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Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years. Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years.Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years. When they occur, he experiences intense burning pain on one side of his head, tearing in his eye, congestion and a runny nose. These headaches generally occur several times a day and last approximately one hour. The headaches are episodic; Bob can be headache free for several months but then experience an attack.1. Based on the case scenario, provide a diagnosis for Bob. Provide the pathophysiology for this type of headache and discuss current treatment options.ORDER A PLAGIARISM-FREE PAPER HEREPathophysiology: Cluster HeadacheCluster HeadacheDiagnosisThe type of a headache presented in the case scenario is a cluster headache. Cluster headache is a primary type of a headache. A cluster headache occurs at one of the head and is accompanied by tearing or reddening of the eye in the affected side and congestion or running of the same side. Similarly, Mr. Bob in the case scenario presents with same characteristic pain, and exhibits two ipsilateral signs and symptoms. In addition, cluster headache is burning in nature, may occur once to twice a day, often lasting for less than three hours and occurs in bouts for several months. Likewise, in the case presented the patient experiences a headache once per day and lasts one hour, characteristics that are consistent with the diagnostic criteria for a cluster headache. A cluster headache occurs in episodes and is chronic, thus relapses after several years. A cluster headache is common between the ages of 20 and 40 years and more prevalent in men than women and Mr. Bob is 38 years old, falling in the most affected age group (Silberstein, 2016).Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years.Pathophysiology The pathophysiology of a cluster headache involves mechanisms of stimulation of the trigeminal nerve and peripheral nervous system, vascular dilatation release of histamine, circadian disturbances, and genetic inheritance. In cluster headache, there is abnormal trigeminal –facial circuit activity with the activation of the hypothalamus and autonomic nervous manifestations including lacrimation and nasal congestion. Additionally, the peripheral nervous system activation leads to the lacrimation and increase in mucous secretion. Vascular dilation after the exposure to potent vasodilators, for example, alcohol, involving extracranial and intracranial blood vessels leads to a headache. Cluster headache is also genetically inherited as an autosomal dominant condition. Disturbance in the circadian cycle contributes since cluster headache occurs mostly during sleep (Silberstein, 2016).Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years.Treatment Triptans are used for acute treatment and cause vasodilation of brain blood vessels by agonizing serotonin receptors. Verapamil and lithium are used for the treatment of a chronic headache. Surgical ocular nerve stimulation is applied where the conventional treatment is not effective (Robbins, Starling, Pringsheim, Becker, & Schwedt, 2016). ReferencesRobbins, M. S., Starling, A. J., Pringsheim, T. M., Becker, W. J., & Schwedt, T. J. (2016). Treatment of cluster headache: The American Headache Society evidence‐based guidelines. Headache: The Journal of Head and Face Pain, 56(7), 1093-1106.Silberstein, S. D. (2016). The American Headache Society Cluster Guidelines.Headache: The Journal of Head and Face Pain, 56(7), 1091-1092. Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years.
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