Pain in the left half of the head is observed with 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, breaking, pulsating. The cause is established on the basis of complaints, interview data, neurological examination, additional studies. As part of therapeutic measures, NSAIDs, triptans, steroids, caffeine preparations, and physiotherapy are prescribed. Sometimes operations are performed.
general characteristics
Pain in half of the head (hemicrania) is a symptom typical of some primary cephalalgias. Sometimes 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 predominates.
Why does the left side of the head hurt?
Physiological causes
Pain in half of the head under certain circumstances can occur in a healthy person. Features of the pain syndrome are episodic, rapid disappearance after rest or taking an analgesic. The symptom is observed in the following cases:
- Intense physical activity . Perhaps a combination with darkening in the eyes, dizziness, shortness of breath, palpitations and tingling in the region of the heart.
- stressful situations . The left or right half of the head hurts against the background of the release of stress hormones, which provokes vasoconstriction and an increase in blood pressure. There is marked emotional stress.
- Mental fatigue . Pain is caused by significant intellectual stress, 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 drinking alcohol. The reason is changes in vascular tone, the entry of toxic substances into the body.
cluster headache
It develops in people of a certain type - predominantly 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 often occurs in the left side of the head. It is most pronounced in the orbit, burning, stitching, intolerable, resembling a "rupture" or "gouging out" of the eye. Cluster headache is accompanied by autonomic disorders. It decreases with movement, so patients rush about, hit the wall with their fists.
Migraine
The left half of the head with a migraine hurts somewhat less often than the right. The pain is pressing, throbbing, with an epicenter in the temple, forehead or eye. Sometimes painful sensations arise 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. Manifestations vary somewhat depending on the type of migraine:
- Simple migraine. Diagnosed in 80% of cases. Aura is missing. Possible prodrome in the form of drowsiness, mood deterioration, decreased performance. Hemicrania is combined with nausea and vomiting, aggravated by movements, the action of auditory and sound stimuli. It 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 an aura - visual disturbances, transient sensory disturbances, ringing in the ears, the appearance of unusual smells or sounds, impaired speech. Migraine in children is often preceded by "Alice's syndrome" - a visual distortion of objects, visual hallucinations. Lasts from several hours to 4 days.
- Eye migraine. Typically, the loss of certain areas of the visual field, the presence of paracentral or central cattle, flickering before the eyes. The headache is throbbing, occurs in the forehead, passes into the orbit. The duration of visual disturbances is 10-2 minutes, an attack of cephalalgia is 30-12 minutes.
- vestibular migraine. Manifests 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 stops with the onset of hemicrania, persists throughout the entire pain attack, or becomes its only manifestation (painless paroxysms).
If the symptom persists for more than 3 days or a series of continuous paroxysms during this time, they speak of migraine status. The pain is very intense, undulating. Pallor, adynamia, severe weakness, inability to eat and take medications due to repeated vomiting, and increasing dehydration are observed. Severe condition.
Pain in the left side of the head
Paroxysmal hemicrania
Unilateral pain paroxysmal, very strong. It can be aching, throbbing, burning, boring, stabbing, or fist-like. It is localized mainly in the temple or eye socket, less often in the area of the forehead, occiput or crown. Associated with damage to the trigeminal nerve. An attack of paroxysmal hemicrania lasts from 5 to 45 minutes, from 1 to 4 episodes can be observed per day during the period of exacerbation. Complemented by vegetative symptoms, eyelid drooping, pupil constriction, photophobia.
Vertebrobasilar insufficiency
Left-sided or right-sided headache is noted in the spondylogenic form of vertebrobasilar insufficiency. It develops suddenly on movement. From the neck and the back of the head it spreads to the forehead, temple and eye socket, extends into the hand. A clear relationship is revealed between the intensity of cephalalgia and the position of the cervical spine. The pain syndrome is supplemented by unilateral hearing loss, tinnitus, dizziness, visual disturbances, cerebellar disorders and autonomic reactions.
Hypnic headache
It is observed in people older than 5 years, it proceeds chronically. It always develops during sleep, 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 30-6 minutes, repeats from 1 time per week to several paroxysms throughout the night. Painful sensations are dull, moderately pronounced, less often intense. There may be mild nausea, increased sensitivity to sounds and bright lights.
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 proceeding in the form of paroxysms. With the progression of neoplasia, hemicrania is supplemented by increasing focal symptoms. Then join the cerebral manifestations caused by edema and intracranial hypertension. The pain becomes diffuse, diffuse, bilateral, complemented by dizziness, nausea, and vomiting.
