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Headache

الكلية كلية طب حمورابي     القسم الكلية ذات القسم الواحد     المرحلة 5
أستاذ المادة مثنى سليم عبدالامير الحميدي       23/05/2017 10:04:19
Headache

Each of us is likely to have experienced headache either sporadically or chronically. Indeed, it is estimated that 40% of the worldwide population suffers with severe, disabling headache at least annually. It is well that such a common ailment usually has a benign course, but headache may be the presenting symptom of life-threatening disease. Given this, and the frequency that the complaint is encountered in ENT practice, we as otolaryngologists should be comfortable with the evaluation, diagnosis and treatment of headache and facial pain.

Brain parenchyma itself is not pain sensitive, but the meninges and supporting structures are heavily innervated. Pain may be elicited when these structures are inflamed or distorted. In the case of migraine, it is believed that activation of trigeminovascular structures is the source of the headache. Processes inside the cranial vault may produce pain referred to areas of the jaw, neck, face and scalp. Pathology within the anterior or middle cranial fossae may elicit pain that is referred to the scalp or face anterior to the coronal suture. Lesions in the posterior fossa cause pain in the more posterior portions of the head and upper neck. Pain arising from processes in the sphenoid or sella is commonly referred to the vertex.

Much attention has been given to the sinuses and nose as a source of acute and chronic head and face pain. It is therefore worth a brief review of sinonasal innervation. The general sensory innervation of the mucosa of the nose and paranasal sinuses is from the ophthalmic and maxillary branches of the trigeminal nerve, with minor contributions from the greater superficial petrosal branch of the 7th nerve. Pain arising from processes within the sinuses is therefore frequently referred to the corresponding cutaneous dermatome innervated by the 5th nerve, or to the auricular or periauricular region due to the contributions of the 7th nerve. The mucosa of the sinuses is rather insensitive to pain, and the turbinates are more sensitive than the nasal septum. The region of the ostia of the sinuses is the most sensitive of any of the nasal structures.


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .