Understand Reasons of Pain in Right Side of Head

Headaches are a common occurrence. They may last for a few hours or several days – often causing throbbing pain in different locations of your head because of emotional, environmental, and medical factors. However, the exact cause of most headaches remains unknown.

By knowing the location of your headache, you can determine what type of headache you have and how serious it is. Based on the symptoms of your headache, you can perform appropriate pain management and decide when to see a doctor. But most headaches are usually not serious.

What causes right-sided head pain?

Contrary to popular belief, headaches do not originate from the brain but the tissues and structures surrounding the skull/brain – because your brain does not have nerve endings that cause the sensation of pain.

If you experience a headache on the right side of your head, it may be caused by:

  • Lack of sleep
  • Stress
  • Caffeine withdrawal
  • Muscle strain in neck
  • Head injuries
  • Allergies
  • Skipping meals

Other common causes of right-sided head pain include migraine and cluster headaches.

Migraine headaches

A migraine headache causes sharp, throbbing pain in one side of the head. It is a type of primary headache – a headache caused by dysfunction or overactivity of pain-sensitive structures in the head. Migraines are usually accompanied by nausea, blurred vision, sensitivity to bright lights, and vomiting. And they are more common in women than men.

Migraines usually come and go without any warning signs. However, most migraines are triggered by specific factors such as:

  • Emotional stress or anxiety
  • Strong smells
  • Tiredness
  • Bright or flickering lights
  • Alcohol, especially red wine
  • Chocolate
  • Skipping meals
  • Loud noises
  • Hormonal changes in women
  • Oversleeping or lack of sleep
  • Weather changes

Treatments for migraines include prescription and over-the-counter pain relievers. By spotting the migraine early, you can control the migraine attacks with nonprescription medicines only. As for frequent migraine episodes, your doctor may prescribe medications and therapies. Nonetheless, you can prevent migraine episodes by avoiding the factors that trigger it.

Cluster headaches

Cluster headaches are uncommon but severe headaches in one side of the head. They usually come in clusters – one to eight headache attacks occur every day for about three months then disappear. Moreover, cluster headaches follow a cyclical pattern and are more common in men than women.

The exact cause of cluster headaches is yet to be known. However, alcohol consumption, smoking, and a family history of cluster headaches are common risk factors – they can increase the risk of developing cluster headaches.

Besides, cluster headaches may be accompanied by:

  • Pale or flushed skin
  • Runny or blocked nose
  • Red or watery eyes
  • Restlessness
  • Swelling around the affected eye
  • Nausea
  • Drooping eyelid on the affected area

Cluster headaches can also cause intense pain around one eye on one side of the head and mostly occur in the middle of the night. Fortunately, cluster headaches are a rare, non-threatening condition and can be reduced with appropriate treatment.

Tension headaches

Tension headaches are the most common types of headaches, usually affecting both sides of the head. However, in some cases, tension headaches only affect one side of the head. They are mostly triggered by stress and last a few minutes or hours.

The symptoms of tension headaches can vary from mild to moderate. You may experience symptoms such as:

  • An aching, dull head pain
  • Scalp, neck, and shoulder muscle tenderness
  • Tight or tender shoulder and neck muscles
  • Pressure across forehead, sides, or back of the head

Most tension headaches can be treated with nonprescription pain relievers and home remedies. In addition, stress management is highly effective in reducing tension headaches. If you experience frequent tension headaches, you should use prescription medications, relaxation therapies, and avoid trigger factors. Making appropriate lifestyle changes can stop tension headaches from recurring.

When to worry?

Most headaches on one side of the head are non-serious. They usually resolve without any medications. However, if the symptoms are severe or chronic, you should seek immediate medical attention to avoid complications and detect the underlying cause, if any.

