Why does the headache get worse in a horizontal position? What are the most common causes of headaches with which patients come to you? What symptoms are observed in this case? Treating pain with fluctuations in blood pressure

Vascular view

Liquorodynamic view

Why do you feel dizzy when you get up or lie down

It is not often that people feel dizzy when standing up and when lying down. In such cases, a person has a clear feeling that objects around him move, rotate, stagger. Severe attacks cause weakness, a feeling of nausea, loss of control over the position of the body, orientation in space. The person may even fall. In medicine, dizziness is referred to as vertigo, and its treatment does not require special procedures, unless it is a symptom of a serious illness.

Most cases of such dizziness arise from extreme fatigue, sleep disturbance, or a strict diet. They are not dangerous to humans and disappear immediately after the normalization of the daily routine, refusal of the diet. Changes in the weather can also make people with low blood pressure dizzy, then pressure treatment is prescribed. However, some cases of vertigo require increased attention, since they can serve as the primary symptoms of any of the serious diseases. Severe and frequent dizziness requires timely treatment for medical help, prescribing appropriate treatment.

If you stand up abruptly

It happens that sudden rises from a bed or a chair lead to short-term dizziness. Some of these attacks are accompanied by darkening, circles before the eyes, a feeling of nausea, and tinnitus. They usually last for a short time, about a few seconds, but the frequency of their occurrence manifests itself in different ways. This can be one attack per month when getting up, or several a day. Depending on the frequency of attacks, diagnosis of the disease, the doctor prescribes treatment.

Standing up suddenly may be caused by orthostatic hypotension. when blood pressure drops sharply and cerebral circulation decreases. It causes dizziness, even fainting, darkening in the eyes. Common seizure symptoms:

• severe weakness;
• feeling of nausea;
• blurry before the eyes;
• hearing impairment;
• cardiopalmus;
• there is ear noise;
• convulsions.

Orthostatic hypotension occurs when a person has problems with vascular system, diseases of atherosclerosis, against the background of the use of diuretic drugs, diabetes and others.

Only the doctor identifies the true causes, after which he carries out the necessary treatment. With hypotension, it is recommended not to get up abruptly, slowly move to a semi-upright position, and only after a few minutes get out of bed. Preventive treatment for not severe cases consists in walking in the air, morning exercises, changing the diet and taking various herbal infusions.

Why does your head spin when you lie down

A slight dizziness when taking a lying position appears due to abnormalities in the spinal region, namely in the neck. Changing the position of the body changes the position of the vertebrae in the neck, and this limits the flow of blood to the brain.

Useful Information: Headache coupled with shortness of breath is a reason for examination

Often, when taking a horizontal position, ear diseases appear, they can also cause dizziness. If they are identified, treatment is carried out.

There are cases in which dizziness when taking a horizontal position can be the cause of old injuries such as a concussion. Turns of the head, osteochondrosis of the neck can also be accompanied by dizziness when lying down, slight nausea, pain in the cervical spine. Any such case requires special diagnostics (X-ray, MRI). Only after identifying the causes and making the correct diagnosis, individual treatment is prescribed.

Dizziness can occur with any movement. The main thing is to distinguish between symptoms and note in what situations an attack occurs. This will allow doctors to make a more accurate diagnosis. Read also:

Other provoking factors for the occurrence of vertigo

Dizziness in itself cannot be a diagnosis, only as a concomitant factor in another disease. Also, do not confuse with visual disturbances, in cases of flashing midges or the appearance of fog in front of the eyes. Real vertigo is a disturbance, not a disturbance, of the vestibular apparatus. In moments of dizziness, the patient feels unstable, it seems to him that not he, but everything around him revolves and staggers.

The list of factors that provoke vertigo includes a variety of life aspects, deviations, diseases. Here is some of them:

• stroke conditions;
• infections;
• vegetative-vascular dystonia;
• multiple sclerosis;
• various tumors;
• cervical osteochondrosis;
• brain injury;
• ear diseases;
• seasickness;
• severe stress;
• mental disorders;
• lack of nutrition;
• low hemoglobin;
• taking medications.

Dizziness attacks are possible, accompanied by nausea in case of impaired brain activity, problems with blood pressure. With a decrease in pressure, they often experience nausea, dizziness. When the pressure rises up to nausea, dizziness, sticky sweat and vomit are added. When these symptoms occur, you need an examination and treatment of pressure. In women, frequent dizziness appears in early pregnancy, during menstruation, or during the onset of menopause.

Useful information

Why do you feel dizzy when you lie down

Dizziness is a very unpleasant symptom, the appearance of which should not be ignored; it develops as a result of a malfunction in the system responsible for the orientation of our body in space. Very often patients at the doctor's office complain: "I get dizzy when I lie on my back."

Causes of dizziness

1. Diseases of the inner ear (various inflammatory processes, atherosclerosis, circulatory disorders, malfunctions of the vestibular organs).
2. Changes in the transmission of impulses to the brain, as a result of alcohol or nicotine poisoning. And also as a result of injury.
3. Incorrect processing of incoming impulses by the central nervous system, provoked by ischemia, intoxication, the consequences of trauma, failure of the delivery of nutrients to nerve cells.

The most common situations requiring a medical examination

Dizziness is not an independent disease, but rather a harbinger of it. You should immediately consult a doctor if you have:

• Head spin with tinnitus.
• Severe headaches with partial or complete hearing loss.
• Against the background of dizziness, nausea and vomiting begins.
• If, with a sharp turn of the head, you experience a light-headed state.
• Vertigo ends in loss of consciousness.
• Double vision, weakness of the limbs, impaired sensitivity.

Diseases accompanied by dizziness

The causes of vertigo while lying down are very varied, but the most common is circulatory failure in the brain. This violation provokes a number of neurological and internal diseases. Among them:

Osteochondrosis in the cervical spine leads to squeezing of the artery, and, accordingly, blood circulation and nutrition of the brain suffers. Dizziness can be almost constant, leading to darkening of the eyes, loss of orientation in space, and sometimes fainting. You can help in such a situation by laying the patient with his head down. Osteochondrosis is the most common cause of dizziness when lying down.

You need to go to a neurologist and be examined. Nonsteroidal anti-inflammatory drugs, physiotherapy, massage, special exercises and diet are prescribed.

Insufficient supply of oxygen and nutrients to the brain as a result of hypotension (low blood pressure). It is necessary to consult a therapist, he will prescribe drugs that normalize vascular tone and general strengthening therapy (vitamins).

Inflammatory diseases of the vestibular nerve are characterized by sudden onset of severe dizziness, which disappears after sleep. This problem is dealt with by an otolaryngologist (ENT). The examination must necessarily include computed tomography in order to exclude a stem stroke, the manifestations of these diseases are very similar. Treatment is aimed at eliminating dizziness, cessation of vomiting and nausea, and anti-inflammatory drugs are also used.

Vegetovascular dystonia with its inadequate vascular response, they either narrow, increasing pressure, then expand, losing tone. Due to improper work, cerebral circulation suffers, and, accordingly, dizziness may appear. The neurologist will prescribe medications that normalize vascular tone, recommends observing the daily regimen, fully resting, spending more time in the fresh air and exercising.

Edema of the canals of the labyrinth of the inner ear. caused by inflammatory processes of the nasopharynx. A visit to the ENT doctor and appropriate anti-inflammatory and circulation-improving treatment will be required.

Spinal hernia. can be completely painless and will only be detected with a medical examination. Their treatment can be conservative (medications, special exercises, physiotherapy procedures, etc.), as well as operative. The principle of treatment is determined after a thorough medical examination and depends on the severity of the patient's condition, the location and number of hernias.

Tumor processes in the brain. Dizziness with hearing loss on the affected side may be a sign. Tumors are benign and malignant. The earlier the patient applies for medical help, the better the chances of successful completion of the treatment. We'll have to visit an oncologist.

Prevention of relapse of dizziness

1. Learn to do without jerky movements. Make gentle turns in bed. Do not jump up abruptly in the morning, turn on your side and stand up smoothly.
2. Get good quality deep sleep.
3. Be outdoors more.
4. Exercise (running, walking, swimming, morning exercises, etc.). Physical activity strengthens vascular tone, improves blood circulation, forms a sufficient muscle corset.
5. Don't get carried away with highly restricted diets. Lack in the body nutrients hazardous to health.
6. Timely heal inflammation in the nasopharynx.

Be sure to undergo a medical examination. to find out the cause of dizziness while lying down. Take care of your health.

Single episodes are not fraught with danger for the human body, but if they are regularly repeated when turning or tilting the head, changing body position (turning in bed, getting up in the morning and lying down in the evening), one cannot do without consulting a doctor, treatment will significantly improve the quality of life ...

Headache lying on its side

Headache when lying down

Headache in the supine position is the result of many different pathological conditions, ranging from banal overwork and ending with a malignant brain tumor.

Depending on the characteristic symptomatology and the cause, doctors distinguish several genetic types of headache, the definition of which is of primary importance for its drug therapy.

Vascular view

It occurs when the tone of the vessels of the brain is disturbed. It is characterized by dull, breaking, throbbing pain, accompanied by darkening in the eyes, a feeling of heaviness in the head and flickering # 171; goose bumps # 187;.

The vascular pain increases significantly with the head down and in the supine position. The group of vascular headaches includes:

• pain with arterial hypertension;
• with migraine and atherosclerosis of the vessels of the brain;
• with acute disturbance of cerebral circulation (stroke);
• premenstrual and menstrual headaches;
• hypotension pain and seasonal headaches.

Liquorodynamic view

It is formed as a result of imbalances between the outflow of cerebrospinal fluid and secretion, as a result of which intracranial pressure either decreases or rises.

Typical symptoms of headaches of CSF-dynamic type: confusion, bursting character, feeling of pressure # 171; outward-from inside # 187 ;, a sharp increase in intensity in the supine position, while walking, when coughing and turning the head.

Diseases provoking liquorodynamic headaches:

• brain abscess, benign and malignant brain neoplasms;
• cerebral edema due inflammatory process or injury.

Muscle tension headaches

They arise against the background of painful pathological impulses during processes of local localization, as well as as a result of a high tone of the nervous system.

They have a feeling # 171; a hoop that squeezes the head # 187;, excessive sensitivity to bright light and loud noises, irritability and tearfulness. Observed when:

• hormonal shifts, neuroses, stress;
• infectious toxic diseases;
• organic lesions of the paranasal sinuses and eyes.

Why does your head spin when you lie down?

Dizziness # 8212; one of the common symptoms of a wide variety of causes. Usually the head is spinning in the weather, in case of illness or with a hangover. But, as it turns out, dizziness can be different. And it can occur under a variety of circumstances. Why can your head spin when you lie on your back or on your side? And what is this vertigo anyway?

What are the types of dizziness?

It is necessary to distinguish between dizziness of a healthy and unhealthy person.

Normally, the head can be dizzy from fast movement: carousels, dancing, riding on something. This is due to the fact that the eyes have time to capture information about the movement of the body in space, but the vestibular apparatus located in the inner ear does not. Confusion arises between the eyes, the organs of balance and the brain, which cannot cope with the flow of raw nerve impulses.

Stress and excitement cause the release of adrenaline into the blood. Under the influence of this hormone, blood vessels constrict, preparing to protect the body from possible danger, and the brain does not have enough oxygen. Hunger can also cause dizziness; # 8212; the brain is in dire need of glucose replenishment. During pregnancy, pressure fluctuations, fasting and diets, the head can also periodically spin.

All this is a common reaction of the body to external stimuli. The problem should be taken more seriously when the head starts spinning at various positions of the body # 8212; tilting, rotating and raising the head, sudden movements and turns, in a prone position. This can be observed in adolescents, when the brain vessels grow rapidly, there is nothing to worry about. But in adults, this can mean some diseases and disorders of the vestibular apparatus and the vascular system.

