Transcription
Hello. In this video, we're going to look at headaches, the main types of headaches, and then treatment as well. So, headaches can be divided into two main types: we have primary headaches and we have secondary headaches. Secondary headaches are pretty bad, so these are these are your red flag headaches, and we'll talk about secondary headaches towards the end of this video. But we will firstly look at primary headaches. And primary headaches are your the main the most common types of headaches that is that are encountered by the general population. So here, I'm drawing this person with a headache, and there are many types of primary headaches. A very common type is one that affects one side of the face, so unilateral and sort of upper half, and these are young, and this is known as the migraine headache. Then you have tension headache, which is sort of feels like a tight tightness around your forehead. You have the cluster headache, which is sort of around your eye orbit area. And then you have sinus headache, which is related when you have sinusitis or irritation of your sinus. And then you have hormonal headache, which is a result of sort of a your home or hormonal levels changing.
Let's talk about each of these types of headaches in a bit more detail, beginning with migraine. So, migraine is a disorder of recurrent attack, so it comes and goes. The location of migraine is mostly unilateral, 70%. The characteristic of the headache: it's gradual onset, crescendo pattern, which is basically increasing intensity sort of and and frequency, with moderate to severe in intensity. So, the pain duration of the headache is between, you know, 4 to 72 hours roughly. Associated symptoms include nausea, vomiting, photophobia, photophobia, and also aura. Aura is sort of the feeling of something about to happen, which is the intense headache.
Then you have the tension headache. No, tension headache, you can think of it as being more muscular. So, it's the most ubiquitous headache and is the most common reason why over-the-counter analgesics are actually bought. So, these are your the most common; this is the most common headache essentially. The location of tension headaches are usually bilateral and around the forehead area. The characteristic: it's pressure or tightness, like a band, which waxes and wanes. The duration is variable, and associated symptoms usually none.
Then you have the cluster headache. Now, cluster headaches are pretty painful. Cluster headaches are a group of idiopathic headaches that is associated also with trigeminal neuralgia. Now, trigeminal, what I mean by that is trigeminal is a nerve, trigeminal nerve, and it's a it's a very important cranial nerve that does as many things around your face essentially. Now, the location of the cluster headaches is always unilateral, and it's usually around the eye, so it's one-sided around the eye. The characteristic of a cluster headache: the pain begins quickly; it's deep, continuous pain, excruciating and explosive in a in quality. The duration: it's it's pretty quick in respect to the other headaches we talked about, 30 to 3 hours. And the associated symptoms are essentially the symptoms of the trigeminal nerve problem as well as some other nerve problems. So, just drawing it out here, I'm drawing a face. Now, we have to quickly just understand what the trigeminal nerve does in order to understand the symptoms associated with the cluster headache. So, the trigeminal nerve, it has sense; it's it's important for sensation around your face. It senses an area around your forehead, which is supplied by the ophthalmic branch of the trigeminal. Then you have the maxillary branch of the trigeminal, V2, which supplies sort of the nose area. And then you have the mandibular branch, which is V3, which supplies sort of the bottom area of your face. So, that's the sensations of the trigeminal nerve sort of is responsible for sensation around your face, and these are its branches, three branches. So, in cluster headache, you have pain in this area in blue here around the eye, and the associated symptoms include Horner's Horner's syndrome, which you have ptosis and meiosis. So, ptosis is drooping of the eyelid, and meiosis is a constriction, so you're unable to dilate your pupils. You can also have lacrimation and also nasal discharge. So, essentially what I'm trying to portray here is that the cluster headache, you can have some associated symptoms involving the trigeminal nerve and sort of other nerve problems there in your neurology problems. Hope that made sense.
Then you have sinus headaches, which is associated with sinusitis. You then you have hormonal headaches as well, and hormonal headaches essentially it's when the changes of your hormone levels causes the headache. So, it can be associated with low estrogen concentration, for example, at the beginning of the menstrual cycle or withdrawal withdrawal of hormone therapy. So, all of a sudden you have estrogen one minute, and then you take away the hormonal therapy, estrogen levels drop, you get this headache. So, those were the five types of headaches: primary headaches, migraine, tension, cluster, sinus, and hormonal.
Now let us look at the drugs used, the common or main drugs used to treat each of these headaches, beginning with the migraine. So, for migraines, which is recurrent, um, NSAIDs or aspirin plus antiemetics and hydration is important. So, antiemetics are drugs that in a stop vomiting. For tension headaches, simple analgesics, so this is paracetamol, and again it's the most common tension headache is the most common reason, I guess, why people, one of the common reasons why people buy over-the-counter paracetamol. For cluster headaches, subcutaneous sumatriptan or oxygen can be given, and this is to prevent vomiting. In general, triptans, which includes sumatriptan, are actually contraindicated in certain patients, in certain patient patients with cardio coronary artery disease, peripheral vascular disease, or cerebrovascular disease. For sinus headaches, supportive therapy is important, and ongoing antiemetics, and also you can prescribe, but you can give antibiotics depending on the cause of the sinusitis. So, I hope you hope you'll just hope that may I hope that was clear, the different types of primary headaches as well as just the general management.
Now let's look at secondary headaches, which as I mentioned earlier are our serious and dangerous. Secondary headaches are a result of serious underlying diseases or other conditions. So, we have some warning signs and symptoms for secondary headaches, and we can remember this by the acronym SNOOP. SN O O P. S stands for systemic symptoms, illness, or condition such as cancer. N is for neurological symptoms or abnormal signs. O is for onset, which is new age greater than 40 or it's sudden, such as when you have a thunderclap sort of feeling, which is a subarachnoid hemorrhage essentially. The other O is for other associated conditions or features. P is for previous headache history with headache progression or change in attack character. So, essentially what SNOOP is trying to say is that you know the headache that the person presents with is very abnormal, and it's got all these signs and symptoms which will tell you, hang on a second, this is not normal; there's a there's this is this is a more serious problem; this is more serious than a tension headache or migraine. So, let's look at some examples. So, here I am drawing a person who has a very serious headache. So, examples of secondary headaches include intracranial hemorrhage, and this can this can include subdural, epidural, or subarachnoid hemorrhage, and of course these these people they they can present with some some neurological problems as well as some, you know, some complaining of thunderclap essentially; the onset was thunderclap. Then you can have another example is giant cell arteritis, which also is known as temporal arteritis, which is essentially the temporal artery with that is inflamed on the side of your head. The final example of a secondary headache is internal carotid dissection.
In summary, we looked at headaches, which can be primary or secondary. Primary include migraine, tension, cluster, sinus, and hormonal, and secondary are your dangerous ones, and weak; it's a it's it's it's a result of an underlying condition that is more serious, and we can we can pick this up with the acronym SNOOP, which helps us sort of identify if it's more serious or not. And yeah, so I hope you enjoyed this video. Thank you for watching. Wait