Observations on headache as a symptom in high blood pressure: with special reference to diastolic hypertension
1. The literature on the causes of headache and the aetiology,, classification and pathological effects of hypertension have been briefly reviewed.2. Clinical observations have been made on eighty - two patients suffering from many types of diastolic hypertension (48 cases) and systolic hyper- tension (34 cases).3. The results of these observations have been analysed and the incidence and severity of the headache have been correlated with the pathological changes and clinical findings at the time of examination.4. The degree of acidaemia of patients with cardiac failure during waking hours and at the time of wakening have been compared with a control series.5. An attempt has been made to explain the mechanism of headache in these cases based upon clinical examination together with the known experimental findings of other workers.6. A purely vascular mechanism for the headache is suggested in these cases.7. The basis of this headache is cerebral vaso- dilatation. This may result from the many causes of a cidaemia, from traction on the vessel, from excess gonadtrophines and from direct irritation. The precipitating factor is a sudden over -distension of these dilated vessels caused by a sudden movement of the head, sudden exertion, or sudden increase in cardiac output.8. The significance, prognosis and mode of relief in these cases are discussed.