Symptoms

Forehead pain, forehead pain

Forehead pain, forehead pain


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Forehead pain or forehead headaches are often described by those affected as a feeling of pressure in the area of ​​the forehead, forehead tension pain or headache, less often as a facial pain. The type and intensity of the pain also differ greatly from one another. In order to find the cause, an in-depth investigation and differentiation from other symptoms is necessary. In addition to functional triggers of the complaints, diseases such as neuropathies, inflammation of the frontal sinus, migraines or eye problems are also possible causes of the forehead pain.

Definition

Forehead pain is a discomfort in the front upper area of ​​the skull below the hairline. The term is used as a symptom and not as an independent clinical picture. The causes are varied and require thorough clarification, since the first illnesses can also be the cause of the complaints.

Migraine headache

Around 10 percent of the population suffer from migraines. The strong, sometimes almost unbearable headache occurs unilaterally in the forehead, temples and eyes of most of those affected and is often accompanied by symptoms such as nausea, vomiting and sensitivity to light, noise and / or smell. The disease is one of the so-called common diseases.

Migraines usually occur like a seizure and run in characteristic phases. For example, many sufferers in the so-called harbinger phase primarily suffer from psychological, neurological and vegetative symptoms such as fatigue or sensitivity to noise. Food cravings for certain foods can also announce a migraine attack. In some cases, this is followed by the aura phase, which is associated with perceptual disorders. Vision is most often impaired. Speech disorders and symptoms of paralysis can also occur in this phase. It is therefore particularly important to clearly classify the symptoms and to differentiate them from other diseases such as stroke.

In the headache phase, there is severe pain, especially in the area of ​​the forehead, temples and eyes, which is usually only noticeable in one half of the face. Other symptoms such as loss of appetite, nausea and vomiting may also occur. Hypersensitivity to light, noise and smells can also occur. Often the forehead pain increases with activity and movement, while it decreases in calm and dark. In the regression phase, the symptoms slowly decrease. The person concerned is usually exhausted and tense.

Lack of sleep, stress, environmental factors, food and hormonal factors are discussed as triggers for migraine attacks. Those affected should therefore often keep a headache diary in order to trace the cause. In it, they document what they ate and drank before the migraine attack and record activities and their mental state.

Cluster headache

Cluster headaches are characterized by one-sided violent excruciating pain attacks, mostly in the area of ​​the temple and eye as well as the lower forehead. Unlike migraine sufferers, people with cluster headaches do not have the urge to go to bed, but wander around and move. Typically, the pain occurs at night, one to two hours after falling asleep, and usually lasts between 15 and 180 minutes. Some sufferers also experience pain attacks during the day. The frequency of occurrence varies between every other day and eight attacks a day. Most often there are other symptoms such as a drooping eyelid, reddened conjunctiva in the eye, increased lacrimation, sweating in the area of ​​the forehead or face and physical restlessness. Some patients have an aura before the attack, which can also occur with migraines. Differentiating from migraines can therefore be difficult.

The causes of cluster headaches have not yet been clarified. An enlargement or inflammation of the blood vessels does not seem to be the trigger of the disease, we assumed earlier, but rather a result of the pain attacks. Alcohol and histamine are known as so-called triggers. However, the triggers can vary widely from person to person.

Forehead pain with tension headache

According to the definition of the International Headache Society (IHS, International Headache Society), tension headache is used when the headache extends to the entire head, including the forehead, and is pressing or pulling, but not pulsating. The intensity of tension headache ranges from mild to moderate complaints. An episodic tension headache occurs when the pain attacks occur at least ten times but less than 180 days a year. Chronic tension headache occurs at least 15 days a month and for six consecutive months. Affected people are often prone to psycho-vegetative abnormalities, which include anxiety, stroke disorders, a depressed mood and excessive drug use. The interaction of various factors is believed to be the cause of tension headache. For example, the tension in the neck muscles leads to the activation of pain receptors, which in turn trigger a process that generally makes the person affected more sensitive to pain. Tense chewing muscles, stress and infections with fever are also discussed as triggers.

In addition, forehead pain can also occur in the context of other types of headache, such as SUNCT syndrome (Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing).

Forehead pain in ophthalmic zoster

Ophthalmic zoster refers to the appearance of shingles in the face and eyes. Chickenpox virus (varicella zoster virus), which causes chickenpox, triggers shingles. Once these have subsided, however, the virus remains in the body for life and nests either in the cranial nerves or in the nerve roots of the spinal cord. For example, due to a weakened immune system, the virus can reproduce again and become noticeable through the typical belt-like rash and sometimes severe pain. The outwardly characteristic signs of shingles are based on the fact that the virus shows up along the supply area of ​​the nerve in which the virus has nested. If the virus appears in the area of ​​the forehead, the result is usually a burning forehead pain. In addition to a weakened immune system, the risk factors of zoster ophthalmicus include stress, trauma and UV radiation.