Visual disturbances are often mistaken for different types dizziness. Shroud or # 171; front sight # 187; before the eyes, the surrounding space suddenly darkens or turns into some color # 8212; dizziness is not considered true. But if there is a feeling of instability, # 171; floating away # 187;, it seems as if everything revolves around, moves, constantly changes position, including your own body, # 8212; here it is already possible to assume a malfunction of the vestibular analyzer. Often these unpleasant sensations are accompanied by nausea, sweating, impaired vision and hearing. Usually, a person with these symptoms complains that they appear when he is lying or getting up.

The reasons that make your head spin when you lie down

If you are experiencing this kind of discomfort, it could mean:

• Vestibular neuritis. Dizziness begins suddenly and may be accompanied by vomiting. The attack usually occurs after sleep.
• Osteochondrosis of the cervical spine. When you try to lie down, stand up, turn or raise your head, the vertebral artery, squeezed by the deposition of salts, is compressed even more, blocking the access of blood to the brain.
• Hypotension. Low pressure acts not only in blood vessels, depriving the brain of blood and, accordingly, the necessary amount of nutrition. The fluid in the inner ear, which is responsible for maintaining balance and signals about body position, is normally also under a certain pressure. If this pressure is not enough, the fluid moves incorrectly, creating informational confusion for the brain.
• Tumors and inflammation of brain tissue. Along with increased dizziness when lying down, warning symptoms can include headaches and one-sided hearing problems.
• Vegetovascular dystonia. The vascular tone from birth can be # 171; wrong # 187; # 8212; inadequately react to situations. Including changes in body position.
• Vertebral hernia. When you change position in a dream or just when a person lies down, dizziness similar to drunkenness occurs. In this case, the neck or back may not hurt.
• Diseases of the outer and inner ear, nasopharynx. With inflammation, the tissues fill with excess fluid, mucus and swell. This can cause pressure on other organs, which manifests itself not only when you hold your head upright, but also when lying down and tilting it.

What to do for dizziness that occurs when you lie down

Why is this happening and how to help yourself? Finding the answer yourself is very difficult. First of all, of course, you should consult a doctor. Consultations with a neurologist, otolaryngologist, and in some cases a therapist and endocrinologist will help answer these questions.

For temporary self-help, you can try:

1. breathing exercises. We sit down or lie down, put our right hand on our stomach. Breathe in slowly through your mouth and at the same time inflate your stomach. When we exhale # 8212; we draw in the stomach. We do it for 5-7 minutes. This helps to stabilize the vascular tone;
2. put your hand on a stationary object and look directly at it during an attack of dizziness;
3. press your finger on point # 171; third eye # 187; on the forehead and hold for 10 seconds, you can massage a little;
4. head, face and neck massage.

In urgent cases, especially if the dangerous symptoms described above appear, an ambulance should be called.

Also, when dizzy when you lie down, experts recommend:

• Do not make sudden movements and turns of the head to avoid fainting. If you get out of bed, then you need to do this first by turning over on your side, and only then gently get up.
• Do not tolerate diseases, especially viral, # 171; on the legs # 187;. It is necessary to lie down for at least a couple of days, and after # 8212; how to finish treatment.
• Normalize work and rest regime. Sleep should be 7-8 hours a day, and most of the sleep should be at night. This should certainly be taken into account by people with vascular dystonia.
• Spend at least one and a half hours a day in the fresh air, preferably on the move.
• Do not go on strict diets.
• Engage in physiotherapy exercises designed specifically for your case.

So, if you are simply eaten by impatience, why does your head spin when you go to bed, do not rush to make yourself terrible diagnoses. But do not postpone going to a specialist, ignoring the attacks. Head # 8212; one of the most sensitive and delicately designed parts of the body, which must be taken care of especially carefully.

Cervical osteochondrosis and headache

Good afternoon. Please help me figure out the reason for the strange sensations in my head, and also clarify the diagnosis. About me: 1. 24 years 2. Height 168, weight 48 3. The lifestyle is completely sedentary (at the computer). I don’t go in for sports. I go out into the street mainly for shopping. 4. My normal pressure is 90/60. 5. Myopia (-5). 6. The type of food is predominantly vegetarian (I do not eat meat and meat products since childhood). 7. I do not smoke, I never drink. Briefly my medical history: 1. At the age of 12, the first complaints of tachycardia attacks, constant headaches. stitching pains in the region of the heart, sleep disturbance, complete absence of independent stool. 2. At the age of 15, she was examined in a hospital (cardiology). ECG: sinus tachycardia, MVP 1 degree. EEG: moderately pronounced diffuse changes, indirect signs of intracranial hypertension, changes at the level of the diencephalic-stem structures of the brain. REG: pulse filling in the system of internal carotid arteries is satisfactory, in vertebro-basilar arteries is reduced. Angiodystonia, normal tone, outflow is not disturbed. Neurologist: NDC for cardiac type. Endocrinologist: epidemic goiter 0-1 degree. After inpatient treatment special effect I did not notice. 3. At the age of 16, surgery for dolichosigma (resection of the distal colon). After the operation, the state of health improved significantly. Many of the symptoms of NCD are almost completely gone. Only occasional headaches remained. 4. At the age of 17 (autumn), severe weakness, shortness of breath, tachycardia appeared. I went to a cardiologist - everything is in order. It was prescribed to calm down and drink vitamins. The symptoms soon disappeared. 5. For 7-8 years, practically nothing bothered, except for headaches (I got used to them since childhood and almost did not pay attention). 6. 4 years ago, the death of a loved one. Since then, a depressed state, a feeling of hopelessness, progressive phobias, inability to rest or relax. During the same period - a fall on the back from a height of 1.5 meters, pain in the lumbar region. 7. During last year 2 or 3 episodes of light-headedness, a feeling of bleeding from the head, combined with intense fear. The attacks lasted no more than 1-2 minutes. I have successfully forgotten about them. 8. 2 months ago the first strong attack. Happened at the computer. Feeling of blood flowing from the head, numbness of arms and legs, a feeling of sinking of the heart, buzzing in the head, tachycardia, unbearable fear. The attack lasted more than an hour until an ambulance arrived. We measured the pressure - 120/80, a pill under the tongue. The doctor said that this is VSD and generally not fatal. I calmed down considerably. In the following days - a gradual fading away of the symptoms of the disease, weakness and fatigue in the evening, headache in the evening. But while sitting at the computer, I was worried about a strong tension in the neck, squeezing of the jaw. If you keep your neck in one position - the sensation of an electric shock from the neck to the head. 9. A month ago, the first visit to a neurologist. An MRI was prescribed with the words: Maybe something is growing in my head. I left the office in a semi-faint state, after these words my condition worsened. My face and head became numb, palms turned blue, panic attacks happened every 2 hours. I lost 3 kilograms in a week. 10. I couldn’t do MRI, there was a strong panic in the machine. 11. After that I turned to a stationary neurologist. The neurologist said that I didn't need an MRI or anything else, and he reassured me. Prescribed a tranquilizer, Mexidol, Bellataminal for the night, glycine. Indeed, after that every day I was getting better, the panic attacks almost disappeared, but by the evening I was consistently dizzy, weak, vasoconstricted in the limbs, severe malaise, burning in the crown. With a Persen tablet, this condition was removed in about 30 minutes. For a month, surprisingly, I did not have a headache. 12. A week ago, for the first time, I had a severe headache. And 3 days ago, a shooting headache appeared (now in the temple, now to the crown, then above the eyes), a feeling of fullness in the head throughout the day, various vascular sensations in the head when moving. I also noticed an increase in the noise in my head (like sand pouring). It also became difficult to find a sleeping position. In the supine position, the head begins to ache (feeling of strong squeezing), on the left side - it shoots in the temple and tingles the right ear. Also, on the left side, the heart begins to skip. Further, there was already pain in the neck itself, radiating to the head. And painful pricks in different parts head when turning the neck. Also, when turning the neck or moving the shoulders, a crunching sound is heard. In addition, the crown of the head is on fire and, when scratching, I feel pain on the surface of the head. I notice memory impairment, periodic dullness, slight deterioration in vision, and ripples in the eyes. The neurologist sent me for an x-ray. In conclusion: the height of the vertebral bodies is not changed. The endplates are moderately compacted, the posterior edges of the C5-C6 bodies are sharpened. The initial manifestations of osteochondrosis of the cervical spine. Since I will get to my neurologist in a few days, I really need your help and clarification of the diagnosis. I have several questions: 1. Can there be such sensations in the head and crunching at the initial stage of osteochondrosis? I am very worried about this, because the Internet says that such symptoms are more typical for more severe stages. 2. Do I need to go through additional examinations? 3. What exercise regimen should I follow before starting treatment? Is it better to sit, lie or walk around the house? I am very afraid to move or bend over. I walk slowly. I wrapped a scarf around my neck (can I do this?). It's easier for me to sit with a scarf, and only with a scarf can I fall asleep now. I'm afraid to do some household chores. The head constantly hurts and tingles. 4. Can I do some neck exercises? 5. Is it possible to visit the pool until the end of the treatment? 6. Can pills relieve pain in the head? I usually take ibuprofen medications. Thank you in advance. Your consultation is very important to me.

Good day! So, in order according to your questions. 1 Feelings may be associated with the manifestation of osteochondrosis 2. Take tests of thyroid hormones 3. Considering your sedentary lifestyle. you need to radically revise it, start taking care of yourself, take walks, exercise in the morning, yoga classes are very useful. 4. It is possible and necessary, it is also important to do massage courses and go to an osteopath 5. In the absence of pain. you can swim, the main thing is not to get cold there if the water is not warm enough. 6. Headache. as well as pain in general it is not necessary to endure, but constantly taking analgesics is also not true. It is necessary to find out the reason and, accordingly, to direct efforts in the right direction. Respectfully yours, neurologist Dzampaev A.T.

The advice is given for informational purposes only. Based on the results of the consultation received, please consult a doctor.

Headache when lying down

A sudden headache is caused by a variety of reasons: neurological, somatic problems, trauma, metabolic disorders, intoxication, drugs. The provision of qualified assistance is possible subject to timely referral to a specialist for a competent examination. Anamnesis will help to get an answer to the questions posed, the determining factor is the study of the circumstances of the onset of seizures, the frequency, duration, intensity, symptoms of a concomitant plan. It is important to know as much as possible about the patient's behavior, only in this way it will be possible to establish a diagnosis by prescribing adequate treatment.

Types of headaches

Quite often, patients come to the doctor complaining that they have a headache while lying down. Such treatment must be dealt with without delay, which sometimes can actually save a person's life.

We note right away that dizziness can be divided into:

• normal, arising under the influence of external factors - carousels, if you look down, sharply change the position of the body; all this is a consequence of imbalance visual analyzer, the vestibular apparatus;
• pathological, the reason is internal violations systems or the whole organism.

It is worth highlighting the following signs:

• it seems that the ceiling is quickly approaching, the walls are falling;
• the feeling that the body is spinning, and it occurs even in a dream;
• Objects "floating" around the room;
• anxiety that increases as night approaches;
• development of nausea, headache in the supine position.

The listed symptoms resemble a state of intoxication, especially during an exacerbation, when a person tries to change position. Sometimes violent vomiting opens. After the attack, weakness is noted.

It is also important to clearly distinguish between dizziness healthy and sick, paying special attention to pathological abnormalities.

The following points are quite common reactions of the body:

• the release of a portion of adrenaline, as a result of stressful circumstances, excitement; there is a narrowing of the cross-section of the vessels, as a protection against possible danger, after which the brain suffers from a lack of oxygen;
• dizziness often occurs due to hunger, this is a glucose deficiency;
• pregnancy, with restructuring hormonal background;
• unfavorable weather conditions often lead to a state of headache even when lying down.

