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1.
Chapter 4 of the International Classification of Headaches contains a group of clinically very heterogeneous primary headache forms. Little is known about the pathogenesis of these headache types and therapy is usually based on isolated case reports and uncontrolled studies. The forms include primary stabbing headache, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, hemicrania continua and the new daily persistent headache. Some of these headache forms may be of a symptomatic nature and require careful examination, imaging and further tests. Primary and secondary headache forms must be carefully distinguished. 相似文献
2.
Marcus DA 《Headache》2003,43(2):117-121
OBJECTIVE: To test the hypothesis that chronic posttraumatic headache is associated with greater severity and psychological distress than headache of nontraumatic origin. METHODS: Two hundred eighty-nine consecutive patients with chronic headache attending a university headache clinic were evaluated. Questionnaires about headache symptoms, quality of life (Medical Outcome Survey SF-36 Health Survey), and psychological distress were completed. RESULTS: Frequent headache (>4 days per week) occurred more often with traumatic (84%) than nontraumatic headache (60%). Traumatic headache resulted in greater reduced activity (3.31 +/- 1.06 days per week versus 2.62 +/- 1.11 days per week with nontraumatic headache; P<.001) and complete disability (2.89 +/- 1.17 days per week versus 2.25 +/- 1.17 days per week with nontraumatic headache; P<.001). Physical function was also rated significantly lower in patients with traumatic headache (SF-36 score: 59.8 +/- 27.7 versus 71.6 +/- 26.4 with nontraumatic headache; P<.01). These differences were not attributable to differences in headache frequency or gender between patients with traumatic and nontraumatic headache. Psychological symptoms were similar between patients with traumatic and nontraumatic chronic headache. CONCLUSIONS: Chronic traumatic headache is associated with increased headache frequency and disability compared with nontraumatic headache. Headache evaluation should include an investigation for origin of headache and consideration for more aggressive treatment in patients with traumatic headache. 相似文献
3.
Harley B Messinger Egilius LH Spierings Arnaud JP Vincent John Lebbink 《Cephalalgia : an international journal of headache》1991,11(1):13-18
In two headache questionnaire surveys we inquired about the occurrence of headache in the mothers, fathers, siblings and children of the respondents. In total, 633 people completed valid questionnaires, 260 in the first survey and 373 in the second. The hypothesis was that familial headache occurrence would be positively associated with headache frequency. In each survey, the regression of headache frequency on the number of parents having headache was highly significant. Neither sex nor the sibling and children variables were significant predictors. In the cross-tabulations of the parental occurrence of headache with headache frequency we saw a clear "break-point" between the "no headache" and the headache frequency categories studied. For the final analyses the dichotomy "headache/no headache" was related in fourfold tables to headache occurrence in the father and the mother separately, and to the number of headache parents. The positive associations were not simply due to the large number of migraine cases since they remained after removing the migraineurs. 相似文献
4.
BJ Wallis SM Lord L Barnsley N Bogduk 《Cephalalgia : an international journal of headache》1998,18(2):101-105
Headache often compounds chronic neck pain following whiplash injury. To better understand post-traumatic headache, the SCL-90-R symptom checklist was used to determine the psychological profiles of patients with whiplash-associated headache and of patients with whiplash-associated neck pain without headache. The psychological profiles of these patients were compared with previously published SCL-9O-R profiles of patients with post-traumatic and nontraumatic headache, and of the normal population. Patients with whiplash-associated headache were not significantly different from those with other forms of post-traumatic headache or with whiplash-associated neck pain without headache. However, when patients with whiplash-associated headache and patients with nontraumatic headache were compared to normal data, significant differences emerged. Patients with nontraumatic headache exhibited higher scores on all subscales, whereas patients with whiplash-associated headache differed from the normal sample only on somatization, obsessive-compulsive, depression and hostility subscales, and the global severity index. These differences imply that patients with whiplash-associated headache suffer psychological distress secondary to chronic pain and not from tension headache and generalized psychological distress. 相似文献
5.
The influence of sex and pre-traumatic headache on the incidence and severity of headache after head injury 总被引:1,自引:0,他引:1
Ole Kudsk Jensen Frank Farsø Nielsen 《Cephalalgia : an international journal of headache》1990,10(6):285-293
Pre- and post-traumatic headache of 168 individuals aged 18-60 years was registered 9-12 months after a head trauma. Headache before the trauma was reported by 39.9%, women being in the majority. After the trauma 64.3% were suffering from headache. Post-traumatic headache was reported by 64 patients (38.1%), of whom 22 patients experienced an increase of already existing headache and 42 patients complained of new headache. Patients suffering from headache before the trauma were not more at risk of having post-traumatic headache than patients who did not suffer from headache before the trauma. Patients who experienced an increase of already-existing pre-traumatic headache used more analgesics than patients first suffering from headache after the trauma. Post-traumatic headache was reported by more women than men (p less than 0.02), the corresponding relative risk being 1.6. Both the use of analgesics and the frequency of headache showed a significant increase for patients with post-traumatic headache when compared with a "control group" of 41 patients with unchanged headache and when compared with all patients with headache before the trauma. There was no significant difference in the location of pain between the groups analysed. 相似文献
6.
