Chronic headache are commonly due to migraine, tension, or depression, but they may be related to intracranial lesions, head injury, cervical spondylosis, dental or ocular disease, temporomandibular joint dysfunction, sinusitis, hypertension and a wide variety of general medical disorders. The intensity, quality, and site of pain-and especially the duration of the headache and the presence of assosiated neurologic symptoms-may provide clues to the underlying cause. Migrain or tension headaches are often described as pulsating or throbbing. A sense of tightness or pressure is also common with tension headache. Sharp lancinating pain suggests a neuritic cause. Ocular or periorbital icepick-like pains occur with migrain or cluster headache, and a dull or steady headache is typical of intracranial mass lesion. In patients with sinusitis, there may be tenderness of overlying skin and bone.
Treatment:
-A simple analgesic (aspirin,acetaminophen, ibuprofen, naproxen)
-cafergot(ergotamine tartrat,caffein) 1-2 tab.
-neuroleptic: droperidol
Prophylatic treatment of migraine
* amitriptyline 10-150mg
* fluoxetine 20-60mg
* cyproheptadine 12-20mg
* verapamil 80-160mg
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