Pain in the crown of the head

Pain in the crown of the head occurs with disorders of cerebral circulation, intracranial hypertension, meningitis, encephalitis, arachnoiditis, traumatic injuries of the head and neck, otolaryngological diseases, their intracranial complications. It is observed in muscle lesions, spinal diseases, infections, intoxication, vegetative-vascular, neurotic disorders. More often pressing or bursting, it can be pulsating, jerking, aching. It is diagnosed on the basis of complaints, anamnesis, general examination, otolaryngological and neurological examination, additional techniques. Painkillers, NSAIDs, antibiotics, nootropics, neurometabolites, and other drugs are used for treatment.

Why does the crown hurt
Physiological causes
Disorders of cerebral circulation
Intracranial hypertension
Inflammatory processes of the central nervous system
Traumatic injuries
Otolaryngological diseases
Diseases of the spine
Muscle pathologies
Other reasons
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
Why does the crown hurt
Physiological causes
Pain may occur in the morning after alcohol abuse, against the background of overwork, excessive physical exertion. In some people with weather dependence, painful sensations when the weather changes are localized in the parietal zone, although other options are possible (temples, the back of the head, the whole head). Sometimes the symptom is provoked by stress. A fairly typical situation is pain in the crown of the head when overheating, prolonged exposure to the sun without a hat.

Disorders of cerebral circulation
The symptom develops with transient disorders of cerebral circulation, pre-stroke conditions. Characterized by a sudden onset, rapid deterioration of well-being. There is blurred vision, weakness, nausea, sometimes vomiting, short–term disturbances of consciousness. The list of possible vegetative-vascular reactions includes sweating, hot flashes, a feeling of heat or chills, trembling throughout the body.

Focal signs are determined by the topic. The duration of the attack varies from several minutes to several hours. With PNMC, all manifestations completely disappear within 24 hours. With a pre-stroke condition, further aggravation of cerebral and neurological symptoms, transformation into hemorrhagic or ischemic stroke is possible.

Intracranial hypertension
Symmetrical pain in the crown of the head, forehead area is a characteristic manifestation of intracranial hypertension. The type of pain is determined by the rate of progression of cerebrospinal fluid disorders. A rapidly developing disorder is manifested by an intense, rapidly increasing pain syndrome. Chronic pathology is accompanied by constant dull pain. In some patients, the symptoms increase or decrease.

Inflammatory processes of the central nervous system
With meningococcal meningitis, painful sensations are painful, pulsating, pressing or bursting, with a maximum in the forehead and crown. There is an increase in the action of stimuli (light, sounds), a change in the position of the head, at night. With other types of meningitis, pain is more often bothered in the occipital zone, from where it spreads to the crown, other parts of the head. There are chills, fever, nausea, vomiting, lethargy, weakness, positive meningeal symptoms.

Increasing headache is also noted in encephalitis. In patients with arachnoiditis, pain is bursting, of moderate intensity, increases with physical exertion, straining, coughing, in the morning. The connection with an increase in intracranial pressure causes mainly parietal localization, a feeling of pressure on the eyes. Possible cerebrospinal fluid crises with a sharp increase in pain, the addition of dizziness, nausea, vomiting.

Pain in the crown of the head
Pain in the crown of the head
Traumatic injuries
The most minor injury is a bruise of the crown of the head. The pains are moderate, local, and their intensity decreases rapidly. With a hematoma, a limited swelling forms with a fluctuation area, which then either resolves within a few weeks or needs an autopsy. Fractures of the cranial vault are also accompanied by the formation of a hematoma, but with them the pain is sharp, explosive, does not subside over time, spreading to the entire head. An indentation may be felt. The general condition is variable – from satisfactory well-being to shock or coma.

Pain in the crown of the head can also manifest injuries to the upper cervical vertebrae. The symptom is most pronounced with damage to C2, observed with fractures, fractures, subluxations, displacement of the vertebrae, including as a result of whiplash injury. There are movement restrictions, neck soreness, possible neurological disorders (numbness, weakness of the limbs, pelvic dysfunction).