Kikuchi H Yoshiuchi K Miyasaka N Ohashi K Yamamoto Y Kumano H Kuboki T Akabayashi A 《Cephalalgia : an international journal of headache》2006,26(11):1335-1343
Recalled evaluation of headache intensity is often affected by several factors. Recently, computerized ecological momentary assessment (EMA) has been developed to avoid such problems as recall bias. Here, we compared recalled headache intensity with momentary headache intensity using EMA in tension-type headache (TTH). Forty patients with TTH wore watch-type computers for 1 week to record momentary headache intensity and also rated their headache intensities by recall. We calculated intraclass correlation coefficients between recalled headache intensity and indices from EMA recordings in the whole study population and in two subgroups divided by variability of momentary headache intensity. The results showed that consistency and agreement of momentary and recalled headache intensity were low, and this was especially marked in the subjects whose headache varied widely. These observations suggested that variability of headache intensity may affect recall of headache intensity and this should be taken into consideration in both clinical and research settings. 相似文献
7.
Anna Cavallini MD Giuseppe Micieli MD Gennaro Bussone MD Francesco Rossi MD Giuseppe Nappi MD 《Headache》1995,35(1):29-35
The present prospective-type study quantified, by way of an ad hoc questionnaire, the impact of the headache attack in its various manifestations and the effect of headache on the quality of life of 400 headache sufferers. In addition, the functional status of episodic headache patients has been compared to that of patients with chronic daily headache.
We observed that during headache attacks, episodic headache patients were significantly more disabled by physical symptoms. On the contrary, patients with chronic daily headache showed a significantly greater occurrence of emotional disturbances. A difference was detectable for mental health which was significantly more compromised in chronic daily headache than in episodic headache patients ( P <0.05).
During the interictal period, quality of life appeared more compromised in chronic daily headache than in episodic headache patients. Chronic daily headache subjects were characterized by higher disability scores in all the sections considered.
The results of this investigation confirm that headache negatively influence a patient's quality of life not only during attack phases but also during interictal periods and underline the importance that future studies on the efficacy of headache treatments should also evaluate the impact on patient's quality of life. 相似文献
We observed that during headache attacks, episodic headache patients were significantly more disabled by physical symptoms. On the contrary, patients with chronic daily headache showed a significantly greater occurrence of emotional disturbances. A difference was detectable for mental health which was significantly more compromised in chronic daily headache than in episodic headache patients ( P <0.05).
During the interictal period, quality of life appeared more compromised in chronic daily headache than in episodic headache patients. Chronic daily headache subjects were characterized by higher disability scores in all the sections considered.
The results of this investigation confirm that headache negatively influence a patient's quality of life not only during attack phases but also during interictal periods and underline the importance that future studies on the efficacy of headache treatments should also evaluate the impact on patient's quality of life. 相似文献
8.
The frequency of common headache instigators or "triggers" and the use of specific behavioral responses to headache episodes were determined using the self-reports of patients with migraine, tension-type, and combined migraine and tension-type headache. Headache diagnostic groups were compared on the nature of headache triggers identified. The diagnostic groups were also compared on the frequency with which they engaged in a set of behavioral responses during headache episodes. No diagnostic group differences were found in triggering stimuli. Emotional, dietary, physical, environmental, and hormonal factors were all reported to be equally likely to precipitate a headache episode regardless of headache diagnosis. There were, however, differences in specific behavioral responses to headache episodes depending upon headache diagnosis. Discriminant analyses were performed to determine the best predictors of headache diagnoses. Migraine patients were significantly more likely to avoid noise, light, social activity, and physical activity compared with tension-type and combined headache patients. When average headache severity was taken into account, the diagnostic group differences in coping responses disappeared. It is concluded from the results of this study that headache severity has a greater impact on coping response than does specific headache diagnosis. 相似文献
9.