However, everything is much more serious if such violations occur in adults, and not only in a horizontal position, but also during inclinations, rotation, simply raising the head. These are the first signs of many diseases, primarily disorders associated with the vestibular apparatus, the vascular system.

Quite often, dizziness is confused with visual disturbances, when "flies" appear in front of the eyes, it darkens, or the space suddenly turns into the most unexpected colors. Usually, discomfort is accompanied by symptoms such as:

Moreover, this is most manifested when lying down or when a person tries to get up. Pathological conditions can be caused by a variety of reasons - banal overwork, malignant neoplasms.

Physicians, based on the information received from the results of the tests, identified certain genetic types of the "sick" head, the correct establishment is extremely important for the appointment of the only correct therapeutic course.

Vascular

It causes a violation of the tone flowing in the vessels of the brain. Breaking, throbbing pain becomes characteristic manifestations, accompanied by darkening of vision, heaviness in the back of the head (like a stone is tied). Reaches maximum values ​​when a person lies or lowers his head. This group includes soreness with:

• attacks of hypertension;
• atherosclerosis, migraines;
• strokes;
• pre- and menstrual condition;
• hypotension, seasonal disorders.

Liquorodynamic

Formed as a result of a failure of the balance of the outflow of cerebrospinal fluid, along with secretion, which leads to an increase or decrease in intracranial pressure.

Typical manifestations are:

• confused consciousness;
• feeling of "fullness" or pressure "outside - from within";
• the intensity of pain increases sharply when walking, lying, standing, coughing, turning.

Among the diseases that can provoke such complications are:

• brain abscesses, neoplasms;
• swelling caused by inflammation or injury.

Muscle tension pain

They can arise as a result of pathological pulsations, when processes that have local localization take place, or because of an increased tone of the nervous system. Distinctive feature: like a hoop squeezes the head, incredible sensitivity to flashes of light, any loud sound. A person's irritability increases, tearfulness appears, which is typical for:

• neuroses, hormonal disruption, stress;
• infectious, toxic diseases;
• lesions of the organic plan of the paranasal sinuses.

Possible causes and accompanying symptoms

The answer to the question why a head hurts when even lying down is often the presence vascular diseases... Any sudden attack, intense development of pain in diffuse or occipital areas should be a reason to consult a specialist, since subarachnoid hemorrhage caused by rupture of a cerebral artery aneurysm is possible.

If it starts to hurt when vascular problems are identified, patients note that this is the strongest feeling they have experienced. Accompanying factors are usually vomiting, up to loss of consciousness. The symptoms of meningitis can significantly facilitate the diagnosis, although there is far from always the possibility of timely determination.

Manifestations of diffuse (local) acute headache, which is combined with depressed consciousness, focal neurological symptoms (weakness, numb limbs, impaired speech, coordination of movements), are most often a sign of:

• hemorrhage inside the brain;
• ischemia;
• thrombosis that clogs the cerebral veins.

Bundle inner carotid artery, which happened as a result of cervical injuries, causes persistent intense pain of the eye on one side, soreness of the head of the periorbital area, Horner's syndrome (pupils narrow, the upper eyelid is moderately lowered), on the affected side, while hemiparesis grows on the opposite side.

Diagnostics

If patients receive complaints of the following content - headache in the supine position, it becomes mandatory to undergo a full examination, and, most likely, you will need to contact several specialists in various fields. It is more difficult to determine the problems of the inner ear, which involves a complex of procedures.

In the course of research, preparation of anamnesis, the doctor must know exactly the nature of the course of the attack, when the following parameters are to be assessed:

• the beginning itself; especially since the consequences of lightheadedness, nausea, lightheadedness often become dizziness when a person just lies;
• frequency of occurrence, duration;
• how provoking factors affect, i.e. how much it increases with changes in body position;
• Does he become stronger when lying on his back, right / left side;
• Availability accompanying symptoms- noises in the ears, headache, stomach ache, hearing loss, vomiting, vomiting, uncertainty of movements is noted.

The final diagnosis is possible only after the completion of all the necessary manipulations, after which it becomes easier to choose an adequate treatment.

It is all the more important to know the order of actions, the observance of which helps a person to relieve an attack of dizziness, returning health to a normal state:

• the first is thorough ventilation of the room, especially when they are forced to stay in a stuffy room for a long time;
• rather take off tight clothes;
• measure blood pressure, diabetics should check their sugar levels.

Often, strict adherence to a diet rich in iron and vitamins is sufficient. A great way is to walk for a dream coming in the fresh air, for example, it is worth visiting a park, any quiet place. If you do not overexert yourself, physical activity and a set of relaxing exercises help well.

The choice of treatment methods directly depends on the root cause of a particular condition. There are a number of serious diseases when it becomes possible to achieve complete recovery only through surgery.

How can you help if a person complains when he lies down, has a headache?

First of all, it is strictly prohibited long time to endure such a condition, you need to see a doctor as soon as possible. Information on the nature of the manifestations of the arising violations will be indispensable, which will help to control your own condition, followed by an accurate and correct description of everything that happens to a specialist who will tell you why complications appear.

Sometimes the problem is solved very easily, especially if the reasons are common:

• to be in the wrong posture, which leads to overstrain of the cervical muscles, disruption of the blood supply to the brain;
• the notorious physical inactivity, the easiest way to cope with the consequences is by changing the rhythm, lifestyle;
• the eyes are under too much stress, which can cause a headache;
• osteochondrosis.

Preventive agents are:

• abrupt movements should be avoided, it is better to smoothly turn your head, you cannot immediately jump up in the morning, slowly turn to one side, then getting up as gently as possible;
• you need to go to bed only in a clean, well-ventilated room, on a comfortable bed, pillow;
• an increase in the time spent in the fresh air;
• sports activities, this includes: walking, running, gymnastics in the morning, swimming; due to physical activity, blood vessels are strengthened, blood circulation improves, a corset of muscles is formed, sufficient to support internal organs;
• avoid strict diets, since a deficiency of even one element is fraught with serious complications;
• it is important to eliminate any inflammation of the nasopharynx as soon as possible;
• say no to alcohol.

A prerequisite for a speedy recovery is to undergo a full-fledged medical examination. Why and why is it extremely important if dizziness begins to intensify while lying down? First of all, for the reason that it will allow you to quickly select the treatment.

Once again, it is worth recalling that when it hurts once, it may not mean anything serious. But the regular repetition of unpleasant attacks becomes a signal to think about your own health.

Regardless of the situation, you should not expect that everything will go by itself. It is better to start by taking tests, visiting a medical institution, where they will be able to provide qualified assistance. It is important to get to the right specialist, whose experience is enough to establish true reasons the failure of the body system.

Bursting headaches can be caused by various factors. Can't be ignored this symptom especially if it is persistent, as headaches can indicate serious health problems.

Basically, patients complain of pressing paroxysmal headaches that are felt throughout the head, noting the strongest impulses of bursting headache in the temples, frontal regions, in the back of the head and neck.

The pains come on suddenly, most intensely at night and in the morning, subside a little in the daytime and in the evening.

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Causes

Bursting headaches may be due to different states and diseases, the main ones of which are:

• VSD (vegetative-vascular dystonia);
• increased ICP (intracranial pressure);
• infectious diseases;
• sharp drops in blood pressure;
• neoplasms in the head area;
• stress and depression;
• hormonal disruptions;
• excessive use of salt, liquids, alcoholic beverages.

Vegeto-vascular dystonia	Headaches with vegetative-vascular dystonia are the result of failures in the functioning of the central and autonomic nervous systems. In terms of strength, headaches with VSD are slightly inferior to toothaches. If the patient is being pursued by the strong sharp pains, then this is probably not an IRR. The pain is permanent and may be accompanied by nausea, dizziness, loss of consciousness, and pressure on the ears. As a rule, it begins immediately after waking up, within 3-5 minutes and can haunt throughout the day without changing the intensity. When tilting, it can intensify, pulsate. The perception of reality becomes difficult, everything becomes like a fog. For the night period, such pains are not typical, but if you wake up, they may arise and do not stop until the next bedtime. Headaches with VSD occur on one side, or affect the entire head. Certain areas may be affected: pain appears in the parietal region, temples, affects the forehead, back of the head. Sometimes it is combined with congestion and pulsation in the ear, a feeling of puffiness and tension in the forehead, eyes, temples.
Increased intracranial pressure	Intracranial pressure can increase due to various reasons: congenital abnormalities and complications during pregnancy; infectious diseases (bronchitis, gastroenteritis, otitis media, malaria, etc.), including those affecting the nervous system (meningitis, encephalitis); taking certain medications (tetracycline-based antibiotics, corticosteroids, biseptol, oral contraceptives); endocrine disorders; neoplasms in the head; swelling of the brain due to injuries, operations,. With ICP, the headache has no specific localization. There is an increase in intensity when bending, coughing (read about), sneezing, turning the head. The pain increases in the morning due to increased blood flow to the head while lying down and increased production of cerebrospinal fluid.
Infection	The course of infectious diseases is almost always accompanied by severe headaches. The reason for this is the intoxication of the body due to the production of toxins by microorganisms. It is accompanied by fever, chills, body aches. Along with the common colds and flu, headache can be a sign of meningitis. On the site you can find out what to do when. In this case, it is growing, in some cases it starts abruptly. May be associated with nausea and photophobia.
Brain tumors	With brain tumors, the pain is dull, bursting. They may be rare at first, but attacks become more frequent as the tumor grows. The headache can be felt all over the head or in one half (where the tumor is located). With an increase in tumor size, ICP increases, so pain is felt in the forehead and back of the head. Nausea, vomiting, weakness, photophobia, mild fever, mental disorders, drowsiness, lack of appetite, seizures... An increase in activity provokes an increase in pain.
Blood pressure surges	During a pressure surge, the load on the heart and blood vessels increases. This condition can be provoked by infectious diseases (sinusitis, tonsillitis), hormonal drugs, and changes in weather conditions. Often, such leaps occur during the restoration of blood vessels after a stroke or after childbirth. Hypotensive patients suffer from attacks more often. Their pressure jump is accompanied by dizziness and light-headedness. People with high blood pressure have a squeezing sensation combined with nausea that can last for several days.
Hormonal disorders	Changes in hormonal levels can be caused by many reasons. The most familiar situation for all women is the change in the concentration of hormones in the blood at the end of the menstrual cycle. Therefore, some women with PMS have headaches. This can be caused by an increased level of progesterone or a disturbance in the water-salt balance due to fluid retention due to an increased level of estrogen. Women who are prone to edema may develop small swelling of the brain tissue. Most often, pains are localized in the parietal and occipital parts and are accompanied by a slight increase in pressure.
Excessive use of salt, alcohol, liquids	Studies have confirmed that increased salt intake leads to the development of headaches. A diet high in sodium (8 g / day) increased by 1/3 the incidence of headaches in the control group. With excessive fluid intake, in the case when it is retained in the body, edema may occur, which also leads to headaches. Alcohol can cause dehydration of the body, it kills nerve cells, affects the liver, which cannot produce glucose in the required amount, disrupts metabolism - all this leads to the fact that after a heavy intake of alcoholic beverages, a headache often hurts.
Stress, depression	During nervous tension, depression, headaches often occur. In this case, there are several difficulties at once - the specialist does not always manage to establish the root cause, since the patient talks about the accompanying symptoms: fatigue, nausea, but not about his psychological state. In addition, it is difficult to get rid of such headaches, as a vicious circle turns out - a person does not rest, because he has a headache, and his head hurts due to tension due to lack of proper rest.

Symptoms

The most common symptoms associated with a headache include:

• feeling of pressure, heaviness in the head;
• inability to concentrate attention;
• aggression, nervousness;
• fast fatiguability;
• accelerated heartbeat;
• excessive sweating;
• pressure surges;
• dizziness, nausea, vomiting;
• sensitivity to weather changes;
• increased heart rate during small physical exertion, intimate relationships.

