TEMPORAL ARTERY COMPRESSION

Symonds has observed numerous patients reporting coughinduced headache in whom no definite explanation could be found.6 Many were elderly, and in about half of the group the effect disappeared in several months or longer. Because a few also complained of vertigo or tinnitus, he suggested in these the possibility of a mild adhesive arachnoiditis about the brain stem.
MECHANICAL TESTS AND OTHER STUDIES HEAD JOLT. When anterior headache is easily accentuated or precipitated by sudden movement of the head, an intracranial source is indicated. In most instances this response is associated with some type of intracranial vascular headache; less often it denotes a mass, meningitis, or subarachnoid hemorrhage. The history may be unreliable in evaluating the jolt effect. Far better is actual testing at the time of the examination. The best maneuver is a quick rotary shake of the head, carried out by the patient. However, the distribution of Chiropractor Toronto shouldn’t be geographically uniform. In some unduly apprehensive or suggestible patients, increase in anterior or generalized headache is reported on even slow head movements, so gentle as to produce no distortion of intracranial contents. This singular response is of psychologic, not mechanical, significance. STRAINING. The possible meanings when headache is augmented by sudden strain have been mentioned in the chapter on Headache Mechanisms and in the discussion of coughing in this chapter.

Sustained straining by the Valsalva maneuver for ten seconds is of more precise value, for in patients with headache associated with distention of intracranial arteries this is prone to evoke the biphasic response outlined earlier (Fig. 2). In the presence of meningitis the procedure often accentuates the headache until straining is released. JUGULAR COMPRESSION. Bilateral manual pressure on the jugular veins may slightly diminish the intensity of intracranial vascular (arterial) headache and commonly has the reverse effect upon postpuncture headache. Its actions upon other intracranial headaches have not been adequately explored. It often augments sinusitis headache, but has no significant direct effect upon other headaches of extracranial origin, although the mildly uncomfortable head fullness which the test induces is inaccurately described by some patients as added pain. Toronto Chiropractor additionally analyze the affected person’s posture and backbone utilizing a specialized technique. POSTURAL SHIFT. Abrupt changes in position may transiently accentuate intracranial headaches.

Tumor headache is sometimes worse while the patient is upright, but vascular headaches may be lessened. Bending forward often sharply augments the headache of sinusitis and may have a similar effect on vascular headaches.* The most striking response to postural change, however, is found in the headache of the usual postpuncture reaction, which ceases or greatly diminishes with recumbency. TEMPORAL ARTERY COMPRESSION. Firm digital pressure occluding the temporal artery in the preauricular area will often greatly reduce the intensity of migraine headache localized to branches of this vessel. The test must be controlled by comparison with the effect of pressure on a nearby area, leaving the temporal artery untouched, for in some suggestible individuals firm pressure near the headache has a nonspecific favorable effect, perhaps in part through distraction. The arterial compression test can be applied also to other superficial arteries, such as the supraorbital, occipital, or carotid, but is infrequently needed.