Pain in the left side of the head

Pain in the left half of the head is observed in migraine, paroxysmal hemicrania, hypnic and cluster headache, vertebrobasilar insufficiency. It is detected at the initial stage of brain tumors, with limited arachnoiditis, Horton’s disease, some ENT diseases and pathologies of the cervical spine. It can be acute, dull, prolonged, paroxysmal, pressing, bursting, aching, pulsating. The reason is established on the basis of the Research Institute of complaints, survey data, neurological examination, additional studies. As part of therapeutic measures, NSAIDs, triptans, steroids, caffeine preparations, physiotherapy are prescribed. Sometimes they perform operations.

General characteristics
Why does the left half of the head hurt
Physiological causes
Cluster headache
Migraine
Paroxysmal hemicrania
Vertebrobasilar insufficiency
Hypnic headache
Cerebral tumors
Arachnoiditis
Other reasons
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
General characteristics
Pain in half of the head (hemicrania) is a symptom typical of some primary cephalgias. Sometimes it is provoked by other neurological, rheumatological and otolaryngological diseases. In some cases, it is preceded by an aura, combined with dizziness, vegetative manifestations, and other disorders. Both the left and right half of the head can hurt, but there are pathologies in which the defeat of a certain side prevails.

Why does the left half of the head hurt
Physiological causes
Pain in half of the head may occur in a healthy person under certain circumstances. The features of the pain syndrome are episodic in nature, rapid disappearance after rest or taking an analgesic. The symptom is observed in the following cases:

Intense physical activity. It may be combined with darkening of the eyes, dizziness, shortness of breath, palpitations and tingling in the heart area.
Stressful situations. The left or right half of the head hurts against the background of the release of stress hormones, provoking vasoconstriction and increased blood pressure. Marked emotional tension is noted.
Mental fatigue. Pain is caused by significant intellectual loads, as well as the need for prolonged concentration of attention and tension when staying in one position, for example, when preparing for an exam or working at a computer.
Bad habits. The symptom sometimes appears with the abuse of tonic drinks (coffee, strong tea, energy drinks), smoking and alcohol intake. The cause is changes in vascular tone, the intake of toxic substances into the body.
Cluster headache
Develops in people of a certain type – mainly tall men of athletic build, ambitious, but indecisive suffer. The pain syndrome develops acutely, reaches a peak within a few minutes, lasts from 15 minutes to 3 hours. Pain occurs more often in the left half of the head. It is most pronounced in the eye socket, burning, stabbing, unbearable, resembling a “rupture” or “squeezing” of the eye. Cluster headache is accompanied by autonomic disorders. It decreases with movements, so patients rush around, punch the wall.

Migraine
The left half of the head with migraines hurts somewhat less often than the right. The pain is pressing, throbbing, with an epicenter in the temple, forehead or eye area. Sometimes painful sensations occur in the back of the head, and from there spread to the entire half of the head. A typical sign of pathology is the periodic change of the affected side. The manifestations vary somewhat depending on the type of migraine:

A simple migraine. It is diagnosed in 80% of cases. The aura is missing. Possible prodrome in the form of drowsiness, mood deterioration, decreased performance. Hemicrania is combined with nausea and vomiting, increases with movements, the action of auditory and sound stimuli. Lasts from 4 hours to 2-3 days.
Migraine with aura. The attack itself proceeds in the same way as with a simple migraine. The difference lies in the presence of aura – visual disturbances, transient sensitivity disorders, ringing in the ears, the appearance of unusual smells or sounds, speech impairment. Migraine in children is often preceded by “Alice’s syndrome” – visual distortion of objects, visual hallucinations. Lasts from several hours to 4 days.
Ocular migraine. Typically, the loss of certain areas of the field of vision, the presence of paracentral or central cattle, flickering in front of the eyes. The headache is throbbing, occurs in the forehead area, goes into orbit. The duration of visual disturbances is 10-20 minutes, an attack of cephalgia is 30-120 minutes.
Vestibular migraine. Manifests with a prodrome, which is subsequently joined by dizziness, sometimes in combination with other variants of the aura. Then half of the patients develop pain in the left or right half of the head, lasting no more than 3 days. Dizziness ceases with the onset of hemicrania, persists throughout the pain attack or becomes its only manifestation (pain-free paroxysms).
If the symptom persists for more than 3 days or a series of continuous paroxysms during this time, they speak of a migraine status. The pain is very intense, undulating. Pallor, adynamia, sharp weakness, inability to take food and medications due to repeated vomiting, increasing dehydration are observed. The condition is serious.Pain in the left side of the head

