Sunday, May 5, 2013

Red flag signs in headache patients.

Headache is not just a headache, and to distinguish the case to show the warning signs ," it hurts a lot of head simply","Some nausea and vomiting",  "the front sight is  black". Not be determined in such conditions. Once you let us know the dangerous situations.
1. (ICH, SAH) cerebral hemorrhage


In the case of cerebral hemorrhage, because it is a  bleeding of the brain. ICH(Intra-Cerebral Hemorrage), it is not accompanied by only a simple headache. Lowering of consciousness , half body paralysis, speech impairment, gait disturbance becomes the main symptom, the headache for just only comes with it is, so, there is little if you can not be distinguished.


But the problem is SAH, SAH is not a cerebral parenchyme's bleeding. Important point is a huge headache.


Simple tension headache and migraine, the patients knows very well.  Because the pain to come on a regular basis almost, the degree of pain is determined, what kind of medicine help this symtom quickly.

In the case of SAH, Features exploding emesis (vomiting due to the rapid rise of the cerebral pressure. Comes out like a fountain soil), 
a huge headache( you haven't  experienced up to now) .
 
Head hurts suddenly and severely, exploding vomitting  without any gastrointestinal symptoms such as diarrhea. If the patient came to clinic with the headache that they have not experienced even once until now, there is no reaction to every treatment . This simply means that it is a situation that must be transfered to specialized  care institutions
2. Brain tumor


In the case of brain tumors, there is a feature associated with cell differentiation and site of occurrence of each. First, I want to describe about childhood cancer.


(1) medulloblastoma (cerebellum tumor)


It is a childhood cancer. If medulloblastoma from adult occurs, it is possible to position rather than the cerebellum, to come to other parts of the body, in this case, is called the neuroectodermal tumor.

 For medulloblastoma response good to chemotherapy and radiation therapy. the 10-year survival rate is more than 50%

Since occur in the cerebellum, as well as headache, involves a severe dizziness. As a result of the tumor size increases, nausea and vomiting continued, and no response to all normal analgesic  Point of differentiation is a vertigo.


(2) encephalocystomeningocele


It is the most common brain tumor, which accounts for about 50% of all brain tumor patients. It is a positive, surgery goes well, the 5-year survival rate is more than 98%. Does not have a malignant tumor.

 
The encephalocystomeningocele can grow slowly in many cases, patients complain the continued headache continued. To distinguish from migraine is sometimes difficult.


Point of differentiation  is a "seizure" and "syncope".

 
Inspection is required if there is "convulsions (such as epilepsy)" or sometimes "syncope" is the patient of headache.


(3) astrocytoma

 
Astrocytoma tumor is typical that occur in adults. Brain tumor does not usually classify a Grade, but  astrocytoma is classified into four stages according to the degree of differentiation of the cells.


The first stage is positive, but it may be able to reoccur as a glioblastoma after treatment in many cases.


Grade III is referred to as a anaplastic astrocytoma,Grade IV is called  glioblastoma. The medulloblastoma, the survival rate is over 50% in 10years,  median survival values ​​are also long. 

Glioblastoma has 10 months of  median survival value.  The 5-year survival rate has been described in an article about 5-7%. 
Glioblastoma is about 50% of all malignant brain tumor.

This glioblastoma is <malignant tumor that grows rapidly>. In other words, if the headache came out first, it is intended that the tumor was the size of the already quite, does not react to any treatment because it is growing rapidly, headache will get even worse. You can can be accompanied by cramps and fainting according to the site that has occurred, . . If it occurs in the cerebellum, you may be accompanied by dizziness.


* Headache, such as crack might occur it when I get up in the morning
*  accompanied by nausea / vomiting and headache
* Problem is not solved even if  every treatment
* Frequency increases more, the intensity becomes strong
*  accompanied by seizure and fainting
* with language disorders and muscle weakness


You will need intensive examination in this case.


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