Wang Y Zhou J Fan X Li X Ran L Tan G Chen L Wang K Liu B 《The journal of headache and pain》2011,12(5):561-567
This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional
study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the
First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used
to collect medical records. Diagnosis of headache was according to the International classification of headache disorders,
2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%)
patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified
(headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster
headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer
than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p < 0.001).TTH patients had more frequent episodes of headaches than migraine patients, and typically headache frequency exceeded
15 days/month (p < 0.001); 22.8% of primary headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the
general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient
headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while
more attention to headache frequency should be given for the TTH ones. 相似文献
10.
《Headache》1993,33(5):249-252
SYNOPSIS
The responses in cervicogenic headache to four different agents have been studied. Nitroglycerin was given sublingually to 27 patients. Eighteen patients got more than 20% increase of their headache. Of those with any headache increase at all, 12 got bilateral and 12 unilateral pain. The typical late cluster headache response to nitroglycerin was not seen in cervicogenic headache. The provocative effect of nitroglycerin seemed less marked in cervicogenic than in cluster headache. Oxygen inhalation, a frequently used treatment for cluster headache, was given to 14 patients with cervicogenic headache. In general, the effect seemed uncertain and probably clearly inferior to the effect in cluster headache. Ergotamine treatment (given to 13 patients) also seemed to be of little avail in cervicogenic headache. Morphine injections given to 11 cervicogenic headache patients resulted in "marked" improvement in 4, but complete pain freedom was only seen in 2 cases. In our opinion, the present results add further evidence to the view that different etiologic and pathogenetic factors underlie cervicogenic headache and cluster headache. 相似文献
The responses in cervicogenic headache to four different agents have been studied. Nitroglycerin was given sublingually to 27 patients. Eighteen patients got more than 20% increase of their headache. Of those with any headache increase at all, 12 got bilateral and 12 unilateral pain. The typical late cluster headache response to nitroglycerin was not seen in cervicogenic headache. The provocative effect of nitroglycerin seemed less marked in cervicogenic than in cluster headache. Oxygen inhalation, a frequently used treatment for cluster headache, was given to 14 patients with cervicogenic headache. In general, the effect seemed uncertain and probably clearly inferior to the effect in cluster headache. Ergotamine treatment (given to 13 patients) also seemed to be of little avail in cervicogenic headache. Morphine injections given to 11 cervicogenic headache patients resulted in "marked" improvement in 4, but complete pain freedom was only seen in 2 cases. In our opinion, the present results add further evidence to the view that different etiologic and pathogenetic factors underlie cervicogenic headache and cluster headache. 相似文献
11.
Liisa Metsahonkala Pirjo Anttila Katri Laimi Minna Aromaa Hans Helenius Marja Mikkelsson Eija Jppil Suvi Viander Matti Sillanp Jouko Salminen 《European Journal of Pain》2006,10(7):581-581
Background Sensitisation of the pain detection system has been suggested to be involved in the pathogenesis of recurrent headache. In adults, increased sensitivity to pain has been found in patients with chronic tension type headache. Children with migraine or with unspecific headache report non‐headache pains and interictal pericranial muscular tenderness more often than headache‐free children. Objective To study if children with different types of headache report non‐headache pain more often than children with no headache and if extracephalic muscular tenderness is different in children with headache in comparison to headache‐free children. To find out if interval to the headache episode has influence on the extracranial muscular tenderness. Design A population‐based sample of 13‐year‐old children with migraine (n = 48), episodic tension type headache (61) or no headache (59) were interviewed for the occurrence and characteristics of headache and fulfilled a questionnaire on non‐headache pain. A structured manual palpation test on muscular tenderness and a pain threshold measurement were done on seven cephalic and three extracephalic points. Results Children with migraine reported other pains, especially stomach pain and limb pain more often than children with episodic tension type or no headache. There were no significant differences in the extracephalic muscular tenderness or in the pressure pain thresholds between the three groups. Conclusions Children with migraine experience more non‐headache pains than children with episodic tension type headache and with no headache. However, neither children with migraine nor children with episodic tension type headache show increased interictal extracephalic muscular sensitivity for palpation. 相似文献
12.