In infectious diseases, headaches are accompanied by high fever, chills, pain in the eyes. Meningitis causes severe headache, vomiting, and stiff neck muscles.

With pressure surges, numbness of the fingers of the upper and lower limbs, the pulse quickens, dizziness occurs.

Headaches caused by impaired circulation of venous blood are aggravated in the supine position, as well as when forced to work with the head down, especially in a room where there is not enough oxygen.

Bundle headaches are characterized by sharp and very intense manifestations. They can be chronic or episodic.

Diagnostics

Early diagnosis will help remove the causes of bursting headaches and exclude the development of dangerous consequences.

The following can be used as diagnostic methods:

Bursting headache treatment

Medical treatment of VSD almost never gives the desired effect. Neither pain medications, nor means for dilating blood vessels and improving blood supply help to relieve painful sensations. In this case, the use of sedatives, including herbal preparations, is relevant.

It is imperative to exclude factors that negatively affect the psyche, bring the work and rest regime back to normal, give up bad habits, and monitor the mood. Since it is stress that is the main cause of headaches with VSD, it is recommended to consult a psychologist who will help to cope with existing problems and increase stress resistance.

Treatment of increased ICP in difficult cases requires surgical intervention... The usual treatment regimen includes medication, massage and exercise therapy.

Medications used include diuretics, potassium medications, and corticosteroids. In some cases, treatment can be supplemented with traditional medicine: decoctions and tinctures.

Physiotherapy procedures involve the use of:

• electrophoresis with euphyllin;
• collar magnet;
• massage of the neck-collar zone and spine;
• acupuncture;
• circular shower.

Dosed physical activity is mandatory:

• swimming lessons;
• tennis;
• race walking.

Treatment of headache for infections is determined depending on its intensity and causes. If you suspect a serious illness (meningitis, encephalitis, etc.), you should urgently consult a doctor for a diagnosis. For colds and SARS, an antipyretic will help relieve headaches.

When a brain tumor occurs, it is important to identify the disease in time. In the early stages, it is possible to remove the neoplasm by surgery without consequences.

With pressure surges, drugs are used, the action of which is aimed at bringing the pressure back to normal.

When treating headaches due to changes in hormonal levels, it is necessary to build on the cause that caused the failure. This can be pregnancy, overweight, endocrine disorders, stress, exercise, or menopause. Depending on the reasons, a treatment regimen is being developed.

It is necessary to avoid dehydration, monitor the amount of fluid consumed, and also fight against its retention in the body and edema. Limit your intake of foods high in salt and do not overuse alcohol.

In case of stress and depression, it is better to seek the advice of a specialist. It is necessary to avoid mental and physical overwork, try to get positive emotions. In this case, a doctor should prescribe drug therapy.

Prophylaxis

There are a number of rules under which the likelihood of developing headaches decreases:

Read what to do when you have a headache and nausea after smoking.

In you can see the treatment of shooting pain in the head on the right side.

Specialists what methods of prevention of tension headaches.

One of the most common complaints about medical practice... To find out its causes, a lot of knowledge and experience is required.

This is one of the most common symptoms of various diseases. Although painful, most headaches are not considered serious illnesses.But if you are worried about prolonged and repeated headaches, you should not neglect a visit to the doctor, as well as a medical examination, as intense and chronic headaches can be harbingers of any serious disorders in the body.

On this page, we will try to briefly and in understandable language understand the mechanisms of occurrence of vertebral headache (associated with disorders in the cervical spine). Then we will list under what other conditions that are not directly related to spinal problems, the occurrence of a headache is possible and how it threatens the patient.

Vertebral headache.

To understand the mechanism of headache in case of problems of the cervical spine, you need to imagine how it all works ...

In the transverse processes of almost all cervical vertebrae there are holes through which the vertebral arteries pass on the right and left side.With normal ratios among themselves, the cervical vertebrae inTogether they form a kind of half-open bone canal in their transverse processes. This canal can be compared to a subway tunnel.If everything is normal, then the tunnel is straight and nothing will interfere with the flow of blood through the artery. And if we imagine that the tunneltwisting or it deforms ... When the "train" moves, problems will arise.

These vessels are very important for the body. They provide blood supply to the cerebellum. With a lack of blood flow, many so-called autonomic disorders or autonomic dysfunctions can occur in them. The main symptom, perhaps, can be called dizziness - an invariable companion of the so-called vertebrobasilar insufficiency (VBI).

The main and common symptoms and syndromes:

• changes in blood pressure accompanied by dizziness;
• dizziness with vomiting;
• nausea with dizziness;
  
• dizziness and bouts of weakness;
  
• frequent dizziness;
  
• very severe attacks of dizziness;
  
• slight dizziness;dizziness accompanied by headache;
  
• constant dizziness;
  
• nausea with dizziness and resulting weakness;
  
• dizziness when lying down.

The vertebral arteries and their branches also supply blood to the brain stem, a structure in which the vital centers of blood circulation and respiration are concentrated. Knowing this is important for understanding the mechanism of the onset of symptoms in cervical osteochondrosis.

To a greater extent, the problems of lack of blood supply arise not due to mechanical compression of the vertebral arteries, but due to their reflex spasm. The body protects important vessels. The guard includes a certain amount of fatty tissue around the arteries and a network of sympathetic nerve fibers, like guarding the artery around the perimeter. Fiber serves as a buffer for the ability to avoid external pressure on the artery, and the nerve plexuses instantly report to the brain about possible compression or any other mechanical threat to the artery. The nerve that protects the vertebral arteries is called Frank's nerve. It departs from the lower sympathetic "stellate" node, which is located in the region of the cervicothoracic junction at the level of the 7th cervical vertebra and the first rib. Often vegetative dystonia is associated precisely with the problems of the spine in the area of ​​the transition of the cervical to the thoracic.

How does it all work?

In the presence of instability of the cervical spine or bone growths in osteochondrosis and spondyloarthrosis, the altered structures have a mechanical effect on the vertebral artery. Her path becomes not straight but winding. So the artery adapts to new conditions with developing osteochondrosis. When the buffer from adipose tissue becomes insufficient, the perimeter of the vertebral artery is irritated, as we discussed above. There is irritation of Frank's nerve and, as a response, a reflex spasm of the vessel walls. It shrinks, as it were, and its diameter decreases. Consequently, less blood can pass through the vessel. But the heart continues to work and, as compensation, the rate of blood flow through the vessel can increase. At the same time, patients often talk about the appearance of a noise in the head, when turning or throwing the head back. This noise occurs when the blood flow swirls through convoluted rather than smooth arteries. Moreover, we noticed that the vertebral arteries supply blood to the brain stem, where the vasomotor center is located. Reflex vasospasm is observed in this area. The vasomotor center "sees" the problem, it lacks oxygen and nutrition. And he takes measures, gives a command to all vessels, thus regulating microcirculation throughout the body, which invariably affects blood pressure indicators. And then everything depends on the type of the human nervous system. Who is he? Sympathetic or parasympathetic. Whichever system prevails, such a reaction to irritation of the vertebral arteries will be. Or their spasm or vice versa - expansion.
Both can cause headaches. Often we meet with a situation where the irritation of the vertebraethe anal artery occurs on one side. Typically, the artery is compressed between the abnormal arch and the muscles in the neck. This occurs with certain head positions or excessive tension in the cervical muscles. This happens with the so-called functional blockages of the intervertebral joints of the upper cervical region, where there are anatomical features of the passage of the vertebral arteries. For example, irritation of an artery by a tense, spasmodic muscle in the C-1 region; C-2(fig.d) Anomalies of development are also found in the place where the vertebral arteries converge into a single basilar one. The so-called anomalyKimerli (fig.b) - an additional bone arch of the first cervical vertebra can compress the vertebral arteries that supply the brain with blood. Or high standing tooth of the second cervical vertebra(fig.c)

Instability of the cervical spine (a kind of backlash between the vertebrae) can lead to a formidable condition - slipping of one vertebra from another (listezu). This condition can also occur after an injury to the cervical spine. It must be remembered that instability is almost never isolated. Always with instability in the cervical spine, there will be limited mobility in the thoracic spine or cervicothoracic junction. Treatment should be primarily carried out where there is no movement. Otherwise, it will not be possible to redistribute the motor load, which is excessive for the cervical vertebrae and is the main damaging factor for the cervical spine. It leads to early aging of the vertebral structures, osteochondrosis, arthrosis, muscle tension and, as a consequence, to headaches and dizziness.

Something like this, in a simplified way, looks like the mechanism of occurrence of disorders in vertebral headache.

Other anatomical abnormalities are known:

Arnold-Chiari anomaly- the prolapse of a part of the cerebellum into a too wide occipital foramen;

Concrescence of the cervical vertebrae or Klippel-Feil syndrome(Klippel-Feil) - fusion of two or three cervical vertebrae with each other, often leads to compression of the vertebral arteries, overload and damage to the upper and lower intervertebral discs;

Basillar impression- "screwing" of the edges of the occipital foramen inside the cranial cavity;

Platibasia- a congenital defect of the occipital bone, leading to a displacement of the cerebellum;

Assimilation of Atlas- the increment of the 1st cervical vertebra to the occipital bone, can cause compression of the vertebral arteries when turning the head;

Proatlant- an additional, often unstable 1st cervical vertebra, often displaced and infringed spinal cord and vertebral arteries

Dangerous Signals for Headache

A sudden onset of acute headache, or a moderate headache rapidly increasing in intensity, more often indicates a serious illness. It can be subarachnoid hemorrhage (stroke), meningitis, brain tumor, and a number of other processes. Persistent or repeated headaches for a long time are not dangerous, they do not threaten life, but they indicate that the aging process of vertebrates structures and vascular reactions, as a result, are and they need to be paid attention to.

When should you sound the alarm?

1. A sharp, acute headache of the "blow to the head" type is a very formidable symptom. Such pain is almost a sure sign of subarachnoid hemorrhage. In this case, you must immediately call an ambulance.

2. If the pain is moderate and increases in a horizontal (lying) position, and disappears within half an hour in an upright position, such a symptom may be a sign of a serious illness associated with impaired cerebrospinal fluid outflow and increased intracranial pressure (first of all, it is necessary to exclude a brain tumor, but this symptom may be a manifestation of other diseases, for example, associated with the consequences of a severe traumatic brain injury).

3. If even a mild headache is accompanied by loss of consciousness or inappropriate behavior, inability to rise and maintain an upright position of the body, this is a sign of a serious illness and requires an immediate call for an ambulance.

4. If the headache has arisen sharply against a background of high temperature and increases with time. If these symptoms are joined by photophobia or pain in the muscles of the neck, this may be a sign of meningitis. And even if this is not the case, it is always better to play it safe and see a doctor.

Causes of headaches

The causes of headache today can be about 46 diseases and pathological conditions. Moreover, many of these diseases are not directly related to the head.

Any inflammatory process in the human body, as well as an increase in blood pressure, can cause headaches. If the headache has a "causal" disease that causes it, it is symptomatic headache.

However, most often, the cause of a headache is the processes occurring directly in the head or on its surface and which have no basis in the form of a specific disease. In this case, the headache is independent disease and called primary headache... The most common causes of headaches are:

1. Spasm of the muscles of the head... The skull is surrounded by muscles along the "perimeter" of the muscles on the forehead, back of the head and temples. These muscles pull the "tendon helmet", which is located just under hairy part heads. In addition, they participate in the formation of facial expressions, and the temporal muscles participate in chewing, helping the masticatory muscles.

2. Spasm of the vessels of the head... For the occurrence of a headache, it is not at all necessary that the vessels of the brain spasm. Enough spasm of the vessels located on the surface of the skull.

