The hurt in headache pain emanates from a network of nerves that covers the scalp and from particular nerves in the face, mouth, and throat. Muscles of the head as well as blood vessels along the surface membrane surrounding the brain and base of the brain also contain pain-sensitive nerve fibers. Many nerves run from the brain directly to the face and head. These nerves have pain receptors that carry pain signals to the brain. Stress, muscular tension, and expanded blood vessels provoke pain sensations. Once a pain message is received, the brain registers pain originating from regions of the head, face, and neck. Two of the familiar causes of headache pain can explain and differentiate two common types of headaches, tension-type and migraine headaches. Tension may strain muscles of the face, neck, and scalp, leading to the tight, pressing pain sensation of tension-type headaches. The bones of the skull and tissues of the brain cannot generate pain sensations because they do not contain pain-sensitive nerve fibers.
About the New Daily Persistent Headache
In the last few years, New Daily Persistent Headache (NDPH) has been recognized as a distinct primary headache syndrome. Primary headache disorders are those for which there is no underlying secondary cause that can be identified. As with Migraine disease and some other headache disorders, there are several secondary conditions that can mimic NDPH, so they must be ruled out before a diagnosis of NDPH can be confirmed. Two conditions in particular that must be ruled out are spontaneous cerebrospinal fluid (CSF) leak and cerebral venous sinus thrombosis. Headache from a spontaneous CSF leak is usually affected by body position, but the longer it continues, the less apparent that becomes. Therefore, patients may not think to mention that their headache was, at one point, affected by body position, and that maybe missed.
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