Where is hypertension headache

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Is a common pain reliever safe during pregnancy? If she does have uncontrolled high blood pressure, she should also be certain to work with her doctor to manage her condition. Unchecked, high blood pressure can lead to numerous complications, including damage to your arteries, brain, heart, and kidneys. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

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Hypertensive crisis needs to be promptly treated in order to prevent lethal complications. Hypertensive urgencies, once no serious end organ damage suspected, may be managed as outpatients with oral antihypertensive agents. However, hypertensive emergencies necessitate admission to the intensive care unit and aggressive therapy. Short-acting titratable intravenous antihypertensives, including labetalol, esmolol, fenoldopam, nicardipine, sodium nitroprusside, and etcetera, are the drugs of choice.

Sodium nitroprusside has the risk of toxicity and should be used cautiously. It has a bilateral throbbing quality. Helpful diagnostic criteria have been validated for the headaches based on the hypertensive crisis without encephalopathy regardless of the etiology.

Diagnostic criteria for headaches in HTN crisis without encephalopathy are listed in Table 2. Accelerated HTN, also named hypertensive encephalopathy, may result in disturbance of consciousness.

It is usually related to hypertensive emergency, as already mentioned. In fact the encephalopathy syndrome headache, neurologic deficit, seizure, and confusional state is a type of organ damage in the setting of hypertensive emergency. Clinical presentation of hypertensive encephalopathy is due to the effect of high blood pressure on the blood brain barrier that impairs its integrity and leads to cerebral hyperperfusion and finally brain edema occurs.

In a normal situation, the well-known cerebral autoregulatory effect inhibits the blood brain barrier from damage in a certain range of systolic blood pressure increments. Indeed, the autoregulatory mechanism is active as long as the mean arterial pressure MAP is kept in a range of mmHg. In chronic hypertensive patients, as a consequence of adaptation, this range is shifted to higher levels of MAP. In extremely rapid accelerations of blood pressure, MAP exceeds the defined level and we have an orthostatic leakage of plasma across the capillaries.

The condition is transient and predominant in posterior cerebral regions and is usually called posterior reversible encephalopathy syndrome PRES. The etiology of hypertensive encephalopathy is almost the same as those for hypertensive crisis without encephalopathy but in a more severe manner.

Clinical signs and symptoms of hypertensive encephalopathy and probable accompanying signs and symptoms are listed in Table 3. Apparently, headache can be an important guiding symptom of the disorder and, has a vascular origin. Criteria for headache in hypertensive encephalopathy are listed in Table 4. The patient may complain of new persistent epigastric pain and vomiting. In examination, brisk tendon reflexes, and swelling of hands, face, or feet can be detected.

A rise in serum creatinine, thrombocytopenia, and liver enzymes are the associated lab data abnormalities. A combination of maternal and placental factors contributes to the condition. Lack of previous pregnancy nulliparity , obesity, a history of pre-eclampsia, and maternal medical comorbidities diabetes mellitus, hypertension, antiphospholipid antibody syndrome, connective tissue disorders, or other thrombophilic situations have been posed as the etiology.

Patient's age is also a determinant factor; pre-eclampsia is more common before 18 and after 40 years of age. Pre-eclamptic women are subjected to cardiovascular complications. Studies show an approximately 4-fold increase in the risk of subsequent development of hypertension later in life, and a 2-fold increase in the risk of ischemic heart disease, venous thrombosis, and stroke in pre-eclamptic women.

Magnesium sulfate is the drug of choice for women with pre-eclampsia since it halves the risk of eclampsia. Neurologic signs and symptoms are common presentations of the disorder, including severe persistent headache, visual defects such as blurred vision, diplopia, or floating spots , confusion, depression of consciousness, and finally may lead to seizures or eclampsia. In this regard the manifestations are much the same as hypertensive encephalopathy.

Whenever pre-eclampsia is superimposed by seizure or coma, or both, then it is named eclampsia. Vasogenic brain edema is the underlying cause of this syndrome and accounts for the loss of consciousness.

Imaging study, especially brain MRI, shows edema in the cortex and subcortical white matter that predominantly involves the occipital lobes. It is very important to manage pre-eclampsia appropriately, as soon as the diagnosis is established, in order to prevent its progression to eclampsia, because the latter is harmful for both mother and fetus. Furthermore, it has been proved that magnesium sulfate is a more efficient drug to control eclamptic seizures in comparison with many antiepileptic drugs.

Headache is a common warning symptom of eclampsia that should be inquired in any pregnant woman visited in perinatal care sessions. Criteria for headache in eclampsia are listed in Table 6.

Acute pressure response to an exogenous agent may cause a hypertensive emergency. The most famous of the agents include cocaine, amphetamines, oral contraceptives, and monoamine oxidase inhibitors MAOI , especially when interacting with tyramine-containing foods.

Hypertensive emergency may also occur following the withdrawal of beta-blockers, alpha-stimulants e. National Center for Biotechnology Information , U. Journal List Iran J Neurol v. Iran J Neurol. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Feb 18; Accepted May Know your blood pressure numbers — and know that your donation helps improve the odds for millions of people just like you.

Other inconclusively related symptoms A variety of symptoms may be indirectly related to, but are not always caused by, high blood pressure, such as:.

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