Sharp throbbing pain in the head on the right ‒ this is a dangerous symptom that requires more detailed diagnosis. She can talk about circulatory disorders, neoplasms, nerve damage and other diseases. It is important to understand the cause of the pain in order to choose the most effective treatment regimen. Doctors at the Clinical Brain Institute say that a throbbing headache is often the first sign of dangerous disorders and rarely occurs in a healthy person.
1. Causes of throbbing pain in the head on the right
1.1 Psychogenic headache
1.2 Migraine
1.3 Vascular diseases
1.4 Pulsating pain in the head on the right side with diseases of the ENT organs
1.5 Neuralgia
1.6 Intoxication and poisoning
1.7 Neoplasms
2. Methods for diagnosing headaches
3. Treatment methods
Why does the right side of my head hurt?
Physiological reasons
Episodic hemicranias are detected in many healthy people and disappear after taking an anesthetic, sleep, and rest. There is a connection with external circumstances and no tendency to relapse. Provoking factors are considered to be acute and prolonged stress, mental and physical overload. The right side of the head can also hurt due to alcohol intoxication, frequent smoking, or abuse of caffeine-containing drinks.
Migraine
A distinctive feature of migraine is paroxysmal unilateral pain with periodic change of half of the head. For unknown reasons, the disease most often manifests itself as pain in the right side of the head. Painful sensations are localized in the area of the eye, forehead, temple, and less often in the occipital region. They often start in one place and then cover the entire half of the head.
For most types of migraine, symptoms persist for a period of several hours to 3 days. Some signs depend on the type of disease:
- Simple migraine.
The most common. Accompanied by classic attacks without an aura, sometimes preceded by a prodrome in the form of impaired performance, deterioration of the emotional state. Nausea, vomiting, light and sound phobia are noted. - Migraine with aura.
Paroxysms are the same as in the previous case. They are preceded by an aura, which is most often represented by visual disturbances. There may be unusual sounds and smells, sensory disturbances, and difficulty speaking. - Vestibular migraine.
A typical feature is dizziness, which occurs at the prodrome stage and may persist or disappear with the onset of the headache. Sometimes different variants of the aura are observed. - Ocular migraine.
Along with visual disturbances (flickering, the appearance of scotomas, loss of parts of the visual field) that precede cephalalgia and persist for 10-20 minutes, this type of migraine differs from others in its atypical duration - less than 3 hours. - Ophthalmoplegic migraine.
Another variant of the disease with ophthalmological disorders and unusual duration. Symptoms persist for more than a week. Disturbances from the oculomotor, and less commonly, trochlear or abducens nerves occur on days 1-4. Diplopia, mydriasis, strabismus, and drooping eyelids are possible.
If the duration of a migraine attack (except for types with ocular symptoms) is more than 3 days or paroxysms during this time continuously occur one after another, migraine status is diagnosed. This condition is characterized by high pain intensity, wave-like decrease and increase in symptoms, and progressive dehydration caused by repeated vomiting.
Paroxysmal hemicrania
It occurs with episodes of extremely intense pain in the right or left half of the head with the epicenter in the orbit, temporal zone, crown, back of the head, and forehead. It can be provoked by sudden turns of the head, drinking alcohol, or strong emotions. Pain sensations are stabbing, boring, burning, pulsating, aching. The duration of the episode is 5-45 minutes; in severe cases, up to 40 attacks occur during the day. Paroxysmal hemicrania is accompanied by autonomic disorders: lacrimation, local hyperhidrosis, feeling of heat, nasal congestion.
Pain in the right side of the head
Hypnic headache
This primary cephalgia is characterized by its occurrence only during sleep. Separately, the right or left half of the head is affected in 40% of patients; in other cases, the pain is bilateral. At the beginning of the attack, the patient awakens, after the end of the paroxysm he falls asleep again. Hypnic headache is dull, moderate, rarely severe. 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 is affected more often than the right, but right-sided cephalgia is also possible. The majority of patients are young men. Attacks of cluster headaches develop suddenly, increase within 1-3 minutes, and stop after 15-120 minutes. The painful sensations are extremely intense. Localized mainly in the orbital area, stabbing, burning, tearing, pressing. They decrease with moderate physical activity, so during paroxysm patients constantly move.
Vertebrobasilar insufficiency
Pain in half of the head is typical for the spondylogenic form of the disease. The left and right halves are affected equally often, the localization is determined by the side on which blood flow disturbances 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, and radiate to the upper limb. Accompanied by autonomic and cerebellar disorders, visual and hearing disorders.
Other cerebral pathologies
Pain in the right side of the head is observed with brain tumors, limited arachnoiditis of the corresponding localization. With neoplasms, it appears in the early stages of the disease, strong or moderate, bursting, deep, often observed in the form of attacks. With arachnoiditis, it occurs chronically, gradually progresses, worries mainly in the morning, and is 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 sinusitis of the right paranasal sinuses. It is more pronounced in the forehead area, extending to the temple. Nasal discharge and general signs of an inflammatory process are characteristic. - Mastoiditis.
Manifests simultaneously with acute purulent otitis media or a few days after its onset. There is intense pain behind the ear, spreading to adjacent parts of the head, increased temperature, and drainage of pus from the ear. - Temporal arteritis.
Rheumatic pathology is caused by damage to the temporal artery and is accompanied by throbbing, dull pain in the temple. The pain intensifies at night and gradually progresses. Combined with general intoxication manifestations. - Spinal diseases.
Pain in the right side of the head is caused by right-sided compression of nerves and blood vessels. It is detected in patients with osteochondrosis and intervertebral hernia. Neck pain is typical and gets worse with movement. Possible muscle weakness, numbness of the right hand.