Paroxysmal hemicrania
Unilateral pain is paroxysmal, very severe. It can be aching, throbbing, burning, drilling, stabbing or resembling a punch. It is localized mainly in the temple or eye socket, less often in the area of the forehead, occiput or crown. It is associated with a lesion of the trigeminal nerve. An attack of paroxysmal hemicrania lasts from 5 to 45 minutes, from 1 to 40 episodes can be observed per day during the exacerbation period. It is supplemented by vegetative symptoms, drooping eyelid, pupil constriction, photophobia.

Vertebrobasilar insufficiency
Left-sided or right-sided headache is noted in the spondylogenic form of vertebrobasilar insufficiency. Develops suddenly with movements. From the neck and back of the head, it spreads to the forehead, temple and eye socket, gives into the hand. There is a clear connection between the intensity of cephalgia and the position of the cervical spine. Pain syndrome is complemented by unilateral hearing loss, noise in the ear, dizziness, visual disturbances, cerebellar disorders and autonomic reactions.

Hypnic headache
It is observed in people over 50 years of age, proceeds chronically. It always develops in a dream, in 40% of cases it occurs only in the left or right half, in other cases it spreads to the entire head. An attack of hypnic headache forces the patient to wake up. On average, it lasts 30-60 minutes, repeats from 1 time a week to several paroxysms throughout the night. Painful sensations are dull, moderately pronounced, less often intense. Slight nausea, hypersensitivity to sounds and bright light are possible.

Cerebral tumors
Local pains in the left half of the head become an early symptom of neoplasms of left-sided localization. Deep, bursting, quite intense, often occurring in the form of paroxysms. With the progression of neoplasia, hemicrania is supplemented by increasing focal symptoms. Then the cerebral manifestations caused by edema and intracranial hypertension join. The pain becomes diffuse, diffuse, bilateral, supplemented by dizziness, nausea, vomiting.

Arachnoiditis
The left half of the head can hurt with limited arachnoiditis, which developed in the long-term period after TBI, inflammatory and infectious diseases. Symptoms increase gradually. Bursting pains, more disturbing in the morning, combined with emotional instability, fatigue, irritability, sleep disorders. In the future, it is possible to attach focal symptoms, the spread of the process with diffuse headaches, cerebrospinal fluid crises.

Other reasons
Pain in the left half of the head is provoked by some rheumatic and otolaryngological pathologies, diseases of the spine. The cause of the symptom is:

Horton’s disease. The pain is one- or two-sided, dull, pulsating, with an epicenter in the temple area, intensifying at night, increasing over several weeks. Fever, anorexia, myalgia, arthralgia, thickening and soreness of the temporal and parietal arteries are noted.
Sinusitis. Left-sided hemicrania accompanies unilateral frontitis and sinusitis with damage to the left paranasal sinus. Pulsating, bursting, localized in the brow and forehead area, radiates into the temple. It is supplemented by general hyperthermia, intoxication, nasal discharge.
Mastoiditis. Develops against the background of purulent otitis media. Accompanied by intense pain in the ear and behind the ear, which extends to the crown, temple, eye socket and upper jaw, sometimes covers the entire half of the head. Febrile temperature, intoxication, abundant suppuration from the ear are observed.
Pathology of the spine. Unilateral compression of vessels and nerves in osteochondrosis, protrusion, hernia and some other diseases of the cervical region causes pain in the left half of the head. It is supplemented by pain in the neck, sometimes – numbness and weakness of the upper limb.
Diagnostics
A neurologist is engaged in establishing the nature of the disease that provokes painful sensations in the left half of the head. According to the indications, a rheumatologist, oncologist, otolaryngologist are involved. Primary cephalgias (migraine, cluster and hypnic headache, paroxysmal hemicrania) are diagnosed on the basis of clinical symptoms, auxiliary methods are prescribed to exclude organic pathology.