3. Compression of the meninges... It can be caused by a tumor, hemorrhage, increased intracranial pressure, edema of the meninges themselves as a result of an inflammatory process, etc.

4. Disruption of the "nutrition" of the brain... The reason for this may be its insufficient blood supply, with reduced pressure, with blockage of blood vessels that feed the brain, with diseases of the lungs or heart, etc.

5. Poisoning- alcohol, narcotic substances or medicines or poisoning with endogenous products formed during inflammatory processes in various tissues.

Headache occurs due to irritation of the nerve endings of the vessels of the head or meninges. Depending on its cause, it has its own characteristics.

• In vascular diseases, it is more often pulsating, aggravated by overwork, alcohol consumption, smoking, from exposure to harsh irritants (noise, odors, bright light).
• Patients with hypertension are often worried after sleep with heaviness in the head and bursting pain in the back of the head. Sleeping in a ventilated room and doing light exercise in the morning tend to relieve this pain.
• Paroxysmal pain localized in one half of the head occurs with migraine.
• A compressive headache can occur due to tension in the muscles of the head with a disease of the cervical spine (osteochondrosis), overexertion of the muscles of the neck, if the head is in the wrong position during work.
• Eye strain can also be the cause of the headache, for example, when poor lighting, a visual impairment that is not corrected by glasses, or an eye condition such as glaucoma.
• "Shooting", "tearing" or "burning" pains in the face and back of the head occur with neuralgia of the trigeminal and occipital nerves.
• Severe headache with vomiting and clouding of consciousness against a background of high temperature occurs with inflammation of the brain and its membranes.
• Quite often, persistent headache is associated with inflammatory diseases of the paranasal sinuses.
• Headache can be the result of a previous traumatic brain injury, and often it accompanies infectious diseases, intoxications, neurotic disorders, and diseases of internal organs.

With persistent headaches, it is necessary to be examined by a doctor to establish their cause. Independent long-term use of pain relievers that do not eliminate the cause can have adverse health effects. With a timely visit to a doctor, the treatment of the underlying disease prescribed by him, as a rule, eliminates or reduces the headache.

In the diagnosis of symptoms of dizziness and headache, an examination of the biomechanics of the cervical spine by an experienced doctor will help. Muscle tone, range of motion, position of the vertebrae at rest and during movement (X-ray with functional tests), vascular examination - Doppler ultrasonography, rheovasography, MRI in angiography mode will be determined.

Osteochondrosis, instability of the cervical spine, atherosclerosis of the vertebral arteries and resulting vertebrobasilar insufficiency require a systematic approach to treatment:

Applicable:

• manual therapy and massage thoracic spine and collar zone;

• physiotherapy (SMT, UHF, DDT, galvanophoresis with enzymes);

• osteopathy;

• reflexology (acupuncture, auriculotherapy);

• therapeutic gymnastics (exercise therapy) - strictly according to the instructions of the doctor !!!;

• dosed wearing of a cervical corset (Shants bus);

• medicines (nootropic, vascular, chondroprotective, antiarthritic and restorative therapy).

• local procedures - compresses and rubbing

Remember! Treat headache - what to walk on thin ice! Treatment must be carried out on time, competently, accurately and carefully.

Do not get sick and stay healthy!

Trust the health of professionals!

Vertebrology Center of Doctor Vladimirov

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The most important in the diagnosis of headaches is to determine the primary or secondary status of cephalalgia. There is no doubt that a secondary headache cannot be cured without affecting the pathological factor that causes it. Also, it is equally important to identify the headache mechanism, since only an adequate effect on the mechanism can lead to a positive result of headache treatment. Otherwise, the use of even the newest and effective drugs can backfire. An example of this is the introduction of antispasmodics at the top of a migraine attack or the appointment of dehydrating therapy for intracranial hypotension.

Today there are 6 headache mechanisms:

• vascular
• liquor-dynamic
• muscle tension
• neuralgic
• liquor-dynamic
• psychoactive.

Vascular cephalalgias, in turn, can be vasomotor with functional impairment of vascular tone, venous and ischemic-hypoxic (with organic changes in the vascular wall in patients with atherosclerosis, arterial hypertension or vasculitis). Moreover, the same patient can combine several mechanisms. Moreover, these mechanisms are to some extent associated with etiology, but often coincide with different causal factors.

In the diagnosis of headache great attention pay to the patient's complaints. They allow one to suspect, first of all, the mechanism of the headache. So, the pulsating nature of cephalgia indicates the vascular mechanism. With unilateral localization of a throbbing headache, we most often deal with migraine. With bilateral pulsation, vegetative-vascular dystonia or cerebrovascular diseases (discirculatory encephalopathy) can be suspected. For venous cephalgias, morning headaches or pains that develop or intensify after being in a horizontal position and are accompanied by swelling of the eyelids are characteristic.

The constrictive nature of the headache speaks in favor of a muscle tension headache. This headache is reduced by movements of the muscles of the shoulder girdle, massage of the collar zone.

Cranial hypertension is characterized by a bursting headache. In this case, the headache increases in a horizontal position, with coughing, straining and may be accompanied by general cerebral symptoms - dizziness, vomiting, etc. It should be remembered that in practice, the role of intracranial hypertension as a mechanism for the development of headache is often overestimated. Moreover, it often happens that the patient, on the contrary, develops an intracranial hypothesis. This may be evidenced by an increase in headache when walking, in an upright position and a decrease in a horizontal one.

The neurological nature of pain is characterized by short-term paroxysms of cephalalgia (seconds) of a shooting character. Pains are localized according to the branches trigeminal nerve... May arise or intensify when exposed to trigger zones. Constant pain does not apply to neuralgic pain, since it is no longer associated with irritation, but with damage to the trigeminal nerve (neuropathy).

Medical history should not be underestimated. The emergence of paroxysmal headaches for the first time at a young age, increased pain with physical exertion is more likely in favor of migraine or vasomotor headaches against the background of vegetative-vascular dystonia. The chronic nature of the pain of a non-intense nature, increased with emotional or mental stress, speaks of tension pain.

In diagnostics, clinical or objective research is of great importance. Often, such a study allows one to suspect the cause of cephalalgia (with its secondary origin) and determine its mechanism.

Identification of danger signals indicating the development of secondary headaches accompanying life-threatening diseases

1. Onset of headache over the age of 50.
2. The onset of a new headache that differs from the usual one or a significant increase in the usual headache.
3. Headache is the cause of nighttime awakenings.
4. The onset of headaches with physical exertion, coughing, sneezing, straining (indicates an increase in intracranial pressure).
5. A combination of headaches with the following neurological disorders (confusion or disturbances of consciousness, memory impairment, ataxia and impaired coordination, paresis and paralysis, asymmetry of the pupils, tendon reflexes, meningeal symptoms, visual disturbances, persistent ringing in the ears, loss of taste or smell.
6. In the morning, nausea, vomiting, dizziness (a volumetric process is possible).
7. The presence of repetitive pulsating pain on one side (suspected vascular aneurysm).
8. The presence of other pathological symptoms (fever, arterial hypertension, weight loss, prolonged cough, lymphadenopathy, runny nose or nasal breathing difficulties).

Additional research for headache.

Although diagnostic tests such as computed x-ray (CT) and magnetic resonance imaging (MRI) scans provide little useful information for the diagnosis of habitual headaches, their use in general medical practice has become commonplace. Unfortunately, in most cases, these studies do not guarantee a diagnosis of primary headache. But neuroimaging, to a certain extent, makes it possible to exclude or confirm the secondary nature of the headache. Therefore, in the presence of obvious warning symptoms, it is prescribed diagnostic research- CT or MRI of the brain, allowing to identify volumetric processes of hemispheric or brainstem localization. In what cases is it necessary to carry out these studies?

Indications for CT or MRI for headache.

1. Disorders of behavior and consciousness.
2. The appearance of a headache during physical exertion, intercourse, coughing or sneezing.
3. Deterioration of the patient's condition during the period of observation by the doctor.
4. Stiff neck.
5. Focal neurological symptoms.
6. The first appearance of headaches is over the age of 50.
7. More severe headaches than usual.
8. Change in the habitual nature of headaches.

If you have a unilateral, throbbing headache, angiography or vascular MRI may be needed.

Principles of headache treatment.

Treatment of secondary headaches involves influencing the cause and mechanism of cephalalgia.

Vascular view

It occurs when the tone of the vessels of the brain is disturbed. It is characterized by dull, breaking, throbbing pain, accompanied by darkening in the eyes, a feeling of heaviness in the head and flickering "goose bumps".

Liquorodynamic view

Typical symptoms of headaches of a liquorodynamic type: confusion of consciousness, bursting character, a feeling of pressure "outside-from the inside", a sharp increase in intensity in the supine position, while walking, when coughing and turning the head.

They differ in the feeling of a "hoop squeezing the head", excessive sensitivity to bright light and loud sounds, irritability and tearfulness. Observed when:

Causes of headache in a supine position

Often, when visiting a neurologist, when asked in what position the pain intensifies, they answer that the head hurts worse when lying down. Based on the combination of the headache with other symptoms, the doctor makes an appropriate diagnosis and explains why the headache (cephalalgia) bothers the patient.

1 What diseases can the presence of cephalalgia indicate?

People are not always in a hurry to diagnose the disease due to various reasons. So why does the headache get worse when a person is lying down?

Before guessing about the disease and making yourself a non-existent diagnosis, it is worth learning to distinguish between headaches. A headache of a pulsating type is characteristic of vascular diseases. Most often, it is experienced by patients with vegetative dystonia, in whom it is bilateral. One-sided headache is characteristic of migraine. This disease does not go away for a long time and is aggravated by bright light, strong noise and other irritating factors. If a person's headache worsens while lying down, and the face swells, then perhaps he has venous cephalalgia.

Other causes of persistent headaches:

• protrusion of intervertebral discs, scoliosis;
• intracranial hypertension or hypotension;
• swelling of the base of the skull;
• brain tumors;
• other neurosurgical ailments;
• gynecological diseases;
• neurological ailments;
• ailments of the cardiovascular system;
• lack of vitamins or oxygen;
• increased fatigue;
• neurosis;
• wrong posture while sleeping or working posture;
• pillow that is too stiff or too high.

In fact, in addition to the above list of reasons for which a headache can be chronic, there are many more provoking factors. Diseases of the kidneys, liver, eyes, ears, smoking, harmful work and other factors can always cause chronic headaches.

2 How the behavior of the cerebrospinal fluid affects the human condition

When a person seeks a neurologist or neurosurgeon, the doctor usually asks when the pain is unbearable: when lying down or when you are in an upright position. In some cases, the patient reports that with such headaches it is better for him to lie down, then he begins to feel much better. Provided that this condition is caused by liquor effects, most likely, the patient suffers from intracranial hypotension. If the headache increases in the supine position, then in this case there is pressure of the cerebrospinal fluid on the walls of the cranium, i.e. there is intracranial hypertension.

Normally, a uniform distribution of cerebrospinal fluid is carried out under a pressure of 7 to 17 mm Hg. Art. (although some experts believe that the maximum value of normal intracranial pressure is no more than 15 mm Hg. Art.). This ensures excellent brain function without headaches. If a person has hypertension, his high blood pressure provokes vascular changes in the brain, resulting in an increase in intracranial pressure and, as a result, prolonged headache.

With hypotension, the lack of cerebrospinal fluid affects the brain in such a way that this organ performs not only nutritional functioning, but also shock-absorbing. In this case, cephalalgia, aggravated by walking or simply by being in an upright position, disappears only during rest, when the patient is lying.

