3 dau dau dau lung

Ho Huu That, MD
Pham Ngoc Thach University of Medicine


8/5/2018

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Introduction

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Tiếp cận chẩn đốn và xử trí đau đầu



Tiếp cận chẩn đốn và xử trí đau lưng

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Headache is among the most common reasons
patients seek medical attention
attention..

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Relatively few cranial structures are pain
pain-producing:: scalp, middle meningeal artery, dural

producing
sinuses, proximal segments of the large pial
arteries..
arteries



Not pain
pain--producing
producing:: much of brain parenchyma,
ventricular ependymal
ependymal…
…

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Harrison’s principles of internal medicine - 19th 2015

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Pain:: an unpleasant sensation localized to a
Pain
part of the body
body..

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Described as a penetrating or tissue
tissue-destructive
squeezing…
squeezing
…)

process
or

(stabbing,
emotional

burning,
reaction

(terrifying, sickening)
sickening)..
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The duality of pain
pain:: sensation and emotion
emotion..
Harrison’s principles of internal medicine - 19th 2015

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Harrison’s principles of internal medicine - 19th 2015

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Triệu chứng Cảm giác

Triệu chứng vận động

Âm tính

Giảm cảm giác

Yếu

(Negative)

Mất cảm giác

Liệt

Dương tính

Tê (Numbness)

Co giật (Convulsion)

(Positive)

Châm chích

Run (Tremor)

(Tingling)

Các loại Rối loạn

Ngứa

vận động (Múa vờn,

Đau…

múa giật…)

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Peripheral mechanism
mechanism:: the primary sensory
afferents..
afferents



Central mechanism
mechanism:: the spinal cord and
ascending pathways
pathways..



Neuropathic pain
pain:: increased sensitivity and
spontaneous activity in the damaged nerve
fibers or CNS
CNS..
Harrison’s principles of internal medicine - 19th 2015

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Primary headache
headache::


Migraine



Tension--type headache
Tension



Cluster headache

Secondary headache
headache::


Meningitis



Intracranial hemorrhage



Brain tumor



Headache attributed to trauma or injury to the head and/or neck



Headache attributed to infection

The international classification of headache disorders – Cephalalgia 2013
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Harrison’s principles of internal medicine - 19th 2015
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Harrison’s principles of internal medicine - 19th 2015
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The international classification of headache disorders – Cephalalgia 2013
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Harrison’s principles of internal medicine - 19th 2015
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Harrison’s principles of internal medicine - 19th 2015
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