Medical Management Harvard Case Solution & Analysis

Medical Management Case Solution


Headache or cephalgia (medical term) is known as the pain in the head due to any disease, condition or even emotional condition. Headache is the symptom that helps the doctor to determine the cause and treatment. Some headaches cause serious illness while some may require emergency care because of life threatening situations. Therefore, it has been classified into two major types of headaches: it includes: (Staff)

  1. Primary headaches
  2. Secondary headaches

A primary headache is carried on by over activity or issues with pain sensitive structures in the brain. A primary headache is not a side effect of a hidden sickness which means it does not cause serious illness. Primary headache occurs due to complex actions in the mind, the nerves or veins encompassing the skull, or the muscles of head and neck (or some mixture of these components) can assume a part in primary migraines. A few people may likewise carry the genes that make them more inclined to grow such headaches.

A secondary headache is a side effect of an ailment that can enact the pain sensitive nerves of the head. Any number of conditions that are fluctuating extraordinarily in seriousness may bring about secondary headaches.

Causes of headaches:

Primary Headaches Secondary Headaches
Cluster headache (cyclic pattern around one side of pain) Acute Sinusitis due to around your nasal passages
Migraine Blood clot in the brain
Tension headache Arterial tears
Chronic daily headache Brain AVM
Cough headache Brain tumor
Exercise headache Carbon monoxide poisoning
A headache due to lifestyle (alcohol, lack of sleep, skipped meal, stress) Others (Dehydration, ear infection, high blood pressure, overuse of pain medication, stroke etc.)

Pathophysiology associated with a headache:

There are two basic reasons for pathophysiology: such as

1.      Stimulation of primary nociceptors:

Cerebral dissemination is innervated by thoughtful, parasympathetic, and tactile nerves, which store an impressive number of neurotransmitters. Apart of these has been assessed in essential headaches. A unique relationship between head pain and the arrival of the calcitonin gene-related peptide was illustrated. In a cluster migraine and for a situation of constant paroxysmal headache, there was also the arrival of vasoactive intestinal peptide, which was connected with the facial manifestations (nasal clog, rhinorrhea). In parallel with sumatriptan treatment, the headache can be subsided and neuropeptide comes in the standardized or normal state. This information demonstrates the contribution of tangible and parasympathetic instruments in the pathophysiology of primary headaches. (L, 2001)

2.      Lesions in pain producing pathways (PNS and CNS)

The brain can sense pain through the pain receptors around head and pain, which incorporate the extra cranial arteries, center meningeal supply route, large veins, cranial and spinal nerves, neck and head physiques, the meninges, falx cerebri, portions of the brainstem, eyes, ears, teethe and covering of the mouth. Pial passages, as opposed to Pial veins, are in charge of pain generation.

It is observed that headaches result in traction and irritation of the blood vessels. The nociceptors cause the head trauma and tumors that are another cause of headaches. Along with this, Vein spasms, widened veins, intensification or contamination of meninges and solid strain can likewise animate nociceptors and cause pain. Once revitalized, nociceptors communicate and send the message up the length of the nerve fiber to the nerve cells in the cerebrum, flagging that a part of the body hurts. (Chawla, 2016)

The brain itself is insensitive to irritation, therefore it is not what harms when a headache emerges. The pain in the head, rather, happens in the accompanying areas such as:

  • The tissues covering the head
  • The attaching structures at the base of the head
  • Muscles and veins around the scalp, face, and neckline

The Primary headaches are difficult to comprehend than secondary headaches. The exact systems which cause headaches, strain headaches, and group migraines are not known. There have been diverse hypotheses after some time which endeavor to clarify what happens in the mind to bring about these headaches............................

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