[Scrumpox]] • [[Shingles]] • [[Siraitia grosvenorii]] • [[Sitophilus granarius]] • [[Sodoku]] • [[St. Louis encephalitis]] • [[Staphylococcal enteritis]] • [[Streptobacillus]] • [[Syphilis]] • [[Thermoactinomyces sacchari]] • [[Thermoactinomyces vulgaris]] • [[Trench fever]] • [[Trichinosis]] • [[Tuberculous meningitis]] • [[Tularemia]] • [[Typhoid fever]] • [[Viral Gastroenteritis]] • [[Viral Hepatitis C]] • [[West Nile Virus]] • [[Yellow fever]] • [[Yersinia Pestis Infection]] • [[Zika fever]] •
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| | '''Musculoskeletal / Ortho'''
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| |bgcolor="Beige"| • [[Cervical spondylosis]] • [[Temporomandibular joint disorder]] •
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| | '''Neurologic'''
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| |bgcolor="Beige"| • [[Acoustic neuroma]] • [[Apoplexy]] • [[Arachnoid cyst]] • [[Arcuate foramen]] • [[Acute disseminated encephalomyelitis]] • [[Arnold nerve cough syndrome]] • [[Epilepsy]] • [[Idiopathic intracranial hypertension]] • [[Multiple sclerosis]] • [[Pituitary apoplexy]] • [[Posterior cervical sympathetic syndrome]] • [[Posterior leucoencephalopathy syndrome]] • [[Raised intracranial pressure]] • [[Spinal autonomic dysreflexia]] • [[West syndrome]] •
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional / Metabolic'''
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| |bgcolor="Beige"| • [[Thiamine (Vitamin B1) deficiency]] •
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| | '''Obstetrics & Gynecology'''
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| |bgcolor="Beige"| • [[Eclampsia]] • [[Pre-eclampsia]] • [[Pregnancy]] • [[Premenstrual syndrome]] •
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| • [[Acoustic neuroma]] • [[Adrenal carcinoma]] • [[Adrenal tumor]] • [[Astrocytoma]] • [[Atypical Teratoid Rhabdoid Tumor]] • [[Brain tumor]] • [[Brain Stem Gliomas]] • [[Carcinoid tumours and carcinoid syndrome]] • [[Craniopharyngioma]] • [[Ependymoma]] • [[Gliomatosis cerebri]] • [[Medulloblastoma]] • [[Meningioma]] • [[Oligoastrocytoma]] • [[Phaeochromocytoma]] • [[Polycythaemia rubra vera]] • [[Subdural hygroma]] • [[Tongue cancer]] •
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| | '''Opthalmologic'''
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| |bgcolor="Beige"| • [[Acute posterior multifocal placoid pigment epitheliopathy]] • [[Aneisokonia]] • [[Asthenopia]] • [[Computer vision syndrome]] • [[Ocular Neurosis]] • [[Oculogyric crisis]] • [[Progressive lenses]] •
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| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| • [[Acute alcohol intoxication]] • [[Alcohol withdrawal]] • [[Alcoholism]] • [[Rebound headache|Medication overuse]] •
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| | '''Psychiatric'''
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| |bgcolor="Beige"| • [[Anxiety disorder]] • Functional disorders • Primary affective disorder • [[Chronic stress]] • [[Clinical depression]] • [[Workplace stress]] • [[Gulf War syndrome]] •
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| | '''Pulmonary'''
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| |bgcolor="Beige"| • [[Acute bronchitis]] • [[Bird breeder's lung]] • [[Bird fancier's lung]] • [[Cheese worker's lung]] • [[Chemical worker's lung]] • [[Cough]] • [[Community-acquired pneumonia]] • [[Grain handler's lung]] • [[Hot tub lung]] • [[Humidifier lung]] • [[Hypersensitivity pneumonitis]] • [[Lower respiratory tract infection]] • [[Malt worker's lung]] • [[Nylon worker's lung]] • [[Obesity hypoventilation syndrome]] • [[Paprika splitter's lung]] •
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"| • [[Diabetic nephropathy]] • [[Hypercalcemia]] • [[Hyponatremia]] •
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| | '''Rheum / Auto Immune / Allergy'''
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| |bgcolor="Beige"| • [[Antiphospholipid syndrome]] • [[Polymyalgia rheumatica]] • [[Systemic lupus erythematosus]] • [[Takayasu arteritis]] • [[Temporal arteritis]] • [[Wegener's granulomatosis]] •
