4 Referral. Refer patient to a physician if the headache increases
in severity, or lasts longer than 24 hours. If a patient has no history of high blood
pressure, refer him to a physician.
(d) Muscle tension headache. These headaches involve contraction of
the muscles of the neck, head, and shoulders causing fatigue and pain.
1 Etiology. Tension and emotional stress contribute greatly
towards these headaches. Pain results from constricted blood vessels in the head that
cause pressure on the walls of the blood vessels (dilated blood vessels in the brain).
2 Signs and symptoms.
a Pain is usually steady, over temples with feeling often stated
"a vise is over the back of my head."
b Unilateral or bilateral, often suboccipital by referring pain to
frontal region of face.
c Moderate pain in the front or back of the head, accompanied
by tight muscles in the neck or scalp.
d Throbbing pain all over the head.
Persistent headaches may be a sign of pending combat stress reaction in
3 Associated causes.
b Tension-producing strain on muscles of neck, scalp, face,
d Anxiety, depression.
e Low blood sugar.
g An environment that is noisy, stuffy, hot, poorly lit, or has