The danger of this disease is that the lack of cerebrospinal fluid has an extremely negative effect on the work of the brain and blood vessels of the head, as a result, a fatal outcome can occur. This is due to the fact that hypotension severely damages blood vessels and can provoke hemorrhage, dislocation of the structures of the hemispheres and the brain stem. As a result, cerebral edema, disturbed substance of the brain stem and hemorrhage lead at best to a stroke, at worst - to death.

Often, the headache is relieved by conservative therapy, aimed at restoring water and electrolyte balance.

In this case, they often resort to therapy using iso-osmolar solutions. If the patient is sick with liquorrhea, most often he needs hospital treatment.

3 Why does a headache from hypertension and tumors and how to treat it

In the case of hypertension, the headache is often due to excess fluid in the ventricles of the brain or fluid space. So that the patient does not bother with the headache, he is prescribed therapy aimed at the gradual normalization of fluid secretion. If the patient's condition is serious, he is referred for a consultation with a neurosurgeon in order to prescribe an operation. this ailment... Then, to drain the excess cerebrospinal fluid, which causes not only a headache, but also weakness, unsteadiness, dizziness, nausea and other signs, a shunt operation is performed.

However, if the outflow of cerebrospinal fluid is too fast, this also leads to multiple bad conditions. In this case, the occurrence of cerebral edema, foci or hemorrhage may occur, which is fraught with serious harm to the patient's health or even death. If it is impossible to carry out bypass surgery, the neurosurgeon performs a puncture of the cerebrospinal fluid. If the patency of the pathways is preserved, the headache may temporarily disappear after a spinal puncture, in this case the main thing is to start treatment on time and correctly.

Tumors at the base of the skull, removed with a cyber knife, can also cause constant and severe headaches, a feeling of drunken gait, fainting, facial pain and epileptic seizures are added to the symptoms. Such a neglected condition is most often fatal, therefore it is necessary, if there are even some signs, to urgently seek medical help.

• Have episodic or regular headaches
• Presses the head and eyes or "hits with a sledgehammer" on the back of the head or knocks on the temples
• Do you sometimes feel sick and dizzy when you have a headache?
• Everything starts to enrage, it becomes impossible to work!
• Do you splash your irritability on loved ones and colleagues?

Stop putting up with it, you can no longer wait, dragging out the treatment. Read what Elena Malysheva advises and find out how to get rid of these problems.

If you have a headache, seek immediate advice.

You can get a free headache questionnaire by sending an e-mail to:

Headache is a painful, unpleasant sensation in the area from the level of the orbits to the suboccipital region, one of the most common and universal complaints. Its presence often reflects not so much trouble in the head itself, but in the body as a whole.

Headaches are primary and secondary.

Primary headaches, which are effectively treated in the Koncha-Zaspa sanatorium, are characterized by the fact that even the most thorough examination does not reveal any organic causes.

Secondary (symptomatic) ones arise as a result of various diseases of internal organs, injuries, metabolic disorders, poisoning, and taking certain medications.

It should be remembered that the substance of the brain does not have pain sensitivity. Painful sensations arise when the receptors of the dura mater, arteries, veins, muscles, skin are irritated.

In only 5% of cases, serious organic diseases can be the cause. But it is precisely on their identification that primary attention should be paid.

Diseases that are accompanied by a headache:

A sudden, severe, diffuse headache is characteristic of a cerebral hemorrhage. It is accompanied by vomiting and sometimes loss of consciousness. Paralysis of the limbs can also occur.

• Vascular diseases of the brain Is one of the most common reasons.
• Hypertonic disease. The pain usually occurs in the back of the head and often occurs in the early morning. There is usually no clear connection between the appearance of a headache and the degree of pressure increase. It usually occurs with a rapid rise in pressure.
• Inflammation of blood vessels (vasculitis). Constant headache. In the temporal and frontal regions in older patients, it occurs against the background of general weakness, constantly elevated temperature, and a decrease in body weight. The pain is often worse at night, especially if the patient touches the painful area by running his head over the pillow.
• Increased intracranial pressure. Headache may be early sign tumors and abscesses of the brain, intracranial hematoma and other masses, as well as dropsy of the brain. The pain is often diffuse, but at first it may occur in the area of ​​the tumor or other formation. The headache occurs intermittently, but then becomes constant. May depend on body position. It is accompanied by vomiting. Aggravated by coughing, sneezing, tilting the head. Wakes up in the middle of the night.
• Decreased intracranial pressure. Less common. The reason is the leakage of cerebrospinal fluid (intracranial fluid) through defects in the tissues of the head. The headache worsens when standing up and is accompanied by nausea, vomiting, dizziness, and tinnitus.
• Orgasmic (coital). Temporarily sudden pulsating headache that occurs in men during intercourse. It usually lasts several minutes, but if it first appeared during intercourse, it persists for several hours, it is necessary to exclude a cerebral hemorrhage.
• Compression of the nerves of the cervical spine. Inflammation or osteochondrosis of the spine. It occurs in the cervico-occipital region, can spread to the forehead, temple, shoulder, arm. May appear on one or both sides. The side of the pain usually does not change. It intensifies when moving the head, prolonged stay in an uncomfortable position, when touching the neck, back of the head.
• Inflammation of the airways of the skull (sinusitis). Sinusitis, frontal sinusitis, ethmoiditis. Pain in the forehead, around the eyes. It is accompanied by fever, nasal congestion, redness of the skin and pain when tapping in the area of ​​the affected sinus. There is almost always purulent discharge from the nose. The pain increases when lying down, after sleeping, decreases when standing.
• Inflammation of the joint of the lower jaw. Pain occurs near the ear, in the muscles when chewing, yawning, wide opening or clenching of the mouth.
• Acute increase in intraocular pressure. Acute angle-closure glaucoma. Pulsating pain in the eye, in the orbit, with redness of the eye, impaired vision, nausea, vomiting.
• Irritation of the cold receptors in the throat. With hypothermia of the head or swallowing cold food, short-term severe pain occurs near the eyes, in the nose, in the throat.
• Pain after a head injury. It can last for several months, several years. It is accompanied by a decrease in memory, attention, mental disorders, dizziness, nausea, increased fatigue, sleep disturbance. The pain is diffuse, dull, aggravated by physical exertion.
• Infectious diseases. Pain occurs with any infection. It is accompanied by an increase in temperature. There may also be pain in muscles, joints, general weakness.
• Poisoning, metabolic disorders. Constant dull pain with nausea, increased sweating, diarrhea, muscle pain.
• Headache when taking medication. When taking vasodilators, hormones, antibiotics. Headache ricochet with an overdose of painkillers. Reduction of headache after drug withdrawal is the main symptom of drug headache.
• Primary headaches- tension headache and migraine. Cluster headache. Indomethacin-sensitive headache.

Tension headache is the most common type, affecting more than 50-80% of the population. More often in women. The pain is mild or moderate, lasts from several tens of minutes to several days, does not increase with physical activity. The pain is bilateral, in the back of the head, in the forehead, pressing, constricting, without vomiting. It is difficult for patients to describe their feelings. Often - not pain, but a feeling of heaviness or pressure of a helmet, a hoop on the head.

Migraine - occurs during adolescence. Paroxysmal. Unilateral or bilateral headache in the frontal, temporal region, in the orbit. The pain is intense, throbbing, with nausea, vomiting, photophobia, sound phobia, desire for rest and isolation.

Cluster headache - occurs at a later age (30-50 years). Characterized clustering pain cycle - 1-3 attacks per day, lasting minutes, for 6-8 weeks. Then the attacks resume after 4-6 months, with a certain cyclicality, seasonality. Pain is strictly one-sided, periorbital, extremely intense ("suicidal"). It is accompanied by redness of the eyes, nose, lacrimation. The patient is constantly moving, cannot find a place for himself.

Indomethacin-sensitive headache is a form of primary headache with a positive reaction to indomethacin. The pain is usually short-lived, repeated for several hours a day. It can be unilateral or bilateral, spontaneous or provoked by straining. Some patients may not respond to indomethacin, and other drugs may have a positive effect, therefore, the allocation of this group of headaches is very conditional.

DIAGNOSTICS

Diagnosis of the type of headache is carried out using the pupillometry method. An indirect sign of a headache is the reaction of the pupils of the eyes. Pupils can expand, narrow, have different diameters. The subjects are invited to perform a series of test exercises and movements, during which pupilometry is performed (video recording of the pupil response with high-precision video cameras). The data obtained on the reaction of the pupils are analyzed by a special computer program that determines the type and nature of the headache. This makes it possible to individually prescribe the necessary and effective treatment.

Types of headaches

Tension headaches

Diagnosis of simple and stressful pains is based on a characteristic clinical picture: the headache is unapproachable in nature with the duration of pain episodes from 30 minutes to 7 days. The pain is squeezing, constricting (not pulsating), the intensity is usually moderate (pain impairs performance, but does not lead to cessation of activity). Localization is bilateral: frontotemporal, parietotemporal, "helmet", "helmet", "hoop", "hood". In this case, the pain is not aggravated by daily physical activity.

Tension headaches are classified as episodic and chronic. In case of episodic forms, the number of days with headache does not exceed 15 per month or 180 days per year. In chronic forms, the number of days with headache exceeds these figures. Such a division is very arbitrary - for example, it is difficult to classify it as episodic or chronic headaches, which occur 13 to 18 times a month.

In the formation of tension headaches, mental disorders play a leading role: anxiety, depression, hypochondria, demonstrative personality traits. However, depression is the leader among them.

The cause of headaches is often prolonged muscle tension in antiphysiological positions. This is often associated with professional activities: working at a computer or a typewriter, with small parts, driving a car, etc. In this case, the external eye muscles, muscles of the scalp aponeurosis of the head, and cervical muscles are in a tense state. An uncomfortable head position during sleep can also play a role. In this regard, one should not forget about such widespread methods as gymnastics, massage, physiotherapy.

The use of drugs for episodic headache is carried out in short courses or once. So, a headache can be stopped with a single dose of analgesics: aspirin, paracetamol, ibuprofen, combined analgesics (citramone, sedalgin) or tranquilizers, as well as their combination. However, at the same time it is necessary to remember about the inadmissibility of the abuse of analgesics and psychotropic drugs, as this leads to a decrease in their effectiveness, the transition of pain to a chronic form, the formation of a chronic daily abusal headache. top scores are achieved with a single dose of muscle relaxants: midocalm in dozemg (1-2 tablets) in combination with 250 mg (1 capsule) of donalgin; sirdalud (2-4 mg).

Migraine

This type of headache is reported in the papyri of the ancient Egyptians: there are descriptions of migraine attacks, as well as prescriptions of medicines used to treat this disease. Despite this, so far in the pathogenesis of migraine, much remains a mystery. Practitioners and patients with migraine are not clear about whether it is curable. What modern medicines most effectively relieve painful migraine attack? Should all migraine patients be treated and how?

Migraine is the second most common primary headache after tension headache.

The criteria for the diagnosis of migraine were defined by the International Headache Society in 1988:

• Paroxysmal headache lasting 4 to 72 hours.
• Headache has at least two of the following characteristics: predominantly unilateral localization, alternating sides, less often bilateral, pulsating character, moderate or significant intensity of the headache (disrupts daily activities), increased during exercise.
• The presence of at least one accompanying symptom: nausea, vomiting, phonophobia, photophobia.

Migraine is a hereditary disease, the course of which is influenced by a number of external and internal factors. The process of formation of migraine attacks is extremely complex, and many of its mechanisms are not fully understood. Modern researchers believe that cerebral mechanisms are leading in the onset of a seizure.

Liquorodynamic type of headache

As you know, the cerebrospinal fluid produced by the vascular plexuses of the brain circulates in the system of the ventricles of the brain, cisterns and spaces of the brain and is directed further along the outflow pathways into the venous system.

Any pathological processes that interfere with the circulation of cerebrospinal fluid or cerebrospinal fluid, entail a change in intracranial pressure (i.e., its increase or decrease).