A headache can be a serious symptom of health conditions like stroke, encephalitis, or brain tumor. You should consult a doctor if you experience these symptoms in conjunction with severe head pain:

  • Fever
  • Blurred or double vision
  • Vision loss
  • Rash
  • Sleeplessness
  • Slurred speech
  • Sleep disturbances
  • Neck stiffness
  • Weakness
  • Pain near temples
  • Increased pain during movements
  • Cognitive changes
  • Numbness
  • Head injury

However, most headaches are not a cause of worry. They usually resolve without the need for medical intervention.

Key takeaways

Headache on the right side of your head is a common health condition– many people experience them on several occasions. In fact, most headaches on the right side of your head are treatable with prescription and over-the-counter medications. But you should see a doctor if your headache persists or becomes worse.

Craniotomy

A craniotomy is a surgical procedure through which the surgeon removes a part of the bone from the skull to access the brain. The surgeon then uses specialised tools to remove the bone flap temporarily and treat the medical condition. Once the condition is treated, the surgeon places the bone flap back to cover the exposed brain.

A craniotomy might be performed to treat a brain tumour, a blood clot in the brain, an aneurysm, a traumatic head injury, swelling in the brain tissue, infection or a foreign object. A craniotomy can be small or large depending on the underlying issue. They also vary in complexity. Small craniotomies are known as burr holes; whereas larger craniotomies are known as keyhole surgeries.

A craniotomy is generally performed with the assistance of stereotactic frames, image-guiders such as MRI, ultrasound, CT scan, etc. Moreover, endoscopes can also be used for assistance.

Typically, burr and keyhole craniotomies are performed to:

Place a shunt into Craniotomy

  • the brain ventricle to flush out the excess cerebrospinal fluid
  • Place a deep brain stimulator
  • Collect a sample tissue for biopsy
  • Guide an endoscope to treat larger issues such as tumour removal
  • Drain a clot in the brain
  • Place an intracranial pressure monitor

That said, complicated skull-based craniotomies, include removing the bone supporting the bottom of the brain.

Types of craniotomy

Some of the common types of craniotomies include:

  • Extended bifrontal procedure
  • Minimally invasive supra-orbital craniotomy
  • Keyhole craniotomy
  • Orbitozygomatic Craniotomy
  • Translabyrinthine Craniotomy

Reasons for craniotomy

A craniotomy can be performed for multiple reasons. Some of the most common purposes of a craniotomy include:

  • Identifying, removing or treating tumours of the brain
  • Repairing an aneurysm
  • Eliminating blood clots or blood from a leaking blood vessel
  • Treating skull fractures
  • Curing epilepsy
  • Draining out the brain abscess
  • Removing malformations and brain fistulas
  • Reducing the pressure in the brain
  • Placing stimulator devices to cure movement issues such as dystonia, Parkinson’s disease and others

However, these are not the only reasons for a craniotomy. A doctor can also suggest a craniotomy for a specific medical case.

Risk of craniotomy

Typically, brain surgery is linked to a specific area in the brain, which will be treated. Thus, the risks and complications are associated with the area that is being treated. Such as, if there is an issue in the part of the brain that controls speech, the complications will be related to speech.

That said, some of the common risks associated with a craniotomy include:

  • Infection
  • Blood clots
  • Pneumonia
  • Bleeding
  • Fluctuating blood pressure
  • Seizures
  • Allergic reaction to anaesthesia
  • Swelling in the brain
  • Leakage of the cerebrospinal fluid
  • Weakness in the muscles

However, the below complications are more specific to a particular issue within the brain. These will apply only to individuals that have the same underlying problem.

  • Problem with memory
  • Difficulty in speech
  • An issue in balancing or coordination
  • Coma
  • Paralysis

The procedure of a craniotomy

Before the procedure, the doctor will ask the patient to sign the consent form and then will conduct a preoperative neurological exam to assess the condition after the craniotomy. The patient will be asked to not eat or drink anything starting the midnight of the procedure. Women who are pregnant or think they might be pregnant, are required to disclose the same to the doctor.