Otolaryngological diseases
The symptom is quite widespread in diseases of the paranasal sinuses, nose, ear and complications of these pathologies. It has a predominantly irradiating character, supplemented by pain in the projection of the forehead or ear. It is observed in the following diseases:

Frontit. In patients with a mild form, the pain syndrome is poorly expressed. In the moderate form, patients complain of severe bursting, throbbing pains in the projection of the brow, giving to the crown, temporal region. The severe form is accompanied by very intense, sometimes unbearable painful sensations. Other manifestations include hyperthermia, intoxication syndrome, nasal congestion, photophobia, lacrimation.
Pansinusitis. The spread of the inflammatory process to all the paranasal sinuses is fraught with very severe pain in the eyebrows, under the eyes, in the back of the head, crown, forehead, orbits. There is an increase in pain syndrome during movements and groping, pronounced intoxication. The condition is serious.
Thornwald’s cyst. Congenital pathology characterized by the presence of a cyst-like formation on the back wall of the nasopharynx. The main clinical manifestations are pain in the occipital and parietal areas, nasal breathing disorders, bad breath. When infected, an increase in body temperature is detected.
Acute otitis media. The epicenter of pain in this disease is located in the projection of the ear. Irradiation to the parietal and temporal regions is typical. There is congestion, tinnitus, hearing impairment, deterioration of the general condition.
Mastoiditis. Occurs simultaneously with acute otitis media or a little later. It is manifested by a rapid deterioration of well-being, severe intoxication, severe pain in the ear and behind the ear, giving to the crown, orbit, temple, upper jaw. In some cases, the pain spreads to the entire half of the head.
Rhinogenic and otogenic intracranial complications are accompanied by pain in the frontal-parietal region against the background of increased intracranial pressure. They are provoked by acute and chronic otitis media, epi- and mesotimpanitis, purulent labyrinthitis. Other possible causes include respiratory infections with the development of acute forms of rhinitis, sinusitis or exacerbation of chronic pathologies, injuries, boils and carbuncles of the nose, abscesses of the nasal septum.

With the spread of infection, arachnoiditis, meningitis, brain abscesses are observed. With sinusitis, thrombosis of the cavernous sinus is possible. The clinical picture is determined by the nature of the complication. Common manifestations, along with pain syndrome, are intoxication, vestibular disorders, insomnia, irritability, visual disturbances, a feeling of pressure from within on the eyes.

Diseases of the spine
Pain in the crown of the head often occurs with radicular syndrome caused by pathologies of the cervical spine, combined with hypesthesia of the skin of the occipital region, restriction of tilts and turns of the head. The most common cause is osteochondrosis. The probability of pain syndrome increases with the formation of a hernia. In addition, compression of the roots can be observed with spondylosis, spondyloarthrosis.

Muscle pathologies
With myositis of the cervical muscles, soreness first appears in the neck, and from there spreads to the back of the head, crown, upper back. There is an increase in pain during movements. Another possible cause is myalgia due to muscle strain during prolonged driving, working at a computer or sewing machine.

Other reasons
Other pathological conditions that can cause pain in the crown of the head include:

Infectious-toxic syndrome. Headaches can be widespread or local with an epicenter in the crown of the head. Accompanied by influenza, acute respiratory viral infections, inflammatory diseases of the kidneys and respiratory tract, local purulent processes.
Endogenous and exogenous intoxication. The symptom is noted in acute alcohol intoxication, food poisoning. It becomes a side effect or the result of an overdose of medicines, occurs in patients with malignant tumors, in specialists who work in harmful chemical industries.
Vegetative-vascular, neurotic disorders. Pain in the projection of the crown sometimes worries patients with vegetative-vascular dystonia, observed in people with anxiety disorders, hypochondria, hysteria.
Diagnostics
The cause of the symptom is determined by a neurologist. If diseases of the ear, nose, and paranasal sinuses are suspected, the patient is referred to an otolaryngologist. According to the indications, consultations of an infectious disease specialist, a traumatologist, a psychotherapist, and other specialists are prescribed. The doctor collects anamnesis of life and disease, conducts an external examination to identify possible changes (for example, wounds, hematomas). To clarify the diagnosis , the following are prescribed:

