Pain in the forehead area
Pain in the forehead is observed with sinusitis, inflammation of cerebral structures, increased blood pressure, intracranial hypertension, vertebrobasilar insufficiency, eye diseases, neuralgia, tumors. It often spreads to the temple, the eye socket. It can be pressing, bursting, jerking, pulsating, acute, dull, prolonged, short-term. It is diagnosed according to the survey, otolaryngological, ophthalmological, neurological examination, additional studies. Treatment is carried out using antimicrobial, painkillers, hypotensive, antihistamines. Sometimes surgical interventions are indicated.
Why does the forehead hurt
Sinusitis
Inflammatory lesions of the central nervous system
Vascular pathologies
Intracranial hypertension
Ophthalmological diseases
Migraine
Nerve and ganglion lesions
Allergic reactions
Febrile syndrome
Other reasons
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
Why does the forehead hurt
Sinusitis
A common cause of pain in the projection of the forehead are sinusitis. Pain syndrome occurs as a result of the inflammatory process, the accumulation of discharge in the adnexal sinuses. The symptom is more disturbing in the morning, because a lot of fluid accumulates in the sinuses overnight. It is observed in the following diseases:
Frontit. With a mild form of pain, minor, signs of rhinitis prevail. The moderate form is accompanied by hyperthermia, intense local pulsating, bursting pain in the brow area. Possible irradiation in the temple, crown, feeling of pressure behind the eye. In severe form, the pain is very strong, sometimes unbearable. Severe intoxication, swelling of the eyelids, puffiness of the face, lacrimation, photophobia are noted.
Sinusitis. It is manifested by febrile, less often – subfebrile temperature, pain in the projection of the maxillary sinus, forehead, cheekbone, nose root, sometimes – giving to the temporal region, half of the face. There is lacrimation, copious discharge from the nose, at first liquid, then thick, greenish, cloudy.
Ethmoidite. As a rule, it develops against the background of other pathologies, so the first signs of the disease remain unnoticed. The prevailing symptom is a headache with an epicenter behind the eyes, under the bridge of the nose. The pain radiates to the forehead area, increases with head tilts. The sense of smell, nasal breathing are disturbed, the temperature rises, intoxication syndrome occurs.
Pansinusitis. The most severe form of sinusitis, in which inflammation spreads to all sinuses. It is characterized by intense pain in the area of the eyebrows, orbits, forehead, occiput, crown, intensifying when feeling, sometimes radiating into the lower jaw. Painful sensations spread to the whole head, they increase with movements. Nasal breathing disorders, anosmia, severe intoxication are detected.
Inflammatory lesions of the central nervous system
The cause of pain in the forehead in inflammatory diseases of cerebral structures is intracranial hypertension, due to increased production of cerebrospinal fluid. With meningitis, severe pain in the back of the head prevails, which can spread to the forehead or the entire head. Marked intoxication, increased tone of the occipital muscles, positive meningeal symptoms are noted.
Painful sensations of similar localization also occur with various types of encephalitis. There is significant hyperthermia, bruising, nausea, vomiting, dizziness. Muscle weakness, salivation disorders, signs of damage to the cranial nerves are possible. In some forms of encephalitis, convulsions occur, sometimes hallucinations, and other mental disorders.
Vascular pathologies
Arterial hypertension can be primary (essential hypertension) or provoked by other diseases (symptomatic hypertension). Secondary forms are caused by pathologies of the central nervous system, endocrine organs, kidneys, renal and extrarenal vessels. The characteristic features of the pain syndrome are symmetry, occurrence in the area of the forehead or the back of the head. Throbbing, bursting pains, increase with sudden movements, loud sounds.
In patients with spondylogenic vertebrobasilar insufficiency, pain appears suddenly against the background of awkward movements. Covers half of the head. It spreads from the back of the head to the forehead, temple, orbit, sometimes gives to the upper limb. At the moment of the attack, there is a fall without loss of consciousness or syncope. The skin of the neck becomes pale, with a marble pattern, a veil, “flies” appear before the eyes.
Pain in the forehead area
Pain in the forehead area
Intracranial hypertension
Pain is the main symptom, localized in the crown of the head and forehead. Symmetrical, accompanied by pressure on the eyes from the inside, increases when the direction of gaze changes. In some cases, nausea and vomiting are observed. In the acute course, the pain syndrome is pronounced, rapidly intensifies, in the chronic – moderate, worries constantly or proceeds with periodic fluctuations. Intracranial hypertension is accompanied by the following pathological conditions:
Volume formations: primary and metastatic neoplasia, abscesses, hematomas, cysts, aneurysms.