The patient should also disclose any allergies or ongoing medications, as well as health complications. Smokers would be required to quit smoking and also inform about any bleeding disorders. The patient will be given a sedative before the surgery and the place of treatment will be shaved.

During the craniotomy, an intravenous line (IV) line will be placed in the arm or the hand of the patient. After this, the surgeon will make an incision as per the specific issue to be treated. Some craniotomies will involve making an incision from behind the hairline in front of the ear, etc. For procedures that require an endoscope, the incision made will be small.

The surgeon will then pull the scalp up and clip it to control bleeding and access the brain. Then a medical drill will be used to make the required holes in the skull. Post this, the bone flap will be removed and placed aside. Then the thick covering of the brain is removed to access the target area. The surgeon uses microsurgical and special instruments to treat the issue. Once the treatment is done, the surgeon sutures the layers of the brain and places the bone flap back with plates, sutures or wires.

However, in cases, where the bone has a tumour or an infection, the surgeon may not replace the bone flap. The scalp is then sutured or stapled, and a sterile bandage is placed over the incision.

Typically, a craniotomy requires the patient to stay under observation for 3 to 7 days or more depending on the condition of the patient. After the surgery, the recovery process can take 3 to 4 weeks, during which the patient will be directed to follow precautions and take medications, as suggested by the doctor.

However, if the patient experiences any of the following problems after the surgery, immediate medical attention should be sought:

  • Fever
  • Chills
  • Confusion
  • Feeling sleepy all the time
  • Weakness in the arms and legs
  • Problem with speech
  • Changes in vision
  • Pain around the site of the incision
  • Problem in breathing
  • Chest pain
  • Issues in mental health
  • Seizure
  • Discoloured phlegm

Overall, a craniotomy is a very effective procedure, but it has its advantages and disadvantages. The suitability of a craniotomy for a patient is determined by the doctor depending on the underlying issue, general health of the patient and the medical history.

Trigger Finger

Trigger finger or also called the stenosing tenosynovitis is a medical condition in which a finger is stuck in a bent position. The finger can suddenly snap straight or bend drastically, imitating the pulling and releasing of a trigger.

A trigger finger occurs because of inflammation in the finger, which reduces within the sheath, surrounding the tendon of the concerned finger. The condition can be easily treated; however, if the problem is intense, it can lead the finger to become locked in a bent position for a lifetime.

People who are engaged in professions or have hobbies that require them to perform repetitive gripping actions are more prone to developing this condition. A trigger finger is very common in women and people with diabetes. The type of treatment varies per the severity of the condition.

Symptoms of trigger finger

Depending on the case, the symptoms of a trigger finger can range from mild to severe. Some common signs of a trigger finger include:

  • Stiffness in the fingers, especially in the morning after waking up
  • A pop or a click sound or sensation upon the movement of the finger
  • Tenderness at the base of the affected finger
  • A bump in the palm – at the base of the impacted finger
  • Unable to straighten a finger, which is locked in a bent position

Trigger finger can impact any of the five fingers of the hand, including the thumb. Also, it can affect more than one finger at a time and could also include both hands. The condition is usually very severe in the morning hours, typically while attempting to grasp an object or straightening the affected finger.

A person should seek immediate medical attention if the finger feels too hot or is inflamed. This could also indicate a possible infection.

Causes of trigger finger

Tendons of the fingers are cords that link the muscle of the fingers to the bones. Each tendon is covered by a protective layer, known as a sheath. A trigger finger occurs when this protective layer of the tendon is inflamed or irritated due to any reason. The problem disturbs the usual gliding of the tendon through the sheath and tends to cause pain, bending of the finger, stiffness, etc.

If the problem persists for a long period, it can lead to scarring, thickening, and development of bumps in the tendon, which will further aggravate the issue.

