headache(redirected from postlumbar puncture headache)
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one of the most frequent symptoms of various diseases.
Headache arises chiefly in response to irritation of the nerve endings (receptors) of the meninges, venous sinuses, and tunicary and cerebral vessels. Leading factors in the development of a headache include inflammatory affection of the meninges (resulting in irritation of the meningovascular receptors by toxins of the pathogenic agent), compression of the receptors by edema in brain tumors and other accumulative processes (for example, abscess, tuberculoma, and cys-ticercosis), impairment of the circulation of the cerebrospinal fluid accompanied by an elevation in intracranial pressure, vascular diseases (hypertension, hypotension, migraine) that cause a change in extracranial and intracranial vascular tone, chronic cardiovascular insufficiency (for example, congestion of the cerebral veins), and infectious diseases and intoxication accompanied by toxic irritation of the nerve endings. Headache also arises through affection of the cervical nerve roots of the spinal cord and affection of the perivascular neuroplexuses of the major blood vessels of the head (for example, in cervical migraine).
Localization of the headache and determination of its character, time of appearance, and other features are important in discovering its causes. Its course and accompanying signs should also be taken into account. Neurological examination and examination of the internal organs, eyes (vision, fundus oculi, intraocular pressure), ears, paranasal sinuses, endocrine glands, and cerebrospinal fluid are also necessary. In a number of cases physicians also make use of cranial roentgenography, electroencephalography, angioenceph-alography or pneumoencephalography, and rheoenceph-alography.
Treatment includes elimination of the cause of the headache and the prescription of preparations (vasodilative or vasoconstrictive, decreasing intracranial pressure [dehydrating], and analgetic) that counteract the cause of the headache.
REFERENCESPlatonova, E. P. Golovnye boli. Moscow, 1960.
Botez, M., and R. Şerbánescu. Algille craniene şi craniofaciale: Fiziopatologie, Diagnosti, Tratament. Bucharest, 1965.
Heyck, H. Bóle gtowy. Warsaw, 1960.
V. A. KARLOV