Pain in the right side of the head
Pain in the right side of the head can accompany migraine, paroxysmal hemicrania, and some other types of primary cephalgia. It is observed with vertebral artery syndrome, a number of diseases of the brain, ENT organs and the cervical spine. By nature, pulsating, aching, pressing, bursting, dull, acute, weak, moderate, intense. Diagnosis is based on the results of a conversation, objective and instrumental studies. Symptomatic and etiopathogenetic treatment is carried out using NSAIDs, analgesics, triptans, other drugs, non-drug methods. Sometimes operations are shown.
General characteristics
Why does the right half of the head hurt
Physiological causes
Migraine
Paroxysmal hemicrania
Hypnic headache
Cluster headache
Vertebrobasilar insufficiency
Other cerebral pathologies
Other reasons
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
General characteristics
Hemicrania (painful sensations in half of the head) is a typical manifestation of primary headaches. Sometimes it occurs in other diseases, it can be caused by unilateral damage to blood vessels, nerves, other structures of the neck, face and head. In patients with primary cephalgia, paroxysmal, in other cases it is prolonged or relatively short-term, less often has a paroxysmal character. Pain can occur in both the right and left half of the head.
Why does the right half of the head hurt
Physiological causes
Episodic hemicranias are detected in many healthy people, disappear after taking an anesthetic, sleep, rest. There is a connection with external circumstances, the absence of a tendency to relapse. Provoking factors are considered acute and prolonged stress, mental and physical overload. The right half of the head can also hurt against the background of alcohol intoxication, frequent smoking, abuse of caffeinated beverages.
Migraine
A distinctive feature of migraine is paroxysmal unilateral pain with periodic change of half of the head. For unknown reasons, the disease is more often manifested by pain in the right half of the head. Painful sensations are localized in the area of the eye, forehead, temple, less often in the occipital region. Often they start in one place, and then cover the entire half of the head.
Most types of migraine are characterized by the persistence of symptoms for a period of several hours to 3 days. Some signs depend on the type of disease:
A simple migraine. The most common. It is accompanied by classic attacks without aura, sometimes preceded by a prodrome in the form of a malfunction, deterioration of the emotional state. Nausea, vomiting, light and sound phobia are noted.
Migraine with aura. The paroxysms are the same as in the previous case. They are preceded by an aura, which is most often represented by visual disorders. Unusual sounds and smells, sensitivity disorders, speech difficulties are possible.
Vestibular migraine. A typical feature is dizziness, which occurs at the stage of prodrome, may persist or disappear with the onset of headache. Sometimes there are different variations of the aura.
Ocular migraine. Along with visual disturbances (flickering, the appearance of cattle, loss of areas of the visual field) that precede cephalgia and persist for 10-20 minutes, this type of migraine differs from the others in atypical duration – less than 3 hours.
Ophthalmoplegic migraine. Another variant of the disease with ophthalmological disorders and an unusual duration. Symptoms persist for more than a week. Disorders on the part of the oculomotor, less often – block or diverting nerve occur on 1-4 days. Possible diplopia, mydriasis, strabismus, drooping eyelid.
If the duration of a migraine attack (with the exception of types with ocular symptoms) is more than 3 days, or paroxysms continuously occur one after another during this time, a migraine status is diagnosed. High pain intensity, wave-like decrease and increase of symptoms, progressive dehydration caused by repeated vomiting are typical for this condition.
Paroxysmal hemicrania
It occurs with episodes of extremely intense pain in the right or left half of the head with an epicenter in the orbit, temporal zone, crown, occiput, forehead area. It can be provoked by sharp turns of the head, alcohol intake, strong emotions. The pain is stabbing, drilling, burning, throbbing, aching. The duration of the episode is 5-45 minutes, during the day in severe cases there are up to 40 seizures. Paroxysmal hemicrania is accompanied by vegetative disorders: lacrimation, local hyperhidrosis, a feeling of heat, nasal congestion.
Pain in the right side of the head
Pain in the right side of the head
Hypnic headache
This primary cephalgia is characterized by occurrence only in a dream. Separately, the right or left half of the head is affected in 40% of patients, in other cases, the painful sensations are bilateral. At the beginning of the attack, the patient wakes up, after the paroxysm ends, he falls asleep again. Hypnic headache is dull, moderate, rarely severe. It is diagnosed in people of the older age group, once it appears, it continues to bother throughout life.
Cluster headache
Unlike migraines, the left side of the head suffers more often than the right, but right-sided cephalgia is also possible. Young men predominate among the patients. Cluster headache attacks develop suddenly, increase within 1-3 minutes, stop after 15-120 minutes. Painful sensations are extremely intense. Localized mainly in the orbital region, stabbing, burning, tearing, pressing. They decrease with moderate physical activity, so during paroxysm patients are constantly moving.
Vertebrobasilar insufficiency
Pain in half of the head is typical for the spondylogenic form of the disease. The left and right half suffer equally often, localization is determined by the side on which blood flow disorders occur in the vertebral artery. The pain is provoked by movements of the neck, its severity clearly depends on the position of the head. Painful sensations with vertebrobasilar insufficiency appear in the back of the head, cover the temple, forehead, orbit, radiate into the upper limb. Accompanied by vegetative and cerebellar disorders, visual and hearing disorders.