With an increase in intracranial pressure, the headache has a bursting character, patients experience a feeling of pressure "from the inside out" (as if "the brains are crawling out"). This pain increases with straining, coughing, sneezing. A common precursor to severe persistent headaches of this type is a brain tumor.

Treatment is done with diuretics and blood pressure lowering drugs.

With a decrease in intracranial pressure, the pain is pulsating, combined with weakness and apathy.

Vascular type of headache

This type is associated with various options for changing the state of the arteries and veins of the brain and skull. So, the first variant of pain - arteriohypotonic - is caused by a decrease in the tone of these arteries, the second - on the contrary, by spasm, and the third - by venous insufficiency.

In the first case, due to a decrease in the tone of the craniocerebral arteries, they are excessively overstretched with blood. Therefore, the pain is of a pulsating nature, but in advanced cases, the pulsating pain is replaced by a dull, bursting pain.

In the second case, with the arteriospastic type of headache, the headache has a dull breaking character, is perceived as a feeling of compression and may be accompanied by lightheadedness, nausea, dizziness, “flies” in front of the eyes.

Pain in venous insufficiency is caused by increased blood filling of the venous vessels and obstruction of venous outflow. Patients experience heaviness in the head and a feeling of dull distention. Most often, these sensations are limited to the occipital region. Venous insufficiency headache occurs or worsens when lying down or when working with a low tilted head. One of characteristic features such a headache is its morning manifestation - arises early in the morning "as soon as I opened my eyes", "heavy head, as if plowing all night."

Treatment of vascular type of pain is carried out with drugs of the xanthine series (aminophylline), ergotamine, antispasmodics, vinpocetine, calcium antagonists (nifedipine).

Abuse headache

This term comes from english word"Abuse" is abuse. The literature also uses the terms "Drug headache", "analgesic-dependent headache", "withdrawal headache", "abuse headache" and others. Abuse headache is the third most common, following migraine and tension headache.

Abuse pain develops in patients suffering from primary headache, more often migraine - 3/4 of patients or tension headache - 1/4. Frequent use of analgesics (daily or every other day) leads to chronic episodic pain and a change in its nature. Patients note a background constant headache of mild intensity and paroxysmal intensification of pain in the head.

The characteristic of pain is mixed: patients experience both pulsating migraine pain and constricting, squeezing, more typical of tension headaches. The pain may be accompanied by nausea, vomiting, phono- and photophobia. The effectiveness of constantly taken analgesics decreases over time, which leads to an increase in dosages, and their withdrawal leads to an increase in pain in half of the patients. A vicious circle is formed:

pain - analgesic - pain

The most common causes of drug abuse are psychological characteristics patients. High level anxiety and depression, the illusion of high self-control pain using an analgesic tablet leads to the formation of an incorrect strategy for coping with pain and leads to drug abuse. It is believed that taking the medication every day or every other day after three months can lead to the formation of an abusal headache.

The most important step in the treatment of abusal headache is the withdrawal of analgesics.

Headache when lying down is worse

Subarachnoid hemorrhage should always be suspected if a sudden, severe headache occurs (emergency).

A patient with a recently appeared, gradually increasing headache that occurs in the morning or with tension should be referred for additional examination.

In case of complaints of headache, it is necessary to measure blood pressure.

It should be remembered that in older people, headache may be due to temporal arteritis or chronic subdural hematoma.

Irritation of the meninges:

- acute and chronic meningitis.

Dystonia of intracranial blood vessels:

- volumetric processes (tumor, hematoma, abscess);

- an increase in intracranial pressure (ICP) (blockade of the cerebrospinal fluid pathways, venous thrombosis, intracranial hypertension, malignant arterial hypertension);

- decrease in ICP (after lumbar puncture, less often spontaneously).

Dilation of intracranial vessels and metabolic disorders:

- generalized infectious disease;

- ischemic cerebral circulation disorder;

- headache after injury or seizures;

- the use of drugs and food products dilating the venous vessels;

- significant increase in blood pressure;

- headache during physical exertion, intercourse;

- hypoxia and hypercapnia;

- anemia or polycythemia;

- headache caused by analgesics.

- Common (simple) migraine (“temporal artery migraine”).

- Bunch headache.

Tension headache:

- primary (psychogenic mechanisms);

- secondary (neck injury, “whiplash” injuries, malocclusion, bruxism1, improper organization of the workplace).

- trigeminal neuralgia;

- neuralgia of the glossopharyngeal nerve;

- atypical neuralgia facial nerve.

- damage to the ears, eyes, paranasal sinuses, oral cavity and bones.

Daily headache

Everyday headache can be due to a variety of concomitant causes. There are many types of headaches, and identifying the cause can be as difficult as treating it. In addition, prolonged use of analgesics can paradoxically lead to the development of headaches.

Examination and diagnostics

Anamnesis data are of great importance. It is necessary to pay special attention to the following points.

Patient's age at the first headache attack

If the headache occurs after 35 years, a careful examination of the patient is necessary (migraine and tension headache usually develop at a younger age).

Duration and frequency of headache attacks

Long-term or recurrent headache often has vascular origin or muscle tension.

Acutely developed headache of various nature can be caused by serious illness(for example, subarachnoid hemorrhage).

Gradually (over days / weeks) worsening headache may be a sign of a brain tumor.

Migraine attacks rarely develop more than 2 times a week. Daily attacks are uncommon for migraines.

Features of a headache

Vascular headache is usually pulsating in nature.

Tension headache - squeezing, squeezing, like a hoop.

Headache in the morning (including early) hours is characteristic of migraine or increased ICP.

Migraine headache is usually unilateral; cluster headache is always one-sided.

Tension headache usually covers the forehead or occiput area evenly (sometimes it is localized only on the “crown” of the head).

Pain in the temporal region can be caused by various reasons (for example, pathology of the mandibular joint). It is necessary to remember about the possibility of developing temporal arteritis in the elderly.

Classical migraine is often preceded by various prodromal symptoms. Typical manifestations include photopsies, scotomas, transient visual impairments (figures with vague contours), visual field defects, sometimes paresthesias or short-term speech impairments.

- If the prodromal signs persist after the onset of the headache, the diagnosis of migraine is uncertain.

- Diplopia is not typical for migraine, its occurrence is considered as an indication for further examination.

Nausea and vomiting are characteristic of migraines, but if present, it is necessary to conduct differential diagnosis, for example, with ischemic cerebral circulation disorders, hemorrhages and increased ICP.

Somatic and neurological status

Although a general examination of a patient with a headache usually does not find any abnormalities, it remains an important step for diagnosis.

It is necessary to measure blood pressure.

It should be remembered that an ophthalmologic examination is necessary (disc edema optic nerves and the absence of venous vascular pulsation indicate an increase in ICP).

Measurement of intraocular pressure is necessary at least in cases where the pain is unilateral and localized in the eye area.

Additional research methods

The diagnosis of migraine and tension headache is usually based on anamnesis, in such cases, the need for further research no.

Ultrasound of the maxillary and frontal sinuses is necessary if there are signs of an infectious disease.

To detect temporal arteritis, it is necessary to determine ESR in patients over 50 years of age.

CT and MRI are the primary research methods when a volumetric process is suspected.

If subarachnoid hemorrhage is suspected, CT is the primary method of investigation.

Sometimes no abnormalities are found with CT, but the study of the cerebrospinal fluid allows you to confirm the diagnosis.

If meningitis is suspected, CSF testing is necessary.

Based on the data of the anamnesis and physical examination, selectively carry out: complete blood count, determination of fasting glucose concentration, serum concentration of sodium and potassium ions, creatinine, TSH and T3, as well as others

enzymes and hormones in the blood serum.

Indications for consultation with specialists or special methods research

Acute severe headache.

Recent severe or continuously increasing headache.

Continuous headache, worse lying down.

Headache in the morning.

Headache provoked by coughing, physical exertion.

The onset of headache in patients over 50 years of age.

Decrease in body weight.

Physical examination data

Fever and general disorder (to exclude meningitis).

Swelling of the optic discs.

Soreness of the temporal arteries on palpation or increased ESR (temporal artery biopsy).

Recently developed gait disorder.

Focal neurological symptoms, including visual disturbances.

Migraine headache that always develops on one side or first occurs after 40 years.

Headache that does not respond to treatment.

A general practitioner can treat a cluster headache, provided that the diagnosis of trigeminal neuralgia is excluded.

Chronic paroxysmal hemicrania (resembles a cluster headache and appears as short frequent attacks among women).

Situations in which consultation may be needed

Patients with chronic pain syndrome not responding to treatment (in this case, trial antidepressant treatment is necessary).

If there is a suspicion of a connection between the occurrence of a headache and a lesion of the neck.

Why does head pain occur at night

Headache is a symptom that is familiar to everyone. Most people experience headaches during the daytime, working hours. However, there are such groups of people who are worried about the heaviness in the head at night. This condition is more severe because the headache at night interferes with sleep.

What is a headache

Such an ailment is not a separate disease, but a symptom that can accompany various pathological conditions. This symptom has a predominantly subjective characteristic - each person feels discomfort in his head in his own way and describes it in different terms.

Headache can sometimes be the only symptom of a latent disease. As for night headaches, their cause lies in various conditions.

Causes of night pains in the head

Oxygen deficiency

The most basic cause of discomfort in the middle of the night is lack of oxygen. The brain reacts sharply to oxygen deprivation. If other organs can maintain their function in conditions of reduced oxygen for up to an hour, then the brain is not able to hold out without it for more than five minutes. In response to the resulting hypoxia, the brain reacts with a headache.

Lack of oxygen can be caused by:

1. Being in a stuffy room without fresh air.
2. Diseases of the upper respiratory tract, accompanied by difficulty in nasal breathing.
3. Anomalies in the development of the nasal passages, which also impede free nasal breathing.

Mental strain

Often sleep headaches are associated with intense mental work during the day. The need to overextend the brain throughout the working day leads to the fact that during the night's sleep, the brain continues to work and does not receive adequate rest. This leads to discomfort in the head at night and feeling tired after waking up.

Hypotension - low blood pressure

The average blood pressure in an adult is 120/80 mm Hg. Art. For some people normal pressure, in which they feel comfortable, are lower numbers - this is due to heredity, with the characteristics of the physique.

For most people, blood pressure is below 100/60 mm Hg. Art. leads to the emergence unpleasant sensations in the head. They are especially pronounced at night. This is due to the fact that in a horizontal position the blood flows from the brain, and if the pressure is low, then this process is more pronounced.

Due to a lack of blood supply, nighttime headaches develop. After waking up, dizziness, a feeling of flies before the eyes may join it.

Why hypotension may occur:

1. Prolonged fasting.
2. Lack of glucose in the blood.
3. Acute or chronic bleeding.
4. Long stay in a forced horizontal position.

On our website there was a detailed article about headaches in hypotensive patients. You can familiarize yourself with it.

Hypertension - high blood pressure

The opposite situation is observed in those whose blood pressure exceeds 130/80 mm Hg. Art. Again, in hypertensive patients, such pressure is comfortable - pathology may not occur. But for those whose comfortable pressure fits into standard numbers, changing it upwards becomes the reason why the head hurts at night.

High blood pressure on the walls of blood vessels causes their reflex spasm. At the same time, the receptors located both in the wall of blood vessels and in the substance of the brain are irritated - a headache arises. The rise in pressure is usually observed in the evening: overwork, emotional fatigue accumulates. During sleep, the vessels begin to react - this condition develops.

Why the pressure rises:

1. Emotional and physical overwork.
2. Acute stressful situation.
3. Overheating.
4. Diseases characterized by high blood pressure.

Circulatory disorders - heart attack and stroke

The development of discomfort in the head at night may be the result of an emerging cerebral circulation disorder - a stroke. The pathological process in stroke consists in acute spasm or obstruction of cerebral vessels. As a result, an ischemic zone is formed.