Risk factors of trigger finger

Some people are at a higher risk of developing trigger finger condition. However, the problem can occur in people of all ages and gender. Some risk factors include:

  • Occupations and hobbies that require regular gripping, repeated use of hands, and extensive pressure on the fingers can increase the chances of the person developing a trigger finger.
  • Trigger finger is a common issue in women. Men are less prone to this medical condition.
  • Trigger finger can also occur as a complication of the carpal tunnel syndrome surgery, especially in the first six months post the surgery.
  • People suffering from rheumatoid arthritis are at a higher risk of developing the issue.

Diagnosis of trigger finger

The doctor does not need extensive testing or diagnostic exams to detect a trigger finger. The healthcare provider can conduct an assessment based on the medical history and the physical exam. In the physical exam, the patient would be required to move the finger, bend and straighten the affected joint to identify areas of pain, the stiffness, smoothness in movements and the existence of locking.

The doctor will also apply pressure on the palm to check for a lump. If there is a lump present in the palm, it will move along with the finger since it develops in the swollen area of the tendon.

Treatment of trigger finger

Trigger finger can be easily treated provided it receives the care in due time. The type of treatment depends on the severity and duration of the problem. Some methods used to treat trigger finger include:

Therapy: Non-invasive method such as therapy can be used to treat the trigger finger condition. These include:

  • Resting the affected area and avoiding activities that involve repeated gripping, grasping or extended use of machinery that sends out vibrations.
  • The doctor can also advise wearing a splint to support the affected finger to stay in an extended position for six weeks.
  • Exercising as suggested by the doctor to restore mobility of the finger.

Steroid injection: This involves treating the affected finger or the tendon directly withsteroid medication to minimize swelling, allowing the tendon to glide smoothly like before. However, this treatment lasts for one year or slightly more in some cases. After which, a repeat procedure may be required if symptoms appear again. In the case of people with diabetes, steroid injections are not that useful.

Percutaneous release: In this method of treatment, the doctor numbs the affected palm and then inserts a strong needle into the tissue surrounding the tendon of the affected finger. The doctor then moves the finger and the needle to remove the blockage that constricts the smooth gliding of the tendon. This procedure is performed under the ultrasound guidance to help reach the right tendon, without harming the surrounding tendon sheaths.

Surgery: In most severe cases of tendon finger, the doctor can also recommend surgery to treat the condition. In this, the healthcare provider makes a small incision at the base of the affected finger to open the affected area of the tendon sheath. The constricted part is then relieved, allowing the tendon to glide smoothly.

Overall, a trigger finger is an uncommon condition but can be treated easily, if it occurs. Only in very severe and rare cases, does a patient need an invasive method such as surgery.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a medical condition caused because of compression of the median nerve in the hand. This median nerve is located on the palm side, called the carpal tunnel, and is basically responsible for delivering sensation to the thumb, index finger, long finger, and a portion of the ring finger. The median nerve provides an impulse to the muscles leading to the thumb. Since the syndrome affects the carpal tunnel (palm), it is referred to as carpal tunnel syndrome.

The problem can affect both hands. It can lead to swelling in the wrists which can further cause compression in the carpal tunnel. The problem causes weakness, numbness, and tingling on the part on the side of the thumb.

Causes of carpal tunnel syndrome

Excessive pressure on the wrist or the carpal tunnel can cause pain in the affected area. The inflammation can lead to swelling. It typically occurs due to an underlying condition, which causes swelling in the wrist, and also restricts the blood flow. Some common medical conditions that could potentially lead to a carpal tunnel syndrome include:

  • High blood glucose levels
  • Thyroid dysfunction
  • Retention of fluid due to pregnancy or menopause
  • High blood pressure
  • Autoimmune issues
  • Trauma or injury to the wrist
  • Fracture of the wrist

The condition can worsen if the patient does not seek treatment and continues to extend the wrist repeatedly. Recurring wrist motions cause swelling and compression of the median nerve due to the below causes:

  • Incorrect positioning of the wrists while using keyboards and mouse
  • Extended contact with vibrations from hand and power tools
  • Particular repeated motions that overextend the wrist, such as playing the piano, typing on the laptop, etc.

