It is caused by abnormal nerve impulses generated when the nociceptors in the head and neck are stimulated and transmitted to the brain. It is one of the common clinical symptoms, with complex disease causes, which may be caused by intracranial lesions, extracranial head and neck lesions, diseases of the body outside the head and neck, as well as functional disorders and mental illnesses.

bubble_chart Diagnosis

1. Medical History Inquiry

1. Understand the cause, course, onset time, location, nature, severity, and factors that aggravate or alleviate the headache. Superficial sharp, stabbing pain is often cranial neuralgia; unilateral throbbing or distending pain is vascular pain; tight, dull pain in the occipital or frontal-parietal region is muscle contraction headache; episodic headache triggered by changes in head or body position is often caused by low intracranial pressure syndrome, transient ischemic attack, cervical migraine, hypotension, or brain ventricular system tumors; morning or nocturnal episodic headache may be caused by hypertension, early-stage increased intracranial pressure, heart failure, frontal sinusitis, or epilepsy; headaches caused by migraine, cluster headache, epilepsy, or hysteria are often related to emotions or fatigue; brief sharp pain after exposure to cold or injury is usually neuralgia.

2. Understand the symptoms accompanying the headache: Headache accompanied by vomiting may indicate intracranial lesions, migraine, glaucoma, epilepsy, or cluster headache; disorders of the five senses or oral cavity often present with symptoms such as tearing, nasal congestion, epistaxis, nasal discharge, or vision impairment; also inquire about systemic symptoms unrelated to the head and neck, such as fever, poor appetite, jaundice, polydipsia, polyphagia, polyuria, cough, or panting.

2. Physical Examination Findings

Focus the examination while ensuring no fistula disease is overlooked. Check for neurological signs such as papilledema, diplopia, visual distortion, visual field defects, balance disorders, bulbar palsy, agnosia, limb numbness, monoplegia, hemiplegia, crossed paralysis, or meningeal irritation signs. Also, assess for hypertension, cervical lymphadenopathy, sinus tenderness, increased intraocular pressure, arrhythmia, heart murmurs, or organ enlargement.

3. Auxiliary Examinations

Perform head and neck CT to detect intracranial space-occupying lesions or ventricular system enlargement; EEG to identify abnormal brain waves; lumbar puncture to measure intracranial pressure (hydrocephalus) and analyze cerebrospinal fluid cytology, generation and transformation, and Chinese Taxillus Herb antibody; X-ray of the paranasal sinuses to check for sinusitis; measure intraocular pressure for elevation; and take cervical spine X-rays to assess cervical vertebrae.

bubble_chart Treatment Measures

Principles are:

1. Actively manage and treat the primary disease;

2. Use antipyretics and analgesics such as Somiton or Migranin appropriately, or administer small doses of codeine or Rotundine;

3. For those with anxiety or irritability, consider adding tranquilizers or sedatives as needed, and for those with depressive symptoms, add antidepressants;

4. Treat according to the disease mechanism, such as administering dehydrating diuretics for high intracranial pressure, intravenous hypotonic solutions for low intracranial pressure, ergot preparations for vascular headaches, tuina, heat therapy, or novocaine block at trigger points for muscle relaxation, superficial nerve pain with block therapy, or cerebrospinal fluid replacement.

AD

TCM can effectively treat dry eye syndrome, floaters, retinopathy, and various chronic eye diseases

I. Migraine:

During an attack, take ergotamine caffeine 0.1–0.2 (total daily dose ≤0.6) orally, or inject ergonovine 0.2–0.5mg intramuscularly. Contraindicated in pregnancy, arteriosclerosis, and cardiovascular/cerebrovascular diseases. Subcutaneous block with 0.5% novocaine around the dilated temporal artery; for chronic, frequent, or drug-resistant cases, consider superficial temporal artery ligation.

II. Cluster headache:

Use ergot preparations during an attack.

III. Cervical migraine:

Cervical traction, vasodilators such as Nimodipine 20mg 3 times/day, Flunarizine 5–10mg nightly, Carbamazepine (0.1g 3 times/day), Prednisone (20mg once/day), or stellate ganglion block, along with treatment for coexisting cervicothoracic radiculitis.

IV. Tension headache:

Tuina, hot compress, and administration of tranquilizers or sedatives, with 2% Lidocaine 2–5ml block at muscle tender points. Cervical traction is recommended for those with cervical spondylosis or injury.

V. Neuralgic headache:

Administer 2% Lidocaine 2–5ml block at cranial nerve sites such as Fengchi point (occipital neuralgia) or supraorbital notch (supraorbital neuralgia). Alternatively, oral Carbamazepine (0.1g 3 times/day) or Phenytoin Sodium (0.1g 3 times/day) may be used.