Brain edema: ischemic stroke, hepatic encephalopathy, hypoxia, exogenous intoxication, brain injury.
Increased blood filling of the brain: hypercapnia, hyperthermia, dyscirculatory encephalopathy.
Disorders of the production and circulation of cerebrospinal fluid: various forms of hydrocephalus due to congenital defects, acquired lesions (for example, adhesions in arachnoiditis).
Ophthalmological diseases
The cause of pain in the eye sockets, the forehead area becomes a constant overstrain of the organ of vision. The symptom is observed in such pathologies as:
myopia;
farsightedness;
astigmatism;
glaucoma.
It is characterized by an increase in unpleasant sensations by the end of the day, after prolonged work at the computer, reading books, performing small actions that require good visual control (for example, embroidery). Complaints are determined by the type and severity of the ophthalmic disease, the inability to clearly recognize distant objects or the inability to read finely written text is noted.
Migraine
The patient complains of unilateral throbbing or pressing pains with an epicenter in the area of the eye, forehead, temple. In some patients, weakness, distraction, visual phenomena occur before the onset of a migraine attack. Painful sensations are combined with light and sound phobia, nausea, vomiting, depression or excessive irritability. Stress, physical exertion, alcohol intake, and certain foods act as provoking factors. Sometimes paroxysms develop for no apparent reason.
Nerve and ganglion lesions
Intense pain impulses resembling an electric shock passing from the lateral surface to the center of the forehead and orbit are characteristic of neuralgia of the orbital branch of the trigeminal nerve. The disease develops as a result of injury or inflammation of the nerve trunk, its compression by a neoplasm or an altered vessel. The duration of the paroxysm can reach 2 minutes, the attacks are repeated repeatedly. The pain is so sharp that patients freeze in place, afraid to move.
Ganglionitis of the pterygoid node is characterized by pain in the eye socket, frontal region, upper jaw, hard palate, sometimes extending to the teeth, gum of the lower jaw, occiput, neck, ear, temple. Painful sensations are sharp, intense, one-sided. They occur spontaneously, more often at night. Accompanied by vivid vegetative reactions: redness, swelling of half of the face, profuse salivation, lacrimation, nasal discharge. They are provoked by inflammatory diseases of neighboring organs.
Allergic reactions
Pain in the forehead is sometimes accompanied by allergic pathologies: angioedema, rhinitis, urticaria. The appearance of painful sensations is possible during an attack of bronchial asthma. The cause of the symptom is swelling of the mucous membranes, respiratory disorders, hypoxia. The pain may be dull or resemble a migraine attack. Disappears along with other manifestations of allergy after stopping contact with the allergen, taking an antihistamine.
Febrile syndrome
Headache is a constant companion of fever, spreads throughout the head or is localized mainly in the frontal region. It is observed with influenza, ARVI. It is detected in patients with bronchitis and pneumonia. It is noted in acute pyelonephritis, other diseases accompanied by febrile syndrome. It is supplemented by malaise, weakness, loss of appetite, myalgia, arthralgia.
Other reasons
Sometimes pain in the forehead area becomes a consequence of prolonged stay in a room with too high a temperature or, on the contrary, being in the cold without a hat. The symptom is detected in some diseases of the cardiovascular system, blood diseases, metabolic, endocrine disorders. Headaches are often complained of by patients with neurotic disorders: neuroses, neurasthenia, anxiety, hypochondriac disorder. With hysteria, complaints can acquire an unusual, pretentious character.
Diagnostics
The neurologist is engaged in establishing the cause of the pain syndrome. According to the patient’s indications, they are sent for consultations to an otolaryngologist, ophthalmologist, and other specialists. The doctor finds out when the symptom first appeared, how often it appeared, how it changed over time, what manifestations it was accompanied by. Collects anamnesis of life, clarifies the presence of chronic diseases that could cause painful sensations.
During the examination, it is sometimes possible to detect external changes, for example, lacrimation, redness and swelling of the face, but in most cases, physical examination is not informative. To make a final diagnosis , the following are assigned:
Otorhinolaryngological examination. Along with the standard techniques used during the general examination, the doctor conducts an examination using mirrors, special devices. With sinusitis, rhinoscopy is indicative, confirming the presence of edema, hyperemia, serous or purulent discharge. Sinusoscopy requires the expansion of the natural openings of the sinuses, so it is rarely performed for diagnostic purposes.