Risk of carpal tunnel syndrome

Some aspects that put a person more at risk for developing this syndrome than others, include:

  • Gender; women are three times more prone to this issue than men
  • Men and women between the ages of 30-60 years
  • Specific medical conditions, such as high blood pressure, arthritis, diabetes, etc.
  • Lifestyle aspects such as smoking, laidback physical attitude, high body mass index (BMI), high salt intake, etc.

Certain 

  • occupations, including manufacturing jobs, assembly link work, construction work, and other professions that require excessive keyboard usage

Symptoms of carpal tunnel syndrome

The symptoms of carpal tunnel syndrome tend to appear in the nerve path due to the compression of the median nerve. Some common symptoms that can point towards a possible problem include:

  • Frequent sleeping of the hand and losing control of motion
  • Pain and numbness that moves up the arm
  • Wrist pain which hampers sleep at night
  • Weakened muscles of the hand

Diagnosis of carpal tunnel syndrome

A doctor can use all or any of these methods to diagnose carpal tunnel syndrome in a patient. These include:

  • A physical examination by extending pressure on the impacted area and checking the pain in different motions. The doctor will assess any signs of swelling, deformity, etc.
  • Medical history of the patient
  • Nerve conduction studies

In a general physical exam, the doctor checks the neck, wrist, shoulder, etc to detect any other reason for the pressure caused on the nerve. The doctor will also check the strength of the hand muscles and sensations to the fingers.

On the other hand, in a nerve study, the test provides a measurement of the conduction speed of the nerve impulses. If the nerve impulse moves slower than normal, the person may have carpal tunnel syndrome.

Treatment of carpal tunnel syndrome

The type of treatment for this condition depends on the pain and symptoms, as well as the intensity of weakness. In most cases, the condition can be treated with non-invasive techniques such as below:

  • Avoiding overextending the wrists in positions
  • Wearing wrist splints that help the hand to stay in place, even at night
  • Taking pain-relieving medication
  • Taking medications to reduce swelling
  • Treating underlying conditions such as diabetes, high blood pressure, etc.
  • Taking steroid injections in the carpal tunnel area to minimize swelling

On the other hand, surgery may be required if there is serious damage to the median nerve. The surgery to treat carpal tunnel syndrome involves removing the tissue band that crosses the median nerve to reduce the pressure on the nerve. However, the effectiveness of carpal tunnel syndrome surgery depends on the duration of the symptom, intensity of the problem, diabetes mellitus, weakness in the area, etc.

In the long-term, treating carpal tunnel syndrome with lifestyle modifications and therapy can provide relief from pain and even improve long-term symptoms. However, if the condition is left untreated, it can cause permanent nerve damage, disability, and loss of hand function.

BRAIN TUMOUR SURGERY: OVERVIEW

BRAIN TUMOUR SURGERY: OVERVIEW

A brain tumour is characterized by an abnormal mass or growth of cells in the brain. While some tumours may be benign and non-cancerous, there are others which are significantly malignant and cancerous. Basically, there are two types of brain tumours – one that originates in the brain and are called primary tumours; and second are the ones that begin in any other part of the body but spread to the brain – these types of tumours are called secondary metastatic brain tumours. However, the intensity of the condition depends on the type of tumour, the location and the rate of growth. These options also determine the course of treatment for a brain tumour.

Diagnosis of Brain Tumour

Based on symptoms per case, the doctor might suggest a few diagnostic procedures to study the conditions. The diagnosis methods for brain tumour include:

  • Neurological exam
  • Imaging tests
  • CT or PET scan
  • Biopsy
  • MRI scanning

Post diagnosis, depending on the size, location and growth of the tumour – the doctor will suggest a treatment method including surgery, radiation therapy, radiosurgery, chemotherapy and targeted drug therapy. However, in most cases, surgery is the primary mode of treatment of brain tumour.