Arachnoiditis
The left half of the head can hurt with limited arachnoiditis, which developed in the remote period after TBI, inflammatory and infectious diseases. Symptoms increase gradually. The pains are bursting, more disturbing in the mornings, combined with emotional instability, fatigue, irritability, sleep disturbances. Subsequently, it is possible to attach focal symptoms, spread the process with diffuse headaches, liquorodynamic crises.
Other reasons
Pain in the left half of the head is provoked by some rheumatic and otolaryngological pathologies, diseases of the spine. Symptoms are caused by:
- Horton's disease. Pain is unilateral or bilateral, dull, throbbing, with an epicenter in the temple area, aggravated at night, increasing over several weeks. Fever, anorexia, myalgia, arthralgia, induration and tenderness of the temporal and parietal arteries are noted.
- Sinusitis. Left-sided hemicrania accompanies unilateral frontal sinusitis and sinusitis with damage to the left paranasal sinus. Pulsating, bursting, localized in the brow and forehead, radiating to the temple. Complemented by general hyperthermia, intoxication, nasal discharge.
- Mastoiditis. It develops against the background of purulent otitis media. Accompanied by intense pain in the ear and behind the ear, which spreads to the crown, temple, eye socket and upper jaw, sometimes covering the entire half of the head. Febrile temperature, intoxication, profuse suppuration from the ear are observed.
- Pathology of the spine . Unilateral compression of blood vessels and nerves in osteochondrosis, protrusion, hernia and some other diseases of the cervical region causes pain in the left half of the head. Complemented by pain in the neck, sometimes - numbness and weakness of the upper limb.
Diagnostics
The neurologist is engaged in establishing the nature of the disease that provokes pain in the left half of the head. According to indications, a rheumatologist, oncologist, otolaryngologist are involved. Primary cephalgia (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. Produced 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 small size of the formations.
- Assessment of cerebral blood flow . Includes duplex scanning, ultrasound of the vessels of the head and neck. As part of the differential diagnosis, it allows to detect hemodynamic disorders characteristic of atherosclerosis and other diseases. Recommended for patients with vertebrobasilar insufficiency to clarify the nature and structure of stenosis.
- Radiography . On standard images of the cervical spine, signs of hernia, osteochondrosis and other diseases of the spinal column are revealed. To confirm extravasal compression of the vertebral artery, radiographs are taken with functional tests. With sinusitis, x-rays of the paranasal sinuses are performed, with mastoiditis - of the temporal bone.
- Tomography . An MRI of the brain is prescribed for suspected neoplasms and arachnoiditis. In the angiography mode, it provides comprehensive information about the state of the main arteries. If a vertebrogenic etiology of pain is suspected, MRI and CT of the cervical region are performed. For sinusitis, an MRI of the sinuses is sometimes performed.
Consultation of a neurologist
Treatment
Conservative therapy
Therapeutic tactics is determined taking into account the cause of the symptom. The basis is drugs, which in some cases are supplemented by non-drug methods:
- Migraine . The attack is stopped with the help of non-narcotic analgesics, caffeine-containing drugs. Sometimes therapeutic blockades are carried out. Very intense pain, prolonged attacks are an indication for the use of triptans. With repeated vomiting, medications are administered subcutaneously, used in the form of sprays or rectal suppositories.
- Cluster headache . To eliminate paroxysm, triptans are prescribed, oxygen inhalations are carried out, and local anesthetics are applied to the nasal mucosa. As part of the prevention, calcium channel blockers are recommended, in case of intolerance - antiepileptic drugs or glucocorticosteroids.
- Paroxysmal hemicrania . The effectiveness of non-steroidal 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.
- Syndrome of the vertebrobasilar system . The treatment regimen includes drugs with vascular, hypotensive and neuroprotective effects, anticoagulants, antiaggregants, antidepressants. As part of non-drug therapy, hyperbaric oxygen therapy, exercise therapy, vestibular gymnastics, massage, post-isometric relaxation, magnetic laser therapy are carried out.
- Arachnoiditis . Anti-inflammatory, antiepileptic, absorbable, antiallergic and dehydrating agents, metabolites, neuroprotectors, tranquilizers, antidepressants can be prescribed.
- ENT pathology . Antibacterial therapy, antihistamine and vasoconstrictor drugs, immunocorrectors, UHF, diadynamic currents are shown. With sinusitis, punctures, sinus evacuation are performed, with mastoiditis - paracentesis of the tympanic membrane.
Surgery
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, endarterectomy.
- Brain tumor : removal of a neoplasm using microsurgical techniques or stereotactic radiosurgery methods, bypass surgery for hydrocephalus.
- Diseases of the ENT organs : open and endoscopic maxillary sinusectomy or frontotomy, mastoidectomy, sanitizing and general cavity interventions on the middle ear.
- Spinal injuries: laser vaporization, microdiscectomy, interbody fusion, fixation with cages.