Headaches and Migraine

Next to pain, headache is probably the most common symptom to affect man­kind. There is hardly a grown person who at one time or another has not experienced mild or severe headaches, for which most people take aspirin or a similar compound because it is often effective and does not require a doctors prescription.

People of especially tense and nervous temperament may experience frequent or daily bouts of severe headache that is usually localized in the front or top part of the head. Those with rheumatism of the vertebrae and muscles of the neck will complain of headache in the back part of the head. This is actually not a true headache and may often be relieved by massage of the neck muscles and aspirin.

Nervous people are continually harassed by real and anticipated problems and fears of dire things to come, so that through over excitability the brain becomes overworked and filled with an excess of blood, which leads to headache. Such high-strung individuals may experience headaches for many years and be none the worse for it, and at times they obtain temporary relief from one or another medication. Some severe attacks may not respond to any medication. Any severe and persistent headach should obtain careful study, since head­aches may also be caused by allergy. sinuses, colds, eyestrain, head injury. meningitis, a brain abscess, or briar. tumor. Severe headache can produce nausea and vomiting and impair the efficiency of work and daily activities.

Migraine is a special variety of intense headache that sets in with suddenness on one side of the head, lasts a day or two .La disappears just as suddenly as it came only to recur every few weeks are months with strange regularity. In women, it seems to come with the men.al periods and disappears entirely sudden they reach the menopause. The sudden migraine attack may be accompanied by vomiting and temporary disturbances of vision. Many remedies are employed for migraine, including steroid compounds and ergot and caffeine preprations which may ameliorate some of the attacks when taken as a doctor directs, but they do not have any curative effect on the underlying condition.

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This is a very serious condition most commonly seen in children under the age of two (the average age is seven months). It is caused by one portion of the intestine pushing inside the next segment. The pressure of the outside intestine compresses the blood vessels of the inner loop, cutting off the local blood supply. If not relieved quickly the inner portion of the loop may become gangrenous. This condition is two times more frequent in boys than in girls.

Symptoms

an infant cries out suddenly with violent abdominal cramps and then starts vomiting. The cramps subside and then occur again at fairly regular intervals, leaving the child weak and almost flaccid. But the telltale and most frequent sign of intussusception is blood in the stools. At times only a slight discharge of blood is passed by rectum, but more frequently there is a mixture of blood and mucus which because of its semblance to cranberry or currant jelly has been frequently called a cranberry stool or currant jelly stool.

Treatment

This is an acute emergency and a doctor should be called immediately, for unless the intussusception is relieved it may prove fatal. Often the physician can feel the mass in the abdomen caused by the condition. In rare instances it will subside under manipulation by the doctor. At other times it will subside when the child is given a diagnostic barium enema prior to x-ray or fluoroscopic examination. But if the intussusception is not relieved, an immediate operation is necessary. Time is very important, for if one waits too long and gangrene occurs, an amputation of a part of the intestine may be necessary. This is a very serious and critical operation for a small child already extremely ill and completely prostrated.

What is this condition?

This disorder involves focal or diffuse inflammation of the cardiac muscle (myocardium). It may be acute or chronic and can occur at any age. Frequently, this disease fails to cause specific cardiovascular symptoms or electrocardiogram abnormalities, and recovery is usually spontaneous, without residual defects. Occasionally, its complicated by heart failure.

What causes it?

Inflammation of the heart muscle is caused by:

  • viral injections, such as coxsackievirus A and B strains and, possibly, polio, influenza, measles, German measles, adenoviruses, and echoviruses (most common causes in the United States)
  • bacterial injections, such as diphtheria, tuberculosis, typhoid fever, tetanus, and staphylococcal, pneumococcal, and gonococcal infections
  • hypersensitive immune reactions, such as acute rheumatic fever and postcardiotomy syndrome
  • radiation therapy from large doses of radiation to the chest in treating lung or breast cancer
  • chemical poisons, as in chronic alcoholism
  • parasitic injections, especially South American trypanosomlasis (Chagas disease) in infants and immunosuppressed adults, and toxoplasmosis
  • injections caused by parasitic worms, such as trichinosis.

What are its symptoms?

Inflammation of the heart muscle usually causes nonspecific symptoms (such as fatigue, shortness of breath, palpitations, and fever) that reflect the accompanying infection. Occasionally, it may cause mild, continuous pressure or soreness in the chest.

How is it diagnosed?

The persons history commonly reveals recent febrile upper respiratory tract infection, viral pharyngitis, or tonsillitis. A physical exam detects irregular heart rhythms, abnormal heart sounds, and possibly a murmur.

An electrocardiogram typically shows abnormalities in heart rhythm. Stool and throat cultures may identifY bacteria.

How is Myocarditis Treated?

Myocarditis treatment includes antibiotics for bacterial infection, modified bed rest to decrease the hearts workload, and careful management of complications.

Heart failure requires restricted physical activiry to minimize myocardial oxygen consumption, supplemental oxygen therapy, restricted salt intake, diuretics to decrease fluid retention, and Lanoxin to increase myocardial contractility. However, Lanoxin must be used cautiously because some people with inflammation of the heart muscle may be sensitive to even small doses.

Irregular heart rhythms require prompt but cautious administration of antiarrhythmic drugs, such as Cardioquin or Pronestyl.

Elliottjohn Author