Brain Tumour Surgery

A brain tumour surgery might appear as a frightening procedure, but it is the most effective method to treat brain tumours while causing minimal damage. Brain tumour surgery is primarily used in treating malign tumours and in the case of malignant tumours – are used in combination with other treatment options such as radiation and chemotherapy. The basic goals of brain tumour surgery include:

  • Remove all or most of the tumour
  • Relieve symptoms caused by the tumour and enhance the quality of life
  • Relieve the intracranial pressure created by the tumour
  • Remove a part of the tumour to slow the growth
  • Drain any build-up of fluid in the brain
  • Make other treatments such as chemotherapy accessible
  • Help diagnose a brain tumour

The type of surgery and surgical method varies per case. However, brain tumour surgery is performed only when the tumour is located in a place which is accessible easily. The basic surgery is performed to remove as much of the tumour as possible and relieve symptoms. This type of brain tumour surgery is called Craniotomy. ‘Crani’ implying skull and ‘otomy’ meaning cutting into; therefore a craniotomy involves cutting into the skull to remove the tumour.

The doctor will perform several tests before the surgery and would restrict all non-steroidal anti-inflammatory medicines, as well as blood thinners. Other lifestyle habits such as tobacco, alcohol, smoking, etc. also will be restricted. During the night before the surgery, the patient is asked to avoid eating or drinking anything.

A craniotomy is performed while keeping the patient under the influence of general anaesthesia. Then a portion of the scalp is shaved to make an incision to enter the skull and remove a piece of bone to access the area of the brain over the tumour. The surgeon opens the outermost layer of the brain tissue, locates the tumour and then removes/resects it. Once, the tumour is removed, the surgeon replaces the part of the brain or bone; this is called a flap which is secured with small metal brackets. Once, this is replaced, the surgeon stitches the scalp.

In a conventional craniotomy, the surgeon relied on pre-operative scans and their knowledge of anatomy to locate and treat the tumour. However, in stereotactic surgery, the surgeon relies on a computer to locate the tumour and guide them to it. A craniotomy involves using different tools to remove the tumour, such as:

  • A scalpel
  • An ultrasound to shrink the size of the tumour and then remove it through a suction process
  • A microscope to differentiate between healthy cells and tumour
  • A blue fluorescent light which enables the surgeon to clearly see the edges of the tumour

Craniotomies differ in size and complexity. In some cases, the surgeon may perform an awake craniotomy where the lesion is very close to a critical area of the brain such as speech. In this surgery, the patient is asleep till the bone opening but is awakened later to help the surgeon precisely map areas of risk. The patient is asked to read, talk or move a part of the body, while a probe is placed on the brain surface to detect the area correctly. This process is also called, Brain Mapping and helps to identify sensitive areas of the brain which need to be avoided and protected.

In some cases, the tumours are small and thus, can be easily removed from the brain tissue. But in many other cases, it is very difficult to separate the tumour from the surrounding tissue or they tend to be located in sensitive areas of the brain – which makes the surgery risky and complicated. In the latter case, the surgeon aims to remove as much a part of the tumour which is not risky and is relatively safe. Even removing a portion of the brain tumour helps to relieve symptoms. However, like other surgeries, even brain tumour surgery has risks associated with it.

Risks of a Brain Tumour Surgery

Some of the common risks linked to brain surgery, specifically a craniotomy include:

  • Bleeding
  • Infection
  • Blood clots
  • Anaesthesia reactions
  • Stroke
  • Seizures
  • Swelling of the brain
  • Nerve damage
  • CSF leak
  • Loss of some mental functions

Overall, a brain tumour surgery is highly effective and often the primary course of treatment; though the recovery period may extend up to 8 weeks with several follow-up appointments.

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