Other cerebral pathologies
Pain in the right half of the head is noted with brain tumors, limited arachnoiditis of the appropriate localization. When neoplasms appear in the early stages of the disease, severe or moderate, bursting, deep, often observed in the form of seizures. With arachnoiditis, it proceeds chronically, gradually progresses, worries mainly in the morning, supplemented by neurosis-like symptoms.
Other reasons
Right – sided cephalgia can be detected in the following diseases:
Sinusitis. The pain syndrome is bursting, pulsating, provoked by sinusitis or frontitis of the right paranasal sinuses. It is more pronounced in the forehead area, gives to the temple. Nasal discharge is characteristic, common signs of the inflammatory process.
Mastoiditis. Manifests simultaneously with acute purulent otitis media or a few days after its onset. There are intense pains behind the ear, spreading to the neighboring parts of the head, fever, discharge of pus from the ear.
Temporal arteritis. Rheumatic pathology is caused by a lesion of the temporal artery, accompanied by pulsating dull pains in the temple. Soreness increases at night, gradually progresses. It is combined with general intoxication manifestations.
Diseases of the spine. Pain in the right half of the head is caused by right-sided compression of nerves and blood vessels. It is detected in patients with osteochondrosis, intervertebral hernia. Neck pain is typical, which increases with movements. Possible muscle weakness, numbness of the right hand.
Diagnostics
The determination of the pathology causing pain in the right half of the head is the responsibility of a neurologist. If necessary, the patient is referred for consultation to an otolaryngologist, rheumatologist, oncologist. To identify focal symptoms, a neurological examination is performed. The diagnosis of primary cephalgia is based on the compliance of the clinical picture of the disease with certain criteria. Additional techniques are used in the course of differential diagnosis. In other pathologies, the list of procedures is determined taking into account the nature of the disease. Can be assigned:
Ultrasonography. Duplex and Dopplerography are informative in assessing the condition of blood vessels. In case of vertebrobasilar insufficiency, cervical and intracranial vessels are examined to determine the localization and prevalence of stenosis. In other cases, they are prescribed to exclude vascular diseases.
Tomography. Patients with arachnoiditis and tumors are referred for MRI of the brain. If the vertebral artery is affected, MR angiography is performed. Diseases of the spine are diagnosed using CT or MRI of the cervical spine.
Otolaryngological examination. It is necessary for sinusitis, mastoiditis. Along with external examination, anterior rhinoscopy, otoscopy, diagnostic puncture of the adnexal sinus can be performed.
Radiography. Images of the cervical spine are recommended for herniated disc, osteochondrosis, suspected compression of the vertebral artery by surrounding solid structures. Radiographs of the temporal bone are shown in mastoiditis, paranasal sinuses – in sinusitis.
Electroencephalography
Electroencephalography
Treatment
Conservative therapy
The plan of therapeutic measures is made taking into account the nature of the disease. The following medications and non-drug methods are used:
Migraine. To eliminate paroxysms, non-narcotic analgesics are prescribed. With persistent attacks, blockades are performed. With intense excruciating pain, migraine status, triptans are used, in tablets, rectal candles, solutions for parenteral administration. The last two options allow you to solve the problem of taking the drug with persistent vomiting.
Paroxysmal hemicrania. NSAIDs, glucocorticosteroids, calcium channel blockers are effective. Depending on the severity of the pathology, medications are taken in short courses or constantly.
Cluster headache. Pain attacks are eliminated with the help of triptans, applications of local anesthetics on the nasal mucosa. The effectiveness of inhalations of 100% oxygen is noted. Preventive measures in the intercrime period are carried out using calcium channel blockers, hormonal, antiepileptic medications.
Hypnic headache. The basis of treatment is hypnotics, lithium preparations, atypical benzodiazepines. Some researchers report on the effectiveness of steroids and NSAIDs. Before going to bed, patients are advised to take caffeinated and melatonin-containing drugs.
Vertebrobasilar insufficiency. Antiplatelet agents, anticoagulants, neuroprotectors, hypotensive, vascular drugs, exercise therapy, massage, manual therapy, hyperbaric oxygenation, magnetotherapy, laser therapy are recommended.
Tumors. To reduce the severity of symptoms, non-narcotic and narcotic analgesics, antiemetics, glucocorticoids, psychotropic drugs are used. Radiation and chemotherapy are carried out as part of palliative therapy or are part of a comprehensive treatment in the pre- and postoperative period.
Pathology of the spine. Pain is eliminated with the help of oral and parenteral forms of NSAIDs, muscle relaxants, local administration of glucocorticosteroids. B vitamins, neurometabolites, phonophoresis, UHF, electrophoresis, magnetotherapy are used.
ENT-diseases. Therapeutic regimens include antibacterial, vasoconstrictive, antihistamines, physiotherapy, paracentesis of the tympanic membrane, puncture of the paranasal sinuses.
Surgical treatment
Treatment of primary cephalgia is only conservative. With other pathologies , they can be shown:
Vertebrobasilar insufficiency: reconstructive surgery to restore blood flow.
Brain neoplasia: removal of cerebral tumors using traditional and minimally invasive surgical methods.
Diseases of the spine: low–traumatic (endoscopic microdiscectomy, puncture laser vaporization) and traditional (discectomy) interventions for hernias, sometimes in combination with fixing operations.
Pathology of ENT organs: sanitizing surgery, mastoidotomy, frontotomy, maxillofacial surgery, microhaimorotomy.
