Causes of Headache

Intracranial:

1. Meningeal: Meningitis
2. Vascular: Intracranial aneurysm, malignant hypertension, subarachnoid hemorrhage
3. Skeletal: Metastasis, Paget’s disease, etc.
4. Space occupying lesion: Subdural hematoma, tumors, granulomas, abscess
5. Post lumbar puncture

Extracranial:

1. Vascular: Migraine, cluster headache, temporal arteritis, etc.
2. Skeletal: Paget’s disease, torticollis, etc.
3. Referred pain: Sinusitis, eye strain, glaucoma, aural, etc.

Miscellaneous:

Psychogenic, post traumatic, alcohol, nitrates, monosodium glutamate ingestion etc.

Common Urinary Problems and Their Causes

Frequency of Micturition and Nocturia

1. Bladder: Cystitis, small contracted bladder, tumors, vesicular calculus, cystocele.
2. Bladder neck: Incomplete evacuation due to enlarged prostrate or stricture of urethra, incompetent internal urethral sphincter, ectopic ureter.
3. Urethra: Urethritis, neoplasms, balanitis, stricture of urethra, pinhole meatus, phimosis.
4. Miscellaneous: Polyuria, psychogenic, pregnancy, pressure from surrounding structures.

Hesitancy and Precipitancy of Urine

1. Cerebral: Cerebrovascular accidents, cerebral tumors, head injuries, etc.
2. Urinary tract disease: Enlarged prostate, bladder neck obstruction.

Anuria or Absence of Urine

1. Renal: Glomerulonephritis, pyelonephritis, polycystic kidney, chronic renal failure, nephrotoxic drugs, SLE etc.
2. Pre-renal: Diarrhea and vomiting, burns, blood loss, hypotension, septicemia, intravascular hemolysis, etc.
3. Obstructive: Calculi in kidney or urinary tract, blockage of ureters by malignancy or crystals, retroperitoneal fibrosis, accidental ligation during surgery, etc.

Retention of Urine

1. Neurological: Spinal cord diseases (Transverse and compression myelitis), cauda equina lesions, multiple sclerosis.
2. Genito-urinary
   • Penis: Phimosis
   • Urethra: Posterior urethral valves, foreign body, stones, stricture, rupture, spasm of the sphincter, etc.
   • Prostatic enlargement
   • Bladder: Atony, tumor, stone, or compression by fibroids or retroverted uterus.
   • Following parturition
3. Drugs: Sympathomimetic agents, salbutamol, terbutaline, anti-cholinergic drugs, etc.
4. Functional

Diseases That Cause Dysphagia or Difficulty in Swallowing

Dysphagia is difficulty in swallowing. It is a symptom and not a disease in itself. It is a pointer to some underlying disease. Following diseases/conditions can lead to dysphagia

Esophagitis: An inflammation in the esophagus can lead to pain on swallowing.

Esophageal webs: Esophageal webs are thin (2-3mm) membranes of normal esophageal tissue consisting of mucosa and submucosa. They can be congenital or acquired.

Esophageal Strictures: Narrrowing of esophagus can lead to this problem

Esophagal Tumors

Achalasia Cardia: Achalasia Cardia is a primary oesophageal motility disorder, characterised by a hypertensive lower oesophageal sphincter (LOS) which fails to relax.

Esophagel Spasm

Hiatus Hernia

Chagas’ disease:Chagas’ disease (also called American trypanosomiasis) is a human tropical parasitic disease which occurs in the Americas

Scleroderma

Radiation

Pharyngeal & Laryngeal Lesions

External compression: Cervical spondylitis, retropharyngeal abscess, goiter, enlarged left atrium, aneurysm.

Neurological: Bulbar palsy, polyneuropathy, motor neuron disease, myopathies, myasthenia, dermatomyositis.