Forehead pain with sinusitis

The frontal sinus (sinus frontalis) belongs to the paranasal sinuses (sinus paranasales) and forms a cavity in the frontal bone. Since the frontal sinus is connected to the middle nasal passage of the nasal cavity, it can catch fire if there are diseases of the nose. Frontal sinusitis (sinusitis frontalis) is often accompanied by fever, runny nose, headache with a feeling of pressure in the front area of ​​the skull, headache, fatigue and general fatigue. Viruses are usually the cause of the infection. However, other pathogens such as bacteria are also possible.

Inflammation of the frontal sinuses can be acute or chronic. The latter is the case if the inflammation persists for more than two to three months. The chronic course is often based on an uncured inflammation of the frontal sinus.

Forehead pain in trigeminal neuralgia

Some nerves run in the area of ​​the forehead, which can cause severe pain when irritated and inflamed. Nerve pain is called neuralgia. These include complaints that occur in the supply area of ​​one or more nerves and are triggered by damage to these peripheral nerves.

Trigeminal neuralgia is one of the most common neuralgias and can be associated with very severe facial and forehead pain. The pain-causing nerve is the trigeminal nerve (fifth cranial nerve, trigeminal nerve), which runs in three main branches on the face. The trigeminal nerve can become irritated and inflamed by changing neighboring blood vessels in the lower brain section or by pinching off other sections of the nerve. In some cases, however, the cause of trigeminal neuralgia remains unknown or there is another underlying disease such as multiple sclerosis or a tumor. Accident-related head injuries can also cause nerve pain.

Symptoms of trigeminal neuralgia include a sudden, stabbing pain that can occur on the forehead, but also on the cheeks, chin and around the teeth. The pain attacks usually last only a few seconds, but are repeated at short intervals. Often there is a phase without pain attacks until they start again.

Trigeminal neuralgia

Some nerves run in the area of ​​the forehead, which can cause severe pain when irritated and inflamed. Accident-related head injuries can also cause nerve pain.

Symptoms of trigeminal neuralgia include a sudden, stabbing pain that can occur on the forehead, but also on the cheeks, chin and around the teeth. Often there is a phase without pain attacks until they start again.

Forehead pain with eye disorders

Overwork and eye diseases can also be the cause of forehead pain. Working for hours every day on the computer can lead to complaints, especially in less than ideal working conditions. Another trigger for pain in the forehead area can be an unknown visual defect or diseases such as glaucoma or cataract. Those with frequent headaches should consider an ophthalmological exam.

In addition, there are numerous other causes of forehead pain such as muscle tension, lack of sleep, side effects of medication, lack of fluids, neurological disorders, brain tumors and accidental injuries to the forehead.

Risk factors

Forehead pain has a variety of causes and therefore different risk factors. Computer work can lead to eye fatigue and consequent pain in the forehead. For acute frontal sinus infections, forehead pain can also occur. If they do not heal, they can take a chronic course. With migraines and cluster headaches, there are often certain individual triggers that trigger symptoms. In addition, an unhealthy lifestyle can cause headaches and headaches.

Diagnosis

Forehead pain often occurs without an underlying disease and disappears on its own after a short time. However, people with prolonged, recurring, or very severe, acute forehead pain should see a doctor to determine the cause of the discomfort. Especially people who suffer from other symptoms besides headache such as dizziness, cramps, nerve dysfunction, personality changes, confusion, cold sores, increased head circumference, visual disturbances, an enlarged pupil as well as externally recognizable changes to the eye are urgently advised to seek medical advice.

Since the causes of headache vary widely, the doctor will first ask questions about the medical history and possible triggers: Are there underlying diseases? When and how long did the complaints occur? Is the pain more dull, throbbing, stinging or oppressive? Are there any symptoms other than forehead pain? In addition, further questions are asked that arise from the individual complaints.

The examinations that can be performed for forehead pain include magnetic resonance imaging (MRI), computed tomography (CT), electroencephalography (EEG), ultrasound examination (sonography), angiography, positron emission tomography (PET), blood and urine. and brain water examinations as well as ophthalmological, dental and ENT examinations.

Treatment options for headache

Therapy for forehead pain is usually based on the cause. If the cause of the complaint is not known, the treatment may consist mainly of analgesic and / or anti-inflammatory drugs. In some cases, massages, autogenic training or other relaxation exercises, physical therapy and traditional Chinese medicine such as acupuncture can be useful. People who often suffer from headaches or forehead pains should make sure they have enough sleep and fluids and avoid stress if possible. A healthy diet and exercise can also prevent the symptoms in some cases. (ag)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr Astrid Goldmayer

Swell:

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ICD codes for this disease: R51ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


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