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造成头疼的原因有哪些?

What causes headaches? - Dan Kwartler

在古希腊 头痛被认为是巨大的折磨
In ancient Greece, headaches wereconsidered powerful afflictions.
患者会向医术之神”阿斯克勒庇俄斯”处祈求病痛得到缓解
Victims prayed for relief from Asclepius,the god of medicine.
如果疼痛仍继续
And if pain continued,
医生会做这个最著名的治疗方法
a medical practitioner would perform the best-known remedy—
在脑壳上钻一个小洞 让被认为是感染的血液流出来
drilling a small hole in the skull to drain supposedly infected blood.
这项叫作”环锯术”的可怕的技术
This dire technique, called trepanation,
常常引起比头痛很更严重的情况 幸运的是
often replaced the headachewith a more permanent condition. Fortunately,
现在的医生不会使用电力工具来治头痛
doctors today don’t resortto power tools to cure headaches.
但是我们仍然需要了解这个古老的疾病
But we still have a lot to learn about this ancient ailment. Today,
今天 我们已经把头痛分为两大类
we’ve classified headachesinto two camps—
原发性头痛和继发性头痛
primary headaches and secondary headaches.
前者是没有任何潜在的疾病 损伤
The former are not symptomatic of an underlying disease, injury,
或病症
or condition;
而仅有症状
they are the condition.
不过我们稍后再讨论原发性头痛
But we ’ ll come back to them in a minute
尽管它也占实际报道案例的50%
because while primary headaches account for 50 % of reported cases,
但是我们实际上还是对继发性头痛更加了解
we actually know much moreabout secondary headaches.
它们一般是由其他的健康问题导致的
These are caused by other health problems,
从身体脱水 咖啡因撤退 到
with triggers rangingfrom dehydration and caffeine withdrawal
头部和颈部的损伤 以及心脏病 都可能引发继发性头痛
to head and neck injury, and heart disease.
医生已经分出了150多种诊断类型
Doctors have classifiedover 150 diagnosable types,
都有不同的潜在病因 症状 和治疗
all with different potential causes,symptoms, and treatments.
不过我们只用一个常见的案例”鼻窦感染”来举例
But we ’ ll take just one common case —a sinus infection—as an example.
鼻窦是一个窦腔系统
The sinuses are a system of cavities
它从我们的前额、鼻子和上脸颊处向后延伸
that spread behindour foreheads, noses, and upper cheeks.
当我们的鼻窦被感染的时候
When our sinuses are infected,
我们的免疫反应会使这个区域发热
our immune response heats up the area,
用来烘烤细菌 然后让鼻腔过热后比平常更大
roasting the bacteria and inflaming the cavities well past their usual size.
充血的鼻窦会压迫颅内动脉和静脉血管
The engorged sinuses put pressureon the cranial arteri es and veins,
以及头部和颈部的肌肉
as well as muscles in the neck and head.
之后痛觉感应器 也叫伤害感受器 会做出反应
Their pain receptors, called nociceptors,trigger in response,
给大脑提出指示 释放大量神经多肽
cueing the brain to release a floodof neuropeptides
这些神经多肽会刺激脑血管 使头部肿胀和发热
that inflame the cranial blood vessels, swelling and heating up the head.
这种不适 再加上脑部肌肉的高度敏感
This discomfort,paired with hyper-sensitive head muscles,
会造成头部的抽动性疼痛
creates the sore,throbbing pain of a headache.
并不是所有的头痛都是由于肿胀
Not all headache pain comes from swelling.
紧张的肌肉和敏感 多热的神经
Tense muscles and inflamed,sensitive nerves
都会造成不同程度的头痛
cause varying degreesof discomfort in each headache.
但是所有的都是对脑内刺激的反应
But all cases are reactionsto some cranial irritant.
尽管继发性头痛的原因已经非常明确了
While the cause is clearin secondary headaches,
但是原发性头痛的原因仍未可知
the origins of primary headachesremain unknown.
科学家们也在不断研究原发性头痛的潜在病因
Scientists are still investigatingpotential triggers
它一共有三种类型 分别是:
for the three types of primary headaches: recurring
复发性 持久性偏头痛
long-lasting migraines;
突发急促性剧烈疼痛 以及
intensely painful,rapid-fire cluster headaches; and,
最常见的 紧张性头痛
most common of all,the tension headache.
顾名思义
As the name suggests,
紧张性头痛会产生一种
tension headaches are known for creating the sensation
头部周围被绑带紧固住的感觉
of a tight band squeezed around the head.
头痛会增加头部周围肌肉的柔韧性
These headaches increase the tenderness ofthe pericranial muscles,
然后肌肉会和血氧一起痛苦地跳动
which then painfully pulsewith blood and oxygen.
病人们反应说 压力 身体脱水 还有激素的变化会引发头疼
Patients report stress, dehydration,and hormone changes as triggers,
但是这些和病症并不完全相符
but these don’t fitthe symptoms quite right.
例如 在脱水导致的头疼中
For example, in dehydration headaches,
大额脑叶实际上会收缩 远离头盖骨
the frontal lobe actuallyshrinks away from the skull,
造成前额肿胀
creating forehead swelling that doesn ’ t match the location
这个位置和紧张性头痛的疼痛位置不匹配
of the pain in tension headaches.
科学家已经研究发现
Scientists have theoriesfor what the actual cause is,
从血管痉挛到痛觉感受器过度敏感
ranging from spasming blood vessels
都可能导致原发性头痛
to overly sensitive nociceptors,
但同时也没有人非常确定
but no one knows for sure. Meanwhile,
大多对原发性头痛的研究主要集中于比较严重的情况
most headache research isfocused on more severe primary headaches.
偏头痛是复发性头痛
Migraines are recurring headaches,
它会产生一种类似于头部被夹住的感觉
which create a vise-like sensation on the skull
并且可能会持续4个小时到3天
that can last from four hoursto three days.
在20%的病例中
In 20% of cases, these attacks areintense enough
这些攻击强度足以使大脑的电能超负荷
to overload the brainwith electrical energy,
从而刺激感觉神经末梢
which hyper-excites sensory nerve endings.
这会让人产生幻觉
This produces hallucinations called auras,
包括看到闪光和
which can include seeing flashing lights
3D图形 还有刺痛的感觉
and geometric patternsand experiencing tingling sensations.
另一个原发性头痛是 丛集性头痛
Cluster headaches,another primary headache type,
它会造成眼部的灼伤 刺痛感
cause burning, stabbing burstsof pain behind one eye,
导致眼睛红肿 瞳孔缩小 眼睑下垂
leading to a red eye, constricted pupil,and drooping eyelid.
针对这些非常影响我们生活质量的状况
What can be done about these conditions,
我们能做什么呢
which dramatically affectmany people’s quality of life?
紧张性头痛和大部分的继发性头痛
Tension headaches and most secondary cases
可以用非处方止痛药物来治疗
can be treated withover-the-counter pain medications,
比如可以消肿的抗炎药
such as anti-inflammatory drugsthat reduce cranial swelling.
很多造成继发性头痛的因素
And many secondary headache triggers,
比如身体脱水 眼疲劳 压力大 我们都能主动避免
like dehydration, eye strain, and stress, can be proactively avoided.
偏头痛和丛集性头痛要更复杂一些
Migraines and cluster headachesare more complicated,
目前我们还没有找到对大家都有效的治疗方案
and we haven’t yet discovered reliabletreatments that work for everyone.
不过值得庆幸的是 药理学家和神经学家们
But thankfully, pharmacologistsand neurologists are hard at work
都在努力想办法去揭开造成我们头脑如此沉重的秘密
cracking these pressing mysteriesthat weigh so heavily on our minds.

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视频概述

介绍了导致原发性头疼和继发性头痛的原因

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收集自网络

翻译译者

ID385818

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视频来源

https://www.youtube.com/watch?v=KpHP8VmxnBo

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