Otorhinolaryngological examination. It involves an examination of available ENT organs, supplemented by the use of special devices to improve visualization. The most common methods are otoscopy and rhinoscopy. Sinusoscopy during diagnosis is rarely performed due to its high traumatic nature.
Neurological examination. The specialist evaluates the symmetry of the face, pupils, and eye slits. Examines muscle strength, range of motion, physiological reflexes, various types of sensitivity. Determines pathological reflexes, meningeal symptoms. Performs clinical topical diagnostics taking into account the detected neurological disorders.
Radiography. It is a mandatory diagnostic technique for injuries. Fractures of the parietal bone can be seen on the skull images, fractures, dislocations, subluxations, fractures of the cervical vertebrae can be seen on radiographs of the spine. Radiography of the accessory sinuses is widely used in sinusitis and mastoiditis, confirms the presence of dense masses in the sinus cavity, inflammatory changes in the mastoid process.
Other neuroimaging methods. MRI, CT, Dopplerography, duplex scanning are used in the diagnostic process. According to research data, injuries, hydrocephalus, hemorrhages or areas of ischemia, displacement of the median structures of the brain, sinusitis, mastoiditis are confirmed.
Lumbar puncture. It is produced for intracranial hypertension, neuroinfections, traumatic brain injuries. It helps to confirm an increase in intracranial pressure, the presence of signs of inflammation or blood in the cerebrospinal fluid.
Laboratory tests. A sample of cerebrospinal fluid obtained during lumbar puncture can be examined by culture media culture, microscopy, PCR, ELISA. According to the indications, general blood tests are performed to confirm inflammation, microbiological examination of the discharge from the nose and ear.
Treatment of head injury
Treatment of head injury
Treatment
Conservative therapy
Therapeutic tactics are determined by the nature of the pathology that provoked the appearance of the symptom:

Disorders of cerebral circulation. Medications for improving rheological parameters of blood, acetylsalicylic acid, neurometabolites are shown. With an increase in blood pressure, the administration of medications with a hypotensive effect is recommended. In the recovery period, sedative therapy is carried out.
Intracranial hypertension. A combination of diuretics with potassium preparations is effective. Neurometabolites are useful. Depending on the etiology of the disease, antibiotics, venotonics, detoxification agents are prescribed.
Inflammatory pathologies of the central nervous system. The basis is antimicrobial drugs (antimicrobial or antiviral). Vitamins, neuroprotectors, neurometabolites are used, symptomatic therapy is carried out. Treatment of arachnoiditis is carried out using antiallergic, antiepileptic, hormonal agents.
Traumatic injuries. With TBI, NSAIDs, antibiotics, neurometabolites, nootropics are required. In case of spinal injuries, immobilization is performed, medications are prescribed to stimulate metabolic processes in the nervous tissue.
Otolaryngological diseases. In most cases, the main method of treatment is antibiotic therapy. Therapeutic regimens are supplemented with vitamins, anticongestants, antihistamines, local antiseptics. With sinusitis, washings and punctures are performed, a yamik catheter is installed.
Radicular syndrome. Analgesics, anti-inflammatory, vascular, decongestants, chondroprotectors of general and local action are used. Resorption therapy, drug blockades are carried out.
Surgical treatment
Patients with pain in the crown of the head perform the following surgical interventions:

Intracranial hypertension: decompressive trepanation of the skull, various methods of bypass surgery, external ventricular drainage.
Traumatic injuries: operations for depressed fractures of the skull, fixation of vertebrae.
Otolaryngological diseases: traditional and endoscopic frontotomy, polysinusotomy, mastoidotomy, myringotomy, bypass surgery of the tympanic cavity, sanitizing surgery on the middle ear.

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