TAILIEUCHUNG - Chapter 015. Headache

General Principles A classification system developed by the International Headache Society characterizes headache as primary or secondary (Table 15-1). Primary headaches are those in which headache and its associated features are the disorder in itself, whereas secondary headaches are those caused by exogenous disorders. Primary headache often results in considerable disability and a decrease in the patient's quality of life. Mild secondary headache, such as that seen in association with upper respiratory tract infections, is common but rarely worrisome. . | Chapter 015. Headache General Principles A classification system developed by the International Headache Society characterizes headache as primary or secondary Table 15-1 . Primary headaches are those in which headache and its associated features are the disorder in itself whereas secondary headaches are those caused by exogenous disorders. Primary headache often results in considerable disability and a decrease in the patient s quality of life. Mild secondary headache such as that seen in association with upper respiratory tract infections is common but rarely worrisome. Lifethreatening headache is relatively uncommon but vigilance is required in order to recognize and appropriately treat patients with this category of head pain. Table 15-1 Common Causes of Headache Primary Headache Secondary Headache Type Type Migraine 16 Systemic infection 63 Tension-type 69 Head injury 4 Cluster Vascular disorders 1 Idiopathic stabbing 2 Subarachnoid hemorrhage 1 Exertional 1 Brain tumor Source After J Olesen et al The Headaches. Philadelphia Lippincott Williams Wilkins 2005 Anatomy and Physiology of Headache Pain usually occurs when peripheral nociceptors are stimulated in response to tissue injury visceral distension or other factors Chap. 12 . In such situations pain perception is a normal physiologic response mediated by a healthy nervous system. Pain can also result when pain-producing pathways of the peripheral or central nervous system CNS are damaged or activated inappropriately. Headache may originate from either or both mechanisms. Relatively few cranial structures are pain-producing these include the scalp middle meningeal artery dural sinuses falx cerebri and proximal segments of the large pial arteries. The ventricular ependyma choroid plexus pial veins and much of the brain parenchyma are not pain-producing. The key structures involved in primary headache appear to be IMG editor tinymce PicExportError IMG the large intracranial vessels and dura mater IMG .

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