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| • [[Spinal cord injury|Cervical spine trauma]] • Dental trauma •
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| |bgcolor="LightSteelBlue" | '''Vascular Diseases & Malformations'''
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| |bgcolor="Beige" | • [[Arteriovenous malformation]] • [[Berry aneurysm]] • [[Carotid artery dissection]] • [[Cavernous angioma]] • [[Cavernous Sinus Thrombosis]] • [[Cerebral venous sinus thrombosis]] • Cerebellar infarction • [[Cerebral aneurysm]] • [[Cerebral arteriovenous malformation]] • [[Cerebrovascular accident]] • [[Cerebrovascular disease]] • [[Epidural hematoma]] • Intracranial haemorrhage • [[Migraine]] • Posterior communicating artery aneurysm • [[Subarachnoid haemorrhage]] • [[Superior vena cava syndrome]] • [[Vascular headache]] • Vertebral artery dissection • Vertebro-basilar artery syndrome •
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| • [[Agastache rugosa]] • [[Bearberry]] • [[Cluster headache]] • [[Colloid cyst of third ventricle]] • [[Hepatic failure]] • [[Intracranial space-occupying lesion]] • [[Paroxysmal hemicrania, chronic]] • [[Parry-Romberg syndrome]] • [[Reversible posterior leukoencephalopathy syndrome]] • [[Spontaneous intracranial hypotension]] • [[Standing (position)]] • [[Thunderclap headache]] •
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| == Treatment ==
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| Not all headaches require medical attention, and respond with simple [[analgesia]] (painkillers) such as [[paracetamol]]/[[acetaminophen]] or members of the [[Non-steroidal anti-inflammatory drug|NSAID]] class (such as [[aspirin]]/acetylsalicylic acid or [[ibuprofen]]).
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| In recurrent unexplained headaches, healthcare professionals may recommend keeping a "headache diary] with entries on type of headache, associated symptoms, precipitating and aggravating factors. This may reveal specific patterns, such as an association with [[medication]], [[menstruation]] or absenteeism or with certain foods. While it can be time consuming and complex, taking the effort to both determine the root cause of each headache type that the afflicted may have and then customize treatment for one aspect at a time can be quite fruitful. This is sometimes referred to as reducing total load [http://www.piedmontpmr.com/disease-management-reducing-total-load].
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| It was reported in March 2007 by two separate teams of researchers that stimulating the brain with implanted electrodes appears to help ease the pain of cluster headaches.<ref>[http://newsmax.com/archives/articles/2007/3/8/155943.shtml Brain Stimulation May Ease Headaches]. Reuters, March 9, 2007.</ref> Since cluster headache is ultimately an autonomic nervous system generated headache, evaluation for [[Barre lieou]] may offer an effective, non-invasive alternative.
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| === Prevention ===
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| Some forms of headache, such as [[migraine]], may be amenable to preventative treatment. On the whole, long-term use of painkillers is discouraged as this may lead to "rebound headaches" on withdrawal. [[Caffeine]], a [[vasoconstrictor]], is sometimes prescribed or recommended as a remedy or supplement to pain killers in the case of extreme migraine. This has led to the development of [[paracetamol]]/[[caffeine]] [[analgesic]]. One popular herbal preventive treatment for migraines is [[Feverfew]]. Magnesium, Vitamin B2, and Coenzyme Q10 are "natural" supplements that have shown some efficacy for migraine prevention(5).<ref>Mauskop A. Alternative therapies in headache: Is there a role? Med Clin North Am 2001;85(4):1077-1084. PMID 11480259.</ref>
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| === Manipulative therapy ===
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| A controversial approach to headache treatment is [[chiropractic]] care. Most research supporting the chiropractic adjustment (also known as [[spinal manipulation]] by the scientific community) has been self-funded by the chiropractic profession.
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| The most compelling study of [[chiropractic]] efficacy is Nelson's randomized trial, comparing chiropractic to medical care,<ref>[http://www.chiro.org/LINKS/ABSTRACTS/Efficacy_of_Spinal_Manipulation_Amitriptyline.shtml "The Efficacy of Spinal Manipulation, Amitriptyline and the Combination of Both Therapies for the Prophylaxis of Migraine Headache."] J Manipulative Physiol Ther 1998; 21 (8) Oct: 511–519.</ref> which included the drug [[amitriptyline]], for the treatment of Migraine Headache. During the 4-week trial, both groups reduced in symptoms. After withdrawal of treatment, the medical group relapsed or got worse, whereas the group receiving chiropractic care maintained their improvements. The amitriptyline is more cost-effective as it is cheaper than the cost of visiting a doctor, but freedom from symptoms or a reduction in frequency only happened in the chiropractic group.
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| Independent (non-chiropractic) researchers reviewed research on many different types of behavioral and physical treatments for tension-type and cervicogenic headaches<ref>[http://www.fcer.org/html/Research/DukeEvidenceReport.htm "Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache."] Duke University Evidence-based Practice Center, Center for Clinical Health Policy Research.</ref> and found that cervical spinal manipulation was associated with improvement in cervicogenic headache outcomes (but not for tension-type headache), and was superior to soft-tissue therapies like [[massage]].
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| ===Reducing Total Load===
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| Reducing the total number of things that can trigger a headache can be one of the most effective approaches toward headache relief. With this approach the patient and doctor try to identify all of the factors that contribute to that person's headache and whittle away at them one at a time [http://www.piedmontpmr.com/disease-management-reducing-total-load]. Treatment therefor is specific to those factors that contribute that person's headache. Cerviogenic nerve irritation with degenerative disc disease and cycle (hormonal) headaches may be important for one patient, however stress and a history of sinus infections may be more important for another. The next patient may have all of these factors and more. In each case an individualized treatment plan is required.
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| == References ==
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| {{Reflist|2}}
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| {{Symptoms and signs}}
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| [[ar:صداع]]
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| [[bar:Schädlweh]]
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| [[bs:Glavobolja]]
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| [[bg:Главоболие]]
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| [[ca:Mal de cap]]
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| [[da:Hovedpine]]
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| [[de:Kopfschmerz]]
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| [[es:Cefalea]] | | [[es:Cefalea]] |
| [[eu:Buruko min]]
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| [[fr:Céphalée]] | | [[fr:Céphalée]] |
| [[it:Cefalea]]
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| [[he:כאב ראש]]
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| [[nl:Hoofdpijn]]
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| [[ja:頭痛]] | | [[ja:頭痛]] |
| [[no:Hodepine]]
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| [[pt:Cefaléia]] | | [[pt:Cefaléia]] |
| [[qu:Uma nanay]]
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| [[ru:Головная боль]] | | [[ru:Головная боль]] |
| [[simple:Headache]] | | [[simple:headache]] |
| [[sk:Bolesť hlavy]]
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| [[fi:Päänsärky]]
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| [[sv:Huvudvärk]]
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| [[yi:קאפוויי]]
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| [[zh:頭疼]] | | [[zh:頭疼]] |
| [[pl:Ból głowy]] | | [[pl:Ból głowy]] |
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| [[Category:Headaches]] | | [[Category:Headaches]] |
| [[Category:Neurological disorders]] | | [[Category:Neurological disorders]] |
| | [[Category:Symptoms]] |
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |
| [[Category:Neurology]] | | [[Category:Neurology]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Overview complete]] | | [[Category:Overview complete]] |
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