Authors: Dumitrache Marieta, Magdalena Anitescu, Miruna Cioboat.
Headache or cephalalgia can be primary - migraine, with/without aura, tension-type, cluster-type, or other primary (idiopathic) headaches, and secondary headaches of multiple etiologies. Emergency signs in headaches are: violent headache (hemorrhage meninges), convulsions in epilepsy, fever, neck pain (meningitis), neurological disorders (vertigo, paresis, diplopia). Migraine begins with aura (20%), with reversible phenomena within 60 min, with small scotoma that expands, associated with homonymous, lateral hemianopsia (or blindness), scotoma bordered by zigzag bright spots (sensory aura may present progressively transient hemiplegia, auditory hallucinations). All signs regress without sequelae. Treatment in primary headache requires elimination of risk factors: stress, fatigue, food chocolate, coffee, wine, cheese, aspartane, prophylactic treatment as needed with propanolol methysergyl, calcium channel blockers, amitriptyline.Treatment of the acute migraine episode with acetaminophen; in aura, ergotamine tartrate, sumatriptan, topiramate, metoclopramide are indicated. Secondary headache recognizes multiple causes: ocular, cerebral, postneoplazic, posttraumatic, postinfectios, in which the treatment is that of the causal condition.
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