This is the 3620th article of Da Medical Care
Xiao Li is a young man who usually works a lot of work. One day a few years ago, after finishing work at the construction site, I slipped on the ground without paying attention to the soles of my feet, and only got up half a day later. Because he felt that his arms and legs were moving well, he didn't care, and the next day he began to work again. Half a month later, the headache gradually appeared, came to the hospital to check the head CT to confirm the subdural bleeding, the headache was still not alleviated after conservative treatment in the neurology department, and the headache completely disappeared after the drilling operation after being transferred to the neurosurgery. This is a typical case of post-traumatic headache induced by a "sitting pier" fall. In the winter of the northeast, there are many people who slip and fall due to snowy roads, headache is a common symptom after falling, and a small number of people may induce cerebral hemorrhage, subarachnoid hemorrhage, subdural hemorrhage, epidural hemorrhage, etc. Today we will talk about one type of secondary headache - acute headache due to head trauma.
The most common type of secondary headache is acute headache due to head trauma, and when a new type of headache first occurs and is closely related to the time of head injury, it is called secondary headache due to trauma. General headaches occur within 7 days of head trauma, but in the clinic, headaches within 3 months from the onset of the attack are generally considered acute, and the headache is relieved within 3 months after the trauma occurs, or the headache is not relieved, but it is not more than 3 months from its occurrence. According to the Third Edition of the International Classification of Headaches, acute headaches due to head trauma are divided into two types according to the severity of the disease: acute headaches due to moderate to severe trauma to the head and acute headaches due to mild head trauma. Severe patients present with impaired consciousness such as coma, imaging may be skull fracture, intracranial hemorrhage, and cerebral contusion laceration. Mild cases may present with nausea, vomiting, headache, dizziness, gait or postural instability, memory impairment, and no imaging changes.
Head trauma is generally well understood and refers to structural or functional damage caused by external forces acting on the head. External forces include impacts between objects and heads, foreign objects piercing into the head, impact or explosive forces on the head, and other undefined external forces. The external force mentioned in the article is not the direct impact on the head, but the subdural hemorrhage caused by the head trauma after sitting on the ground. Direct impact is easy to identify, indirect trauma is often ignored in daily life, such as slipping a fall on the ground pier, or suddenly being tripped after the body violently vibrates a little, etc., may be a little dizzy, nauseous, a few seconds to ease up, the average person will not take it seriously. Therefore, a detailed history is key to diagnosing this type of headache.
Acute headaches due to mild head trauma generally do not require special treatment, timely rest, and can be relieved by conventional administration of nonsteroidal anti-inflammatory drugs to relieve pain. Acute headaches due to moderate to severe trauma to the head require neurosurgical surgery if there is an imaging fracture or intracranial hemorrhage. Preventing various accidents in life is the most important point of protection to avoid head trauma.
No winter will not pass, no spring will not come, some types of headaches are closely related to living habits, the daily life is sound and colorful, good at seeing the six ways and listening to the eight directions, try to avoid all kinds of accidental injuries, acute headaches due to head trauma will also be far away from careful you.
Author: Department of Neurology, Second Hospital of Jilin University
Man Yuhong Deputy Chief Physician