In other cases, the diagnosis is based on both objective data and the results of imaging and laboratory techniques. The examination program includes the following procedures:

Echoencephalography. It is made to measure intracranial pressure, helps to exclude conditions accompanied by intracranial hypertension. Despite the possibility of detecting volumetric processes, in the early stages of tumors it may be uninformative due to the insignificant size of the formations.
Assessment of cerebral blood flow. It includes duplex scanning, ultrasound of the vessels of the head and neck. Within the framework of differential diagnostics, it allows detecting hemodynamic disorders characteristic of atherosclerosis and other diseases. It is recommended for patients with vertebrobasilar insufficiency to clarify the nature and structure of stenosis.
Radiography. Standard images of the cervical spine reveal signs of hernia, osteochondrosis and other diseases of the spinal column. To confirm the extravasal compression of the vertebral artery, X-rays with functional samples are made. With sinusitis, radiography of the paranasal sinuses is performed, with mastoiditis – the temporal bone.
Tomography. MRI of the brain is prescribed for suspected neoplasms and arachnoiditis. In the angiography mode, it provides comprehensive information about the condition of the main arteries. If vertebrogenic etiology of pain is suspected, MRI and CT of the cervical spine are performed. With sinusitis, an MRI of the sinuses is sometimes performed.
Consultation of a neurologist
Consultation of a neurologist
Treatment
Conservative therapy
Therapeutic tactics are determined taking into account the cause of the symptom. The basis is medicines, which in some cases are supplemented with non-drug methods:

Migraine. The attack is stopped with the help of non-narcotic analgesics, caffeine-containing drugs. Sometimes medical blockades are carried out. Very intense pain, prolonged seizures are indications for the use of triptans. With repeated vomiting, medications are administered subcutaneously, used in the form of sprays or rectal candles.
Cluster headache. To eliminate paroxysm, triptans are prescribed, oxygen inhalations are carried out, local anesthetics are applied to the nasal mucosa. As part of prevention, calcium channel blockers are recommended, in case of intolerance – antiepileptic drugs or glucocorticosteroids.
Paroxysmal hemicrania. The effectiveness of nonsteroidal anti–inflammatory drugs, sometimes steroids, calcium channel blockers is noted. Due to prolonged use of painkillers, damage to the gastric mucosa is possible, so patients are additionally prescribed antacids and proton pump blockers.
Hypnic headache. There is no single treatment regimen. It is possible to use lithium and melatonin preparations, hypnotics, benzodiazepines, NSAIDs, steroid and caffeine-containing drugs.
Vertebrobasilar system syndrome. The therapy regimen includes medications with vascular, hypotensive and neuroprotective effects, anticoagulants, antiplatelet agents, and antidepressants. As part of non-drug therapy, hyperbaric oxygenation, physical therapy, vestibular gymnastics, massage, post-isometric relaxation, magnetolaser therapy are performed.
Arachnoiditis. Anti-inflammatory, antiepileptic, absorbant, antiallergic and dehydrating agents, metabolites, neuroprotectors, tranquilizers, antidepressants can be prescribed.
ENT pathology. Antibacterial therapy, antihistamine and vasoconstrictor medications, immunocorrectors, UHF, diadynamic currents are indicated. With sinusitis, punctures are performed, sinus-evacuation, with mastoiditis – paracentesis of the tympanic membrane.
Surgical treatment
Patients with primary cephalgia do not require surgery. Surgical techniques can be used in the following cases:

Insufficiency of vertebrobasilar blood flow: carotid-subclavian bypass surgery, endarterectomy.
Brain tumor: removal of neoplasms using microsurgical techniques or methods of stereotactic radiosurgery, bypass surgery for hydrocephalus.
Diseases of ENT organs: open and endoscopic maxillary or frontotomy, mastoidotomy, sanitizing and general cavity interventions on the middle ear.
Spinal lesions: laser vaporization, microdiscectomy, interbody fusion, cage fixation.

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