The cells of the brain substance in this zone are in a state of acute hypoxia - as a result, discomfort develops.

Sometimes a headache at night can appear and due to acute heart attack... The mechanism of pain here is associated with a sharp myocardial ischemia, pain in the heart. With sensitive parasympathetic nervous system the sensation can spread to other organs, in particular to the head.

Pain in pathology of the spine

There are frequent cases of nighttime discomfort in the head in persons suffering from diseases of the spine, especially the neck and back. Immediate cause the appearance of pathology in this case is excessive muscle tension.

Back pain makes a person take a forced position, sometimes different from the physiological one. This leads to tension in the muscles of the back and neck - a so-called tension headache occurs. It appears in the evening and at night when tense muscles begin to relax.

Psychological problems

Perhaps this is one of the main reasons for the appearance of nighttime discomfort in the head. Negative stress, melancholy, depressive states almost always accompanied by the appearance of unpleasant sensations at night. Of course, it can occur during the day. But at night, such a person is left alone with his experiences, scrolls it all in his head - a combination of this with sleep disturbance leads to the appearance of a pronounced headache.

Metabolic Disorder - Diabetes Mellitus

Another organic cause of unpleasant pain at night is diabetes mellitus. The condition in this case is due to several factors:

1. Glucose deficiency with insulin overdose.
2. Night hunger also leads to a decrease in glucose levels - brain cells are very sensitive to this.
3. With diabetes, peripheral nerve pathology develops - this also leads to the appearance of a headache.
4. The late stage of diabetes is characterized by pathology of the organ of vision - retinopathy, glaucoma. These conditions are always accompanied by a headache at night.

Infectious diseases

There are infections, the main symptom of which is headache. It can occur at any time of the day, including at night. The appearance of discomfort with an infectious disease may be due to the following:

1. As a symptom of intoxication with severe flu or adenovirus infection.
2. As a consequence of dehydration with intestinal infections.
3. As a direct damage to the structures of the brain with meningococcal infection, tick-borne encephalitis, meningitis and encephalitis of other infectious etiology.

Migraine

This is a particular cause of headache. Migraine attacks tend to occur in the evening and can continue throughout the day. The pathogenesis is based on persistent spasm of cerebral vessels.

Diagnostics

The diagnosis of nocturnal headache depends on its characteristics. Additional research methods are used if necessary.

Discomfort in the head with fatigue, emotional and mental stress, hypoxia has the following characteristics:

1. It develops gradually, reaching its peak in the evening and night hours.
2. It is dull, monotonous.
3. Moderate intensity.
4. Accompanied by a feeling of fatigue, weakness.

Discomfort with low blood pressure also develops gradually, accompanied by general weakness and dizziness, and loss of consciousness is possible.

Discomfort with high blood pressure often occurs suddenly, a person wakes up in the middle of the night due to pain and a feeling of throbbing in the head. If the pressure reaches very high numbers, the headache becomes more intense, and nosebleeds may occur.

Pain in strokes and heart attacks occurs suddenly, a person wakes up from a sharp headache. This sensation is accompanied by visual impairment, flashing of flies before the eyes, signs of paresis and paralysis.

Headache with pathology of the spine is formed throughout the day, and by the evening and at night it becomes as intense as possible. It is characterized by a feeling of heaviness in the head, the inability to turn or tilt it.

Pain in diabetes mellitus occurs suddenly - just like a hypoglycemic state occurs. It is accompanied by severe weakness, dizziness, trembling hands and sweating.

Discomfort in the head with infectious diseases is characterized by the following symptoms:

1. Abrupt, sudden onset.
2. Combined with a rise in body temperature.
3. Flu headache is combined with photophobia, redness of the eyes.
4. With infections that cause meningitis, the headache will be pronounced, combined with nausea and vomiting, photophobia, hearing impairment. Meningeal symptoms are observed.

Migraine pain occurs in one half of the head, accompanied by visual impairment and lacrimation on this side. Can reach high intensity.

In addition to clinical data, instrumental research methods are used to diagnose some types of pathology:

1. Doppler ultrasound of the vessels of the head and neck;
2. Electromyography - a study of the electrical activity of the muscles of the back and neck;
3. Electrocardiography;
4. For headache caused by an infection, a diagnostic spinal tap is done.

Pain treatment

Treatment methods largely depend on the cause of the discomfort. In most cases, pain relievers alone are not enough.

Treatment of pain caused by hypoxia

This condition is the easiest to stop. It is enough just to provide a constant flow of fresh air and prescribe pain relievers:

These measures are sufficient to eliminate pain caused by hypoxia.

Pain treatment for psychoemotional and physical stress

In these cases, the headache can go away on its own - after a good rest. To reduce the intensity of sensations, you can use the following drugs:

1. Analgesics - Nurofen, Pentalgin;
2. Sedatives - valerian, motherwort, combined drugs (Persen, Novo-passit, Afobazol).

Treating pain with fluctuations in blood pressure

Hypotonic headache is treated with drugs that can increase blood pressure:

If hypotension has developed due to starvation, a full meal can eliminate the discomfort even without pain relievers.

Hypertensive headache will disappear after lowering blood pressure special drugs... Only a specialist is involved in their selection and appointment. You can relieve the condition on your own by taking a cool bath, rest, and proper sleep.

Treatment of the head for diseases of the spine

Here, the treatment should be comprehensive, aimed not only at eliminating the headache itself, but also at the discomfort in the spine. If the back pathology remains untreated, the head will not go away after any pain relievers.

Gymnastics for the back, massage, acupuncture, physiotherapy methods will be useful. Swimming and water aerobics have a good effect.

Pain treatment for circulatory disorders

Stroke and heart attack - indications for immediate hospitalization in the department intensive care... Headache in such conditions cannot be tried to heal on your own.

Treatment for infectious diseases

The headache in infectious diseases will completely disappear only after the pathogen is eliminated. During etiotropic therapy, discomfort can be relieved with any anesthetic drugs - Diclofenac, Ibuprofen, Pentalgin.

Migraine treatment

Migraine pain is treated with a special group of drugs - sumatriptans. At the moment, there are many trade names of this substance - Amigrenin, Sumamigren, Nomigren. In addition to taking these drugs to stop a migraine attack, it is necessary to create complete rest, a dark environment. Hot compresses are applied to the forehead - to relax the spasmodic vessels.

Prevention of headaches

Preventive measures for headaches are as follows:

1. Full physical activity.
2. Adequate outdoor exposure.
3. Airing the room before going to bed.
4. Blood pressure control.
5. Timely treatment of infectious diseases and diseases of the nasopharynx.
6. Proper nutrition.
7. Treatment of pathology of the spine.

Conclusion

Headaches at night have many causes. Often, to eliminate this sensation, you must first act on the original cause.

Headache in a horizontal position

Diagnosis of headaches

Identifying the causes of headache or diagnosing it is important in terms of treatment tactics. After all, it is precisely on the causal factor, or at least one of the links in the development mechanism, that therapy should be directed. Finding the primary or secondary headache is the first task of doctors. Primary headache occurs with pathological processes developing in the brain itself. And the secondary type is formed as a response to distant foci of pathology.

Specialists of the Kiev "Clinic of Dr. Ignatiev" are trying to determine the cause of the distant type of pain. Their competence includes pathologies of the spine, and it is they who often cause a symptom complex, accompanied by a headache. Therefore, it is possible that one of the sides of the body that needs to be subjected to detailed diagnostics may be the spine and its individual parts. The clinic's vertebrologists conduct daily consultations after an appointment.

Headache mechanisms

To make a correct diagnosis, it is important to understand the mechanism of the syndrome:

• Vascular mechanism - may have the character of a vasomotor reaction, when a headache occurs in response to a violation of vascular tone. The venous type is a consequence of an increase in the blood filling of the veins. The ischemic-hypoxic type of pain is more often associated with deposits of cholesterol plaques inside the vessel wall in atherosclerosis or with arterial hypertension.
• Neuralgic mechanism - gives a reflected type of headache, for example, when the nerve roots are squeezed by the protrusion of the disc between the vertebral bodies during protrusion or hernia in the cervical spine.
• The mechanism of muscle tension - in this case, the so-called tension headache appears. It occurs when nerve fibers or supply vessels are compressed by spasmodic muscles.
• Liquorodynamic mechanism - associated with deviations in intracranial pressure indicators. Liquor is one of liquid media organism, located in the ventricles of the brain and in the spinal canal, it, along with blood and lymph, plays an important role in the metabolic processes of the nervous tissue.
• Psychalgic mechanism - headache occurs as a result of psycho-emotional overstrain.

Thus, having understood the mechanism of headache formation, it is already possible, without hesitation, to establish a preliminary diagnosis.

Symptoms of different types of cephalalgia (headache)

In diagnostics, recognition of the characteristic symptoms of a particular type of headache is of great importance. So, vascular pain comes to light in the form of pulsating cephalalgia. One-sided pain speaks of the presence of migraine, and the bilateral character indicates the phenomena of vegetative vascular dystonia. Venous cephalalgia worsens when lying down and is accompanied by swelling of the face and eyelids.

Tension headache has a compressive type, the patient's condition is relieved by kneading the neck-collar zone and with rhythmic movements of the shoulders. Intracranial hypertension produces a bursting headache that worsens when lying down. On the contrary, a decrease in pain in the supine position indicates a reduced cerebrospinal fluid pressure.

Diagnostics and treatment in Kiev

Neuralgic cephalalgia is usually paroxysmal and has the form of shooting short-term pains. In this case, the sources of pain are determined that correspond to the exit sites of the branches of the trigeminal nerve.

Diagnostic techniques such as computed tomography and magnetic resonance imaging confirm a preliminary diagnosis, but they usually provide comprehensive results for more obvious causes of cephalalgia, for example, brain tumors, hematomas, and other masses.

Doctors of the "Clinic of Dr. Ignatiev" advise not to neglect the manifestations of cephalalgia. Pathology is best treated at the very beginning of its development, therefore timely therapy is the most important condition for complete recovery.

Headache when lying down

Headache in the supine position is the result of many different pathological conditions, ranging from banal overwork and ending with a malignant brain tumor.

Depending on the characteristic symptomatology and the cause, doctors distinguish several genetic types of headache, the definition of which is of primary importance for its drug therapy.

Vascular view

It occurs when the tone of the vessels of the brain is disturbed. It is characterized by dull, breaking, throbbing pain, accompanied by darkening in the eyes, a feeling of heaviness in the head and flickering # 171; goose bumps # 187;.

The vascular pain increases significantly with the head down and in the supine position. The group of vascular headaches includes:

• pain with arterial hypertension;
• with migraine and atherosclerosis of the vessels of the brain;
• with acute disturbance of cerebral circulation (stroke);
• premenstrual and menstrual headaches;
• hypotension pain and seasonal headaches.

Liquorodynamic view

It is formed as a result of imbalances between the outflow of cerebrospinal fluid and secretion, as a result of which intracranial pressure either decreases or rises.

Typical symptoms of headaches of CSF-dynamic type: confusion, bursting character, feeling of pressure # 171; outward-from inside # 187 ;, a sharp increase in intensity in the supine position, while walking, when coughing and turning the head.

Diseases provoking liquorodynamic headaches:

• brain abscess, benign and malignant brain neoplasms;
• swelling of the brain due to inflammation or injury.

Muscle tension headaches

They arise against the background of painful pathological impulses during processes of local localization, as well as as a result of a high tone of the nervous system.

They have a feeling # 171; a hoop that squeezes the head # 187;, excessive sensitivity to bright light and loud noises, irritability and tearfulness. Observed when:

• hormonal shifts, neuroses, stress;
• infectious toxic diseases;
• organic lesions of the paranasal sinuses and eyes.