Signs of migraine
Migraine is characterized by the onset after the appearance of precursors - weakness, weakness, unpleasant odors or other sensations. This is the so-called “aura”. If the aura is followed by pain on the right side of the head, the doctor will first consider a diagnosis of migraine.
Migraine pain is characterized by paroxysmal, burning sensations: the patient experiences pressure on the right eye, photophobia occurs, and nausea appears. The pain is sharp, intensifies, and is localized on the right side of the head. Unfortunately, it is still unclear why migraines occur; it is only clear that the problem is neurological in nature. Usually doctors look at the whole picture and strive to eliminate possible causes: psycho-emotional stress, overexertion, trauma.
Diagnostics
Determining the pathology that causes pain in the right side of the head is the responsibility of a neurologist. If necessary, the patient is referred for consultation to an otolaryngologist, rheumatologist, or oncologist. To identify focal symptoms, a neurological examination is performed. Diagnosis of primary cephalgia is based on compliance of the clinical picture of the disease with certain criteria. Additional techniques are used during differential diagnosis. For other pathologies, the list of procedures is determined taking into account the nature of the disease. May be assigned:
- Ultrasonography.
Duplex and Doppler sonography are informative in assessing the condition of blood vessels. In case of vertebrobasilar insufficiency, they are performed to study the cervical and intracranial vessels, determine the localization and extent 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 damaged, MR angiography is performed. Spinal diseases are diagnosed using CT or MRI of the cervical spine. - Otolaryngological examination.
Necessary for sinusitis, mastoiditis. Along with an external examination, anterior rhinoscopy, otoscopy, and diagnostic puncture of the accessory sinus can be performed. - Radiography.
Images of the cervical spine are recommended for disc herniation, osteochondrosis, and suspected compression of the vertebral artery by surrounding hard structures. X-rays of the temporal bone are indicated for mastoiditis, and of the paranasal sinuses for sinusitis.
Electroencephalography
Unfavorable factors
Various disorders in the body can cause an abnormal condition. Most often this is associated with the functionality of the spine, its diseases (osteochondrosis, hernia, tumors of various types, spondylosis, previous trauma). These disorders lead to compressive pressure on the roots of the nerve canals, which causes severe pain to be transmitted to the central nervous system. Each touching of a nerve, its compression leads to an attack.
There is a high probability of pain paresis with previously diagnosed diseases:
- trigeminal neuritis;
- traumatic brain injury;
- damage to the glossopharyngeal processes;
- aneurysm, hematoma, tumor formations and cysts;
- osteomyelitis of the jaw.
A previous infection can also become an unfavorable factor, since extensive inflammation damages the internal organs of hearing and smell, and affects the intracranial nerve pathways.
Treatment
Conservative therapy
The treatment plan is drawn up 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. For persistent attacks, blockades are performed. For intense excruciating pain and migraine status, triptans are used in tablets, rectal suppositories, and solutions for parenteral administration. The last two options allow you to solve the problem of taking the drug for persistent vomiting. - Paroxysmal hemicrania.
NSAIDs, glucocorticosteroids, and calcium channel blockers are effective. Depending on the severity of the pathology, medications are taken in short courses or continuously. - Cluster headache.
Painful attacks are eliminated with the help of triptans and applications of local anesthetics to the nasal mucosa. The effectiveness of inhalation of 100% oxygen is noted. Preventive measures in the interictal period are carried out using calcium channel blockers, hormonal, and antiepileptic medications. - Hypnic headache.
The basis of treatment is hypnotics, lithium preparations, and atypical benzodiazepines. Some researchers have reported the effectiveness of steroids and NSAIDs. Before going to bed, patients are advised to take caffeine-containing and melatonin-containing medications. - Vertebrobasilar insufficiency.
Antiplatelet agents, anticoagulants, neuroprotectors, antihypertensive, vascular drugs, exercise therapy, massage, manual therapy, hyperbaric oxygenation, magnetic therapy, laser therapy are recommended. - Tumors.
To reduce the severity of symptoms, non-narcotic and narcotic analgesics, antiemetics, glucocorticoids, and psychotropic drugs are used. Radiation and chemotherapy are carried out as part of palliative therapy or are part of complex treatment in the pre- and postoperative period. - Spinal pathologies.
Pain is eliminated with the help of oral and parenteral forms of NSAIDs, muscle relaxants, and local administration of glucocorticosteroids. They use B vitamins, neurometabolites, phonophoresis, UHF, electrophoresis, and magnetic therapy. - ENT diseases.
Treatment regimens include antibacterial, vasoconstrictor, antihistamines, physiotherapy, paracentesis of the tympanic membrane, and puncture of the paranasal sinuses.
Surgery
Treatment of primary cephalgia is only conservative. For other pathologies, the following may be indicated:
- Vertebrobasilar insufficiency
: reconstructive surgery to restore blood flow. - Brain neoplasia
: removal of cerebral tumors using traditional and minimally invasive surgical techniques. - Spinal diseases
: low-traumatic (endoscopic microdiscectomy, puncture laser vaporization) and traditional (discectomy) interventions for hernias, sometimes in combination with fixation operations. - Pathologies of ENT organs
: sanitizing surgery, mastoidotomy, frontotomy, maxillary sinusotomy, micromaxillary sinusotomy.
Problems in the temporomandibular joint
The lower jaw is connected to the skull by a cartilaginous disc, which can become inflamed or “wear out” because it is a moving part. A problem with the temporomandibular joint is quite easy to recognize: in addition to acute pain localized on the right, there are sensations of “shooting” in the eye and ear, the face may become asymmetrical, a burning sensation in the mouth, dryness or increased salivation may appear. If you suspect this pathology, you should contact your dentist - he will prescribe a diet, medications and, if necessary, refer you to a surgeon. If the joint is completely destroyed, it is replaced with an implant.
