Kubva Kwekurwa Kwemusoro | El Paso, TX.

Origin: Chikonzero chakanyanya kuita migraines / musoroRelateinogona kuenderana nematambudziko emutsipa. Kubva pakushandisa nguva yakawandisa uchitarisa pasi palaptop, desktop, iPad, uye kunyangwe kubva pakutumira mameseji, chimiro chisina kukodzera kwenguva yakareba chingatanga kumanikidza pamutsipa uye nechekumusoro kumashure zvichitungamira kumatambudziko anogona bvisa musoro. Ruzhinji rwemhando idzi rwemusoro dzinowanzoita sechisimba pakati pemakumbo emapfudzi, izvo zvinokonzera mutsara pamusoro pemapfudzi kuomesa uye kuisa marwadzo mumusoro.

Kubva Kwekurwa Kwemusoro

• Inomuka kubva mumarwadzo akaoma maziso mumusoro
• Zviduku zvakakura mashizha (kurwadziwa / temp) zvisina kunaka
• Meninges
• Tsinga
• Zvinyorwa zvekuwedzera
• TMJ
• Eyes
• Sinuses
• Neck muscles uye ligaments
• Dental structures
• Uropi hauna hutambudzo hwemapurisa

Mharapara Trigeminal Nucleus

• Trigeminal nerve
• Nhengo dzemaziso
• Glossopharyngeal nerve
• Vagus nerve
• C2 nerve (Greater occipital nerve)

Occipital Nerves

dailymedfact.com/neck-anatomy-the-suboccipital-triangle/

Sensitization Of Nociceptors

• Mhinduro muAllodynia uye hyperalgesia

slideplayer.com/9003592/27/images/4/Mechanisms+associated+with+peripheral+sensitization+ to+pain.jpg

Headache Types

Mutadzi:

• Meningeal irritation
• Intracranial masonda emasi
• Vascular headaches
• Cervical fracture or malformation
• Metabolic
• Glaucoma

Benign:

• Migraine
• Cluster headaches
• Neuralgias
• Kurwisana musoro
• Secondary headaches
• Post-traumatic / post-concussion
• "Analgesic rebound" musoro
• Psychiatric

HA Kubva Kuchengeta Zvipembenene

• Sinuses (utachiona, tumarara)
• Cervical spine chirwere
• Matambudziko emeno
• Temporomandibular joint
• Utachiona hutachiona, nezvimwewo.
• Ziso (glaucoma, uveitis)
• Extracranial arteries
• Nerve zilonda

HA Red Red Flags

Sirasi yemavhogi mutsvuku uye funga nezveHA dzenjodzi kana dziripo

Zviratidzo zvemuitiro:

• Kuonda
• Njodzi dzinomutsa kuti varare
• chimhepo

Zviratidzo zveeurologic kana zviratidzo zvisingaiti:

• Kungoerekana kwaitika kana kuputika
• Zvitsva kana zvinokurudzira HA zvakanyanya kunyanya kuvarwere vakura
• HA kurwadziwa kunogara kuri munzvimbo imwe chete

Pakave musoro wepashure

• Iyi ndiyo yekutanga HA yawakambove nayo here?
  Iyi ndiyo HA yakaipisisa yawakambove nayo here?

Secondary risk factors:

• Nhoroondo yekenza, immunocompromised, etc.

Dangerous / Sinister Headaches

Meningeal irritation

• Subarachnoid homorrhage
• Meningitis uye meningoencephalitis

Kuchengetedza masizi makuru

• Neoplasms
• Intracerebral hemorrhage
• Subdural kana epidural hemorrhage
• Kusuruvara
• Acute hydrocephalus

Vascular headaches

• Temporal arteritis
• Hypertensive encephalopathy (semuenzaniso, yakaipa youtachiona, pheochromocytoma)
• Arteriovenous malformations uye kuwedzera kusimba
• Lupus cerebritis
• Venous sinus thrombosis

Cervical fracture or malformation

• Kuputsika kana kuparadzaniswa
• Occipital neuralgia
• Vertebral artery dissection
• Chiari malformation

Metabolic

• Hypoglycemia
• Hypercapnea
• Carbon monoxide
• Anoxia
• Anemia
• Vitamini A chepfu

Glaucoma

Subarachnoid Hemorrhage

• Kazhinji nekuda kwekuputsika aneurysm
• Nenguva isipi inotanga kurwadziwa kukuru
• Kazhinji kurutsa
• Murwere anorwara
• Kazhinji nuchal rigidity
• Taura nezveCCT uye zvichida kuvhara

Meningitis

• Murwere anorwara
• chimhepo
• Nuchal rigidity (kunze kwevakwegura nevana vaduku)
• Tsvaga kuvharwa kwechiremba - kuongorora

Neoplasms

• Zvisingabviri chikonzero cheHai muhuwandu hwevarwere varwere
• Urombo uye hutsinye hunorwadza musoro
• Zvakaipisisa mangwanani
• Ingave inokurudzirwa nesimba rakaoma musoro kuzununguka
• Kana zviratidzo zvakanyanya, zvirwere, zviratidzo zvepfungwa neurologic, kana uchapupu hwekuwedzera kusagadzikana kushandiswa kwezviripo mutemo wedu neoplasm

Subdural Or Epidural Hemorrhage

• Nokuda kwehutachiona hwepamusoro, kushungurudzika kana kukanganisa mukubatana
• Kazhinji kazhinji inowanikwa mumamiriro ekutambudzika kwemazwi makuru
• Kuwedzerwa kwezviratidzo kunogona kuva vhiki kana mwedzi mushure mekukuvara
• Kusiyanisa kubva kune imwechete mushure-kugadzikana musoro musoro
• Post-Concussive HA inogona kupfuurira kwemavhiki kana mwedzi mushure mekukuvadzwa uye inofambidzana nechezzinesi kana vertigo uye kuchinja kwepfungwa, izvo zvese zvichapera