Marcus DA 《Headache》2000,40(5):373-376
OBJECTIVE: To test the hypothesis that anxiety and depression are associated with headache frequency, severity, and disability. BACKGROUND: There is significant comorbidity between chronic headache and psychological distress. Headache associated with anxiety or depression tends to be more severe and often requires supplementary psychological treatment in addition to headache therapy. Therefore, the identification of patients with headache who are at risk of psychological distress is important. METHODS: One hundred twenty-seven consecutive patients with headache attending a university headache clinic were evaluated. Questionnaires about headache symptoms and psychological distress were completed. Comparisons were made between psychological distress and headache frequency, severity, and disability. RESULTS: Depression and anxiety were significantly greater in the subjects of this study who had frequent headache (>4 days per week) and frequent headache-associated disability (activities reduced or prohibited because of headache >3 days per week). Subjects who reported their headache severity as typically severe were no more likely to report depression or anxiety than those with mild or moderate headache severity. Quality-of-life measures of physical and social functioning, emotional distress, and general health and vitality were reduced in subjects with frequent episodes of headache-associated disability. All areas, with the exception of general health perception, were reduced in subjects with frequent headache. Severe headache was associated with reductions in role and social functioning. CONCLUSIONS: Frequent headache and frequent disability are associated with depression, anxiety, and impaired quality of life. Reports of typical headache severity are less likely to correlate with psychological distress. Therefore, patients with headache who report frequent headache or frequent periods of headache-related disability should be further evaluated for the presence of psychological disturbance. 相似文献
13.
Ozge A Termine C Antonaci F Natriashvili S Guidetti V Wöber-Bingöl C 《The journal of headache and pain》2011,12(1):13-23
Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history
of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological
factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice
of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the
headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological
disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations
are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness
and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal
autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other
abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or
frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated
with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary
headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to
make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience
psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this
creates an important healthcare problem for their future life. 相似文献
14.
Laurell K Larsson B Mattsson P Eeg-Olofsson O 《Cephalalgia : an international journal of headache》2006,26(7):809-815
Information is sparse concerning the incidence and prognosis of headache in children from the general population, especially of tension-type headache. In this study, headache diagnoses and symptoms were reassessed in 122 out of 130 schoolchildren after 3 years. Nearly 80% of those with headache at first evaluation still reported headache at follow-up. Although the likelihood of experiencing the same headache diagnosis and symptoms was high, about one-fifth of children with tension-type headache developed migraine and vice versa. Female gender predicted migraine and frequent headache episodes predicted overall headache at follow-up. The estimated average annual incidence was 81 and 65 per 1000 children, for tension-type headache and migraine, respectively. We conclude that there is a considerable risk of developing and maintaining headache during childhood. Headache diagnoses should be reassessed regularly and treatment adjusted. Girls and children with frequent headache have a poorer prognosis and therefore intervention is particularly important in these groups. 相似文献
15.
Review of epidemiological and clinical studies suggests that sleep disorders are disproportionately observed in specific headache diagnoses (eg, migraine, tension-type, cluster) and other nonspecific headache patterns (ie, chronic daily headache, "awakening" or morning headache). Interestingly, the sleep disorders associated with headache are of varied types, including obstructive sleep apnea (OSA), periodic limb movement disorder, circadian rhythm disorder, insomnia, and hypersomnia. Headache, particularly morning headache and chronic headache, may be consequent to, or aggravated by, a sleep disorder, and management of the sleep disorder may improve or resolve the headache. Sleep-disordered breathing is the best example of this relationship. Insomnia is the sleep disorder most often cited by clinical headache populations. Depression and anxiety are comorbid with both headache and sleep disorders (especially insomnia) and consideration of the full headache-sleep-affective symptom constellation may yield opportunities to maximize treatment. This paper reviews the comorbidity of headache and sleep disorders (including coexisting psychiatric symptoms where available). Clinical implications for headache evaluation are presented. Sleep screening strategies conducive to headache practice are described. Consideration of the spectrum of sleep-disordered breathing is encouraged in the headache population, including awareness of potential upper airway resistance syndrome in headache patients lacking traditional risk factors for OSA. Pharmacologic and behavioral sleep regulation strategies are offered that are also compatible with treatment of primary headache. 相似文献
16.
Coexistence of migraine with tension-type headache, that is, so-called combined headache is a disabling chronic headache disorder and is often seen in daily practice. Combined headache is a common disease, but it is not so easy to do an accurate diagnosis and adequate treatment because clinical spectrum is wide. For clinician, it is especially important to understand characteristics of patient's headache enough to diagnose correctly by using such as a headache diary and, to educate patients to differentiate between migraine and tension-type headache in order to select the right treatment and to prevent medication-overuse headache. 相似文献
17.
The overuse of acute medications in patients who are headache-prone poses a great challenge to headache management. Medication
overuse-induced headache represents one of the most common iatrogenic disorders. It is the reason that most patients visit
headache subspecialty clinics worldwide and often is the cause of an intractable or worsening headache in primary headache
sufferers. The recent development of acute headache medications, especially the triptans, has provided increased migraine
relief; however, the incidence of triptan-overuse headache has also increased. Awareness of medication overuse-induced headache
and familiarity with the diagnosis and the treatment of this disorder are important to physicians who treat patients with
headache. 相似文献
18.
