Victims prayed for relief from Asclepius, the god of medicine.

患者向醫神阿斯克勒庇俄斯祈求減輕痛苦

And if pain continued,

如果痛苦持續不斷

a medical practitioner would perform the best-known remedy—

醫生就會執行一個眾所皆知的療法

drilling a small hole in the skull to drain supposedly infected blood.

在腦袋鑽個小洞，讓那些可能被感染的血液流出

This dire technique, called trepanation,

這個可怕的技術，稱為環鋸術

often replaced the headache with a more permanent condition.

經常使患者得到其他永久性的傷害

Fortunately, doctors today don't resort to power tools to cure headaches.

幸好現今的醫生不會使用電動工具來治療頭痛

But we still have a lot to learn about this ancient ailment.

但我們對這古老的疾病還是有許多東西要了解

Today, we've classified headaches into two camps—

現在，我們將頭痛分成兩大類

primary headaches

原發性頭痛

and secondary headaches.

跟次發性頭痛

The former are not symptomatic of an underlying disease, injury, or condition;

前者不是一種潛在的疾病、傷害或身體狀況的徵兆

they are the condition.

它們本身就是種身體狀況

But we'll come back to them in a minute

但我們待會再回來討論它

because while primary headaches account for 50% of reported cases,

因為雖然在有記錄的案例中，原發性頭痛佔了 50%

we actually know much more about secondary headaches.

實際上我們對次發性頭痛有更多認識

These are caused by other health problems,

這些是因為其他健康問題而引起的

with triggers ranging from dehydration and caffeine withdrawal

觸發原因從脫水、咖啡因戒斷

to head and neck injury,

到頭部與頸部損傷

and heart disease.

以及心臟病

Doctors have classified over 150 diagnosable types,

醫生已歸類出超過 150 種可診斷的類型

all with different potential causes, symptoms, and treatments.

全都有潛在發生原因、症狀與療法

But we'll take just one common case —a sinus infection—as an example.

但我們就先以最常見的案例來說明，鼻竇炎

The sinuses are a system of cavities

鼻竇是鼻腔周圍的系統

that spread behind our foreheads, noses, and upper cheeks.

遍布於我們的前額、鼻子與顴骨

When our sinuses are infected,

當我們的鼻竇受感染

our immune response heats up the area,

我們的免疫系統會提升這個區域的溫度

roasting the bacteria and inflaming the cavities well past their usual size.

熱死這裡的細菌，使這些腔室發炎、腫大

The engorged sinuses put pressure on the cranial arteries and veins,

充血的鼻竇對顱部動脈與靜脈加壓

as well as muscles in the neck and head.

還有頭部跟頸部肌肉

Their pain receptors, called nociceptors, trigger in response,

它們的痛覺受器，稱為傷害感受器，被觸發並進行回應

cueing the brain to release a flood of neuropeptides

提醒腦部釋放大量神經肽

that inflame the cranial blood vessels, swelling and heating up the head.

使得頭部血管發炎、腫大，也使頭部升溫

This discomfort, paired with hyper-sensitive head muscles,

這樣的不適感，加上頭部肌肉屬於高度敏感肌肉

creates the sore, throbbing pain of a headache.

造成痛苦、頭部抽痛

Not all headache pain comes from swelling.

並非所有頭痛都來自組織腫大

Tense muscles and inflamed, sensitive nerves

繃緊的肌肉與發炎的、敏感的神經

cause varying degrees of discomfort in each headache.

會對每次頭痛造成不同程度的不適感

But all cases are reactions to some cranial irritant.

但全部案例都是對某些頭部刺激產生反應

While the cause is clear in secondary headaches,

雖然次發性頭痛的起因很清楚了

the origins of primary headaches remain unknown.

原發性頭痛的起因還是個未知數

Scientists are still investigating potential triggers for the three types of primary headaches:

科學家還在調查三種原發性頭痛潛在的觸發原因：

recurring, long-lasting migraines;

持續性偏頭痛

intensely painful, rapid-fire cluster headaches;

叢集性頭痛

and, most common of all, the tension headache.

以及最常見的，緊縮型頭痛

As the name suggests,

如字面所說

tension headaches are known for creating the sensation of a tight band squeezed around the head.

緊縮型頭痛的由來，是因為就像有條帶子在頭上束緊的感覺

These headaches increase the tenderness of the pericranial muscles,

這些頭痛增加顱骨骨膜肌肉的敏感性

which then painfully pulse with blood and oxygen.

會隨著發送血液與氧氣的脈衝引起疼痛

Patients report stress, dehydration, and hormone changes as triggers,

病人轉述壓力、脫水與荷爾蒙變化是為起因

but these don't fit the symptoms quite right.

但這些症狀的描述並不完全準確

For example, in dehydration headaches,

例如脫水導致的頭痛

the frontal lobe actually shrinks away from the skull,

實際上額葉會有點萎縮

creating forehead swelling

造成前額腫起

that doesn't match the location of the pain in tension headaches.

這跟緊縮型頭痛的痛點不同

Scientists have theories for what the actual cause is,

科學家對於真正的起因有些推測

ranging from spasming blood vessels

從血管痙攣

to overly sensitive nociceptors,

到過度敏感的傷害感受器

but no one knows for sure.

但沒人敢肯定

Meanwhile, most headache research is focused on more severe primary headaches.

同時，大多數頭痛研究著重在更嚴重的原發性頭痛

Migraines are recurring headaches, which create a vise-like sensation on the skull

偏頭痛是種不斷復發的頭痛，就像有個虎頭鉗夾住頭部的感覺

that can last from four hours to three days.

可以持續四小時至三天

In 20% of cases, these attacks are intense enough to overload the brain with electrical energy,

在 20% 的病例中，這樣疼痛造成的電流足以使腦袋超載

which hyper-excites sensory nerve endings.

高度刺激感官神經末梢

This produces hallucinations called auras,

這會產生幻覺，稱為先兆

which can include seeing flashing lights

包括看見閃爍光線

and geometric patterns and experiencing tingling sensations.

幾何圖案，以及經歷刺痛的感覺

Cluster headaches, another primary headache type,

叢集性頭痛，另一種原發性頭痛類型

cause burning, stabbing bursts of pain behind one eye,

在單眼產生灼燒感、戳刺般劇痛

leading to a red eye, constricted pupil, and drooping eyelid.

導致眼睛充血、瞳孔縮小、眼瞼下垂

What can be done about these conditions, which dramatically affect many people's quality of life?

碰到這些嚴重影響生活品質的狀況，大家能做些什麼？

Tension headaches and most secondary cases

緊縮型頭痛與其他大多數次發性頭痛案例

can be treated with over-the-counter pain medications,

可以吃頭痛成藥治療

such as anti-inflammatory drugs that reduce cranial swelling.

像是消炎藥可以減少頭部腫脹

And many secondary headache triggers,

許多次發性頭痛的起因

like dehydration,

像脫水

eye strain,

用眼過度

and stress,

以及壓力

can be proactively avoided.

都能主動預防

Migraines and cluster headaches are more complicated,

偏頭痛跟叢集性頭痛則複雜多了

and we haven't yet discovered reliable treatments that work for everyone.

我們還沒發現對每個人都有效的可靠療法

But thankfully, pharmacologists and neurologists are hard at work

但謝天謝地，藥理學家與神經學家都很努力

cracking these pressing mysteries that weigh so heavily on our minds.

破解我們腦中神秘且沉重的壓力