Kuwedzera Kuita Kuda Kufurirwa

• Papilledema
• Inogona kukonzera kuona maonero

openi.nlm.nih.gov/detailedresult.php?img=2859586_AIAN-13-37- g001&query=papilledema&it=xg&req=4&npos=2

Nguva (Giant-Cell) Arteritis

• > 50 makore
• Polymyalgia rheumatic
• Malaise
• Kuwedzera kwekubatana kurwadziwa
• Myalgia
• Nonspecific musoro wemusoro
• Unyoro hwakanyanya uye / kana kuzvirumbidza pamusoro pemasero ezuva kana occipital
• Uchapupu hwekusagadzikana kwemasimba mukupararira kwematazi emidziyo yemagetsi
• High ESR

Cervical Region HA

• Neck trauma kana nezviratidzo kana zviratidzo zvemuviri wekervical kana cord compression
• Raira MR kana CT kambani kudzvinyirira nekuda kwekuputsika kana kuparadzaniswa
• Cervical instability
• Raira cervical spine x-rays lateral kuruka uye kuwedzerwa maonero

Kutonga Hangozi HA

• Kutonga nhoroondo yedu yekuremara musoro kana kuputsika kwemutsipa, kukanganisa kana kuisa pfungwa dzehutano hwehutano, uye hutachiona hunogona kutotangira ku meningitis kana kubatwa kweuropi
• Tarisa fever
• Edza BP (hanya kana diastolic> 120)
• Ophthalmoscopic test
• Chengetedza mutsipa kuti usimbise
• Auscultate for cranial bruit.
• Kuzadza kwehutano hwehutano
• Kana zvichidiwa urongwa hwakazadza nhamba yezivi yeropa, ESR, hupombwe kana chiberekiti chekufungidzira

Episodic Kana Isingaperi Here?

<Mazuva gumi nemashanu pamwedzi = Episodic

> Mazuva gumi nemashanu pamwedzi = Chisingaperi

Migraine HA

Kazhinji nekuda kwekuwedzera kana kushandiswa kwechiremba vasculature

Serotonin MuMigraine

• AKA 5-hydroxytryptamine (5-HT)
• Serotonin inopera mumagraine episodes
• IV 5-HT inogona kumira kana kuderedza kusuruvara

Migraine NaAura

Nhoroondo yekuti zvisungo zve 2 zvinokonzera zvinotevera

Chimwe chezvinotevera zviratidzo zverara zvakazara:

• zvekuona nemeso
• Somatic sensory
• Kutaura kana mutauro kunonetsa
• motokari
• Brain stem

2 yezvinhu zvinotevera zve4:

• 1 aura chiratidzo chinopararira zvishoma nezvishoma pamusoro pe5 min, uye / kana 2 zviratidzo zvinoitika zvichiteerana
• Chimwe nechiratidzo chema aura chinopedza 5-60 min
• 1 kanara chiratidzo chisina kubatana
• Aura yakaperekedzwa kana kuteedzerwa mu <60 min nemusoro
• Kwete zviri nani zvakataurwa nomumwe ICHD-3 kuongororwa, uye TIA haina kubviswa

Migraine Pasina Aura

Nhoroondo yekuti zvisungo zve 5 zvinokwana zvinotevera:

• Kushungurudzwa kwepfungwa kunogara kwenguva refu 4-72 h (isina kupomerwa kana kuti isina kubudirira)
• Unilateral kurwadziwa
• Kuchengetedza / kuvhara unhu
• Zvichienzanisa nekurwadziwa kukuru zvakasimba
• Kushungurudzika kana kuita kuti usadzivirire kuita zvepabonde nguva dzose
• Munguva yepfungwa misungo uye / kana kushushikana kune chiedza uye inzwi
• Kwete zviri nani zvakataurwa nomumwe ICHD-3 kuongorora

Cluster Headache

• Yakakura unilateral orbital, supraorbital uye / kana kurwadziwa kwepanguva
• "Senge chando chando chinondibaya ziso"
• Pain inotora 15-180 maminitsi

Pane chimwe chezvinhu zvinotevera kune rumwe rutivi rwemusoro:

• Conjunctival injection
• Facial sweating
• Kurambidzwa
• Miosis
• Nasal kusanganiswa
• Ptosis
• Rhinorrhea
• Eyelid edema
• Nhoroondo yemakumbo akafanana munguva yakapfuura

Kupopotedzana musoro

Kutambudzika kwepfungwa kunofambidzana nezviviri zvinotevera:

• Kuomesa / kusimbisa (kusinga-kutakurira)
• `` Anonzwa kunge bhanhire rakatenderedza musoro wangu ''
• Nharaunda
• Haisi kukurudzirwa nekuita mabasa ose

Musoro unofanirwa kushayikwa:

• Nausea kana kurutsa
• Photophobia uye phonophobia (imwe kana imwe inogona kuvapo)
• Nhoroondo yemakumbo akafanana munguva yakapfuura

Kudzokorora Musoro

• Musoro unoitika pamazuva gumi nemashanu mumwedzi murwere ane chirwere chepfungwa chisati chavapo
• Kugara uchishandiswa zvakanyanya kwe> 3 mwedzi yemumwe kana anopfuura madhiragi anogona kutorwa zvakanyanya uye / kana chiratidzo chekurapa kwemusoro
• Pamusana pemishonga yekurapa / kubvisa
• Kwete zviri nani zvakataurwa nomumwe ICHD-3 kuongorora

Sources

Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.