M-L. Honkasalo M.D. J. Kaprio M.D. K. Heikkilä Ph.lic M. Sillanpää M.D. M. Koskenvuo M.D. 《Headache》1993,33(8):403-412
SYNOPSIS
A population-based epidemiological study of the prevalence of headache in a sample of 24,682 adults was carried out in Finland. Enquiries were made concerning the frequency of headache, migraine and characteristics of headache attacks in a questionnaire survey in 1981. Headache was classified as migraine, and headache without migrainous features. Possible somatic causes of headache were excluded by record-linkage with three nation-wide medical registries.
The prevalence of both headache types depended on age and gender. Among women the overall prevalence of migraine was 10.1% with a maximum of 11.5% in the 40-49 age group. The prevalence rate among men was 2.5% and the female/male gender ratio was 4.0. Women with migraine had an average of 52.5 headache occasions during a year and men with migraine 61 headache occasions per year. At the individual level, headache without migrainous features was least invalidating. There were only 16.5 headache occasions a year among women and 11.5 among men. However, from a population perspective headache without migrainous features accounted for 46.5% of all headache occasions among women and for 60.8% among men. Thus, from the public health viewpoint, studies of "non-clinical" headache, e.g. headache without migrainous features should be emphasized. 相似文献
A population-based epidemiological study of the prevalence of headache in a sample of 24,682 adults was carried out in Finland. Enquiries were made concerning the frequency of headache, migraine and characteristics of headache attacks in a questionnaire survey in 1981. Headache was classified as migraine, and headache without migrainous features. Possible somatic causes of headache were excluded by record-linkage with three nation-wide medical registries.
The prevalence of both headache types depended on age and gender. Among women the overall prevalence of migraine was 10.1% with a maximum of 11.5% in the 40-49 age group. The prevalence rate among men was 2.5% and the female/male gender ratio was 4.0. Women with migraine had an average of 52.5 headache occasions during a year and men with migraine 61 headache occasions per year. At the individual level, headache without migrainous features was least invalidating. There were only 16.5 headache occasions a year among women and 11.5 among men. However, from a population perspective headache without migrainous features accounted for 46.5% of all headache occasions among women and for 60.8% among men. Thus, from the public health viewpoint, studies of "non-clinical" headache, e.g. headache without migrainous features should be emphasized. 相似文献
19.
SYNOPSIS
Headache is the formost somatic symptom among depressed patients. Patients from an outpatient headache clinic, and from a field study were examined to determine the incidence of depression among headache sufferers. A preponderance of depressive criteria in the headache population was found. Depression was more common in non-paroxysmal headache sufferers than in migraine patients. Subjects with headache and depression required twice as many leave days per year as those suffering from headache alone. Vertebral-basilar insufficiency is a frequent cause of "depressive headache". Anti-depressant drugs should be used along with headache medication when depression is found. The relationship of depression and headache in the same patient is also discussed. 相似文献
Headache is the formost somatic symptom among depressed patients. Patients from an outpatient headache clinic, and from a field study were examined to determine the incidence of depression among headache sufferers. A preponderance of depressive criteria in the headache population was found. Depression was more common in non-paroxysmal headache sufferers than in migraine patients. Subjects with headache and depression required twice as many leave days per year as those suffering from headache alone. Vertebral-basilar insufficiency is a frequent cause of "depressive headache". Anti-depressant drugs should be used along with headache medication when depression is found. The relationship of depression and headache in the same patient is also discussed. 相似文献
20.
蛛网膜下腔出血剧烈头痛相关因素分析 总被引:9,自引:1,他引:9
目的 了解蛛网膜下腔出血 (SAH)后剧烈头痛的相关因素 ,探讨SAH性头痛发病机制 ,为头痛的治疗提供理论依据和途径。方法 制定头痛程度量表 ,根据CT分析SAH在颅内的分布情况以及脑压、脑脊液 (CSF)改变与头痛程度的关系。结果 CT显示阴性或阳性结果均出现剧烈头痛 ;SAH头痛程度与CSF发生血性质变有关 ,而与血性程度和出血部位无关 ;脑压在 30 0mmH2 O以下时 ,头痛加重不明显 ;当脑压升高超过 30 0mmH2 O时 ,头痛明显加重 (P <0 0 0 5 ) ;用地塞米松鞘内注射能显著改善头痛。结论 发生质变的血性CSF引起蛛网膜下腔广泛的炎性反应是导致头痛的重要原因 ,高颅压是SAH头痛的次要因素 ,出血量导致高颅压引起头痛 ,可能与头痛持续时间有关。 相似文献