Headache: providing emergency medical care

Physicians of various specialties often encounter patients whose primary complaint is headache. According to current understanding, headache is defined as painful or unpleasant sensations in the area ranging from the supraorbital region to the occipital-cervical region. Pain impulses arise as a result of irritation of receptors in the dura mater, the arteries of the brain base, venous sinuses, branches of the external carotid artery, cranial nerves, upper cervical roots, as well as the muscles of the neck and occiput. Epidemiological data indicate that up to 85% of people experience tension-type headaches at some point during the year, with approximately 38% of them seeking medical care. It is important to remember that headaches can be a symptom of organic pathology of the nervous system (brain tumors, acute cerebrovascular accidents, inflammatory processes, vascular malformations), as well as arise against the backdrop of psychogenic disorders (stress, anxiety) or as a side effect of medications (medication-overuse headaches). Contrary to popular belief, hypertension is rarely the primary cause of a headache (with the exception of a hypertensive crisis), and traumatic brain injury always requires special attention. According to the International Classification of Headache Disorders (ICHD-3), headaches are classified as primary (not a symptom of another disease) and secondary (symptomatic). In this publication, we will focus on the most common forms of headaches, their diagnosis, and emergency care.