Therapy
There is no treatment to cure cluster headache. The goal of treatment is to help decrease the severity of pain and shorten the term of the attack. Drugs that are used for cluster headache can be divided into symptomatic medications and prophylactic. Obta-symptomatic
 medication intended to stop or reduce pain after a cluster headache 
attack, while prophylactic medications used to reduce exacerbation 
frequency and intensity of headaches.Because
 this type of headache is increasing rapidly symptomatic treatment 
should have the nature of work quickly and can be given promptly, 
usually using inhalers instead of injections or tablets by mouth.Symptomatic treatment including:1. Oxygen. Inhalation
 of 100% oxygen through a face shield with a capacity of 7 liters / min 
gives a good recovery in 50 to 90% of people who use it. Sometimes larger amounts can be more effective. The effect of the use is relatively safe, inexpensive, and the effect can be felt after about 15 minutes. The
 main disadvantage of this is the use of oksdigen patients have to carry
 around an oxygen tank and governing, making the treatment in this way 
to be uncomfortable and can not be accessed any time. Sometimes oxygen may only delay rather than stop the attack and the pain will return.2. Sumatriptan. Sumatriptan injection drug commonly used to treat migraine, is also effectively used in cluster headache. Some
 people benefit from the use of sumatriptan in the form of a nasal 
spray, but more research is still needed to determine its effectiveness.3. Ergotamine. This ergot alkaloids cause vasoconstriction in the smooth muscles in the blood vessels of the brain. Available
 in the form of injections and inhalers, use of intra-venous works 
faster than the inhaler dosage should be limited to prevent the 
occurrence of side effects, especially nausea, as well as caution in 
patients with a history of hypertension.4. Local anesthetic medications. A local anesthetic that stabilizes the neuronal membrane of nerve cells become less permeable to ions. This prevents the formation and delivery of nerve impulses, causing a local anesthetic effect. Intra-nasal lidocaine can be used effectively in cluster headache attacks. But be careful if used in patients with hypoxia, respiratory depression, or bradycardia.Prophylactic medications:1. Anticonvulsants. The use of prophylactic anticonvulsants in cluster headache has been demonstrated in several studies is limited. Mechanism
 of action of these drugs to prevent cluster headache remains unclear, 
it may work by regulating central pain sensitization.2. Corticosteroids. Corticosteroid medications are very effective at removing cluster headache cycle and prevent recurrence soon. High doses of prednisone next few days diving down slowly. Mechanism of action of corticosteroids in cluster headache is still unknown.SurgerySurgery
 is recommended in people with chronic cluster headaches that do not 
respond well to treatment or to people who have a contraindication to 
the use of drugs. Someone who will undergo surgery merely that had a lump on one side only because this operation can only be done once. People who experience a move from one side to the other at risk of failure.There are several types of surgery that can be done to treat cluster headache. Procedure is destructive neural pathways responsible for pain.Nerve
 block invasive neurosurgical procedures or non-invasive (eg radio 
frequency pericutaneus, gangliorhizolisis trigeminal, rhizotomi) has 
been proven to successfully treat cluster headache. However, side effects such as facial diastesia, sensory loss in the cornea and anesthesia dolorosa.Surgery using gamma rays are now more often used as a less invasive. The new method is a promising and stimulating electrode implantation using stereostatik signpost at the inferior hypothalamus. Research
 has shown that stimulation of the hypothalamus in cluster headache 
patients with severe provide a complete cure and no significant side 
effects.PreventionBecause the cause of cluster headaches is still not known with certainty we have not been able to prevent the first attack. But we can prevent headaches replicates heavier. The use of preventive medications over the long term than the short-term benefit. Preventive medications long term include calcium channel blockers and channel carbonate. Sedangakan the short term including the corticosteroids, ergotamine and local anesthetic drugs.Avoid alcohol and nicotine, and other risk factors can help reduce the occurrence of attacks.9. Prognosis• 80% of patients with cluster headache recurring tend to have recurrent attacks.• type of episodic cluster headache can turn into a chronic type sampai13 in 4% of patients.• Spontaneous Remission and durable occurred in 12% of patients, especially in the type of episodic cluster headache.• Most cluster headache is a lifelong problem.• The onset of this disorder teruama up in men with a history of episodic cluster headache types have a worse prognosis.
0 Response to "Cluster Headache 4"
Post a Comment