Ophthalmological examination. It includes visometry, ophthalmoscopy, measurement of intraocular pressure, refraction study, biomicroscopy of the eye, and other studies. It helps to determine the nature of visual disturbances, the preferred correction option, the need for surgical intervention.
Neurological examination. It involves an assessment of the symmetry of the eye slits, pupils, facial features, a study of the sense of smell, checking the preservation of the function of the facial muscles, palpation of the exit points of the branches of the trigeminal nerve. The doctor examines movements, sensitivity, reflexes in the trunk and limbs. Detects pathological symptoms (for example, meningeal).
Radiography. With sinusitis, radiography of the paranasal sinuses is shown. The study reveals the accumulation of dense masses, with a chronic process – deformation of the bone walls of the sinuses. To increase the information content, it can be carried out with contrast. Radiography of the skull is mandatory in case of suspected TBI. With long-term intracranial hypertension, visualizes “finger indentations”.
Ultrasound techniques. During echoencephalography, hydrocephalus, brain edema, displacement of median structures in tumors, hematomas, and other volumetric processes are determined. Duplex scanning and Dopplerography are recommended for patients with vascular lesions. They allow you to get an idea of the speed of blood flow, the state of blood circulation in various parts of the brain.
Tomography. Computer and magnetic resonance imaging of the brain provide complete information about structural changes in brain tissue, size, location of pathological foci. They are used at the final stage of diagnosis. To assess the condition of blood vessels, differentiation of tumor processes is performed with contrast enhancement. CT and MRI of the paranasal sinuses are required with insufficient information content of basic diagnostic procedures, confirm the presence of sinusitis, other pathologies (tumors, cysts).
Lumbar puncture. It is carried out to determine the pressure of cerebrospinal fluid, to detect hemorrhages, inflammatory processes. During the subsequent microscopic examination of the cerebrospinal fluid, the composition of the cerebrospinal fluid is clarified. For bacterial and viral infections, a microbiological analysis or PCR test is performed.
In some cases, special tests are required. For example, ganglionitis of the wing node is confirmed if the symptoms disappear after smearing the nasal cavity with a solution of dicaine and adrenaline. In a number of pathologies, laboratory tests are necessary to confirm the inflammatory process, to determine the pathogen.
Neurological examination
Neurological examination
Treatment
Conservative therapy
Therapeutic tactics are determined by the nature of the pathology:
Sinusitis. At the initial stage, drugs from the group of aminopenicillins or cephalosporins are prescribed, then, if necessary, medications are replaced taking into account antibiotic sensitivity. NSAIDs, antihistamines, decongestants, vitamins, local antiseptics are used. Punctures, rinses, and anemization of the mucous membrane are carried out.
Encephalitis, meningitis. The basis for the treatment of inflammatory processes of bacterial etiology is massive antibiotic therapy. Medications are administered parenterally (intramuscularly, intravenously or endolumbally). Antiviral and symptomatic therapy is indicated for viral encephalitis.
Arterial hypertension. Blood pressure is normalized with the help of antihypertensive drugs. They use disaggregants, beta-blockers, diuretics, drugs with hypolipidemic effect. Patients with secondary hypertension need treatment of the underlying pathology.
Intracranial hypertension. Diuretics are used, as a rule, in combination with potassium–containing medications. The treatment of causal pathology is carried out by detoxification, the use of venotonics, antibiotics. Neurometabolic agents are prescribed.
Migraine. Relief of seizures is performed using painkillers and caffeine-containing drugs. Triptans are effective for the prevention of new paroxysms in the intercrime period.
Ganglia and nerve damage. With trigeminal neuralgia, anticonvulsants, antispasmodics, microcirculation correctors, therapeutic blockades, physiotherapy are indicated. With Slader syndrome, anti-infectious, anti-inflammatory, anti-allergic agents are necessary.
Patients with ophthalmological pathologies undergo vision correction using glasses and contact lenses. With glaucoma, medications are prescribed to reduce intraocular pressure. Treatment of diseases with intoxication syndrome involves taking a large amount of fluid or intravenous infusions, therapy with drugs with symptomatic and etiopathogenetic effects.
Surgical treatment
The following operations may be recommended to patients:
Sinusitis: open or endoscopic frontotomy, maxillary sinusitis, ethmoidotomy, polysinusotomy.
Intracranial hypertension: decompressive trepanation of the skull, external ventricular drainage, various bypass options.
Eye diseases: laser correction of myopia, hyperopia and astigmatism, laser and traditional iridectomy, iridoplasty, trabeculoplasty, other interventions for glaucoma.
Trigeminal neuralgia: stereotactic operations, microsurgical decompression, radiofrequency destruction.
