腰麻术后患者去枕平卧和垫枕自由卧位效果比较

目的 探讨蛛网膜下腔麻醉(腰麻)患者术后垫枕自由卧位的可行性。 方法 将200例腰麻术后患者随机分为观察组和对照组,每组100例,观察组术后采取垫枕自由卧位,对照组术后采取常规去枕平卧位6h。结果 2组均未发生头痛;观察组不舒适率、皮肤受压及腰背酸痛发生率均低于对照组(χ²=67.307,P<0.001; χ²=7.446,P=0.006; χ²=42.017,P<0.001)。2组生命体征比较,差异无统计学意义。 结论 腰麻术后患者若无特殊医嘱或麻醉师交班时有明确要求,可予垫枕自由卧位,有利于提高患者舒适度,防止术后并发症的发生。     

儿童头痛的脑电图分析

目的 通过分析头痛儿童脑电图变化,提高临床对儿童头痛脑电图癫痫的认识。方法 对120例发作性头痛患儿进行脑电图检查。结果 本组120例中常规描记111例,其中正常40例（36%）,非特异性异常68例（61%）,痫性放电3例（3%）;长程电脑图监测9例,其中正常2例（22%）,非特异性异常5例（56%）,痫性放电3例（3%）;长程脑电图监测9例,其中正常2例（22）,非特异性异常5例（56%）;痫性放电2例（22%）。结论 脑电图（或长程脑电图）检查对发作性头痛患儿诊断有一定意义。     

Epidemiological and clinical characteristics of headache in university students

OBJECTIVE: Epidemiological studies regarding headache are abundant in developed countries; however, the data in developing countries are scarce. This study aims to detect the prevalence and clinical features of headache in Gaziosmanpasa University students in Tokat, Turkey. PATIENTS AND METHODS: 2168 subjects were selected with randomized stratified sampling, and 92.5% of them participated in the study (2023 students). Two neurologists from our medical faculty interviewed and examined the students with headache. Assessment was done according to The International Classification of Headache Disorders, 2nd edition. RESULTS: In our study, 22.64% of the students had tension-type headache (TTH), 17.89% had migraine headache, 0.29% TTH plus migraine headache, 0.20% had cluster and variants type of headache. Migraine type of headache was more common in females than in males (p=0.0001); however, no significant difference was present between males and females who had migraine with aura and tension-type headache. DISCUSSION: The clinical features of tension-type headache and migraine in our university students were similar to the ones of general population and to the studies conducted on university students.     

The role of headache chronicity among predictors contributing to quality of life in patients with migraine: a hospital-based study

Background

Headache chronicity has been known to elicit deleterious effects on quality of life (QOL). We evaluated the contribution of headache chronicity to QOL in relation to clinical, psychiatric, and psychosocial variables in patients with migraine.

Methods

Subjects were recruited from a headache clinic and completed self-report questionnaires including the Migraine Disability Assessment (MIDAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Migraine-Specific Quality of Life (MSQoL). We obtained predictors of MSQoL by multiple regression analyses. A path analysis model was constructed to analyze interrelationships between the variables.

Results

Among 251 eligible patients, 183 (72.9%) had episodic migraine (EM) and 68 (27.1%) had chronic migraine (CM). Patients with CM had more serious clinical, psychiatric, and poor QOL than did patients with EM. The strongest predictor of the MSQoL score in all patients with migraine was the BDI score (β = -0.373, p < 0.001), followed by the MIDAS score (β = -0.223, p < 0.001), female gender (β = -0.192, p < 0.001), attack duration (β = -0.159, p = 0.001), and headache chronicity (β = -0.130, p = 0.012). Headache chronicity had a direct effect on the MSQoL score and exerted an indirect effect on the MSQoL score through the MIDAS and the BDI scores.

Conclusions

Chronic migraine appears to impair QOL directly as well as indirectly by provoking disability and depression.     

The methodology of population surveys of headache prevalence,burden and cost: Principles and recommendations from the Global Campaign against Headache

The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against Headache to improve and standardize methods in use for cross-sectional studies, the most important is the production of consensus-based methodological guidelines. This report describes the development of detailed principles and recommendations. For this purpose we brought together an expert consensus group to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most of all, these recommendations seek to encourage collaborations between specialists in headache disorders and epidemiologists. The focus is on migraine, tension-type headache and medication-overuse headache, but they are not intended to be exclusive to these. The burdens arising from secondary headaches are, in the majority of cases, more correctly attributed to the underlying disorders. Nevertheless, the principles outlined here are relevant for epidemiological studies on secondary headaches, provided that adequate definitions can be not only given but also applied in questionnaires or other survey instruments.     

脑静脉窦血栓形成的临床特点、危险及预后因素分析

[目的]探讨脑静脉窦血栓形成（CVST）的临床特点、诱因及影响预后的因素.[方法]回顾性分析2007年9月至2012年10月就诊于本院的40例CVST患者的临床表现、危险因素、影像学特点.所有患者均通过头磁共振平扫及静脉血管成像（MRI＋ MRV）或数字减影血管造影术（DSA）确诊.[结果]本组女26例（65％）,男14例（35％）,平均年龄（34±6.25）岁.头痛症状最为常见,占70％（28/40）.最常见的危险因素是口服避孕药和孕产妇,分别占30.0％（12/40）和27.5％（11/40）.上矢状窦和侧窦受累最常见,分别为65.0％（26/40）及55.0％（22/40）,病死率为15％（6/40）,发病时即出现意识障碍或颅内血肿与预后不良有关.[结论]CVST患者临床表现及体征多样,头痛为最常见临床表现,女性口服避孕药及妊娠生产为主要危险因素.该病病死率较高,尤其是发病后即出现意识障碍或伴有颅内血肿患者应给予足够重视.     

针刺对于脑梗死恢复期头痛及吞咽障碍的干预及治疗作用

脑梗死具有高死亡率、高残障率和高复发率的特点,且发病有年轻化趋势。脑梗死恢复期头痛及吞咽障碍对患者的日常生活能力造成严重影响,导致患者的生命质量下降,给人们经济带来沉重的负担。现通过检索各大中英文数据库,对筛选出的临床试验文献进行深入剖析,并针对目前针刺治疗存在的问题提出发展性的建议,为今后针刺治疗脑梗死恢复期的临床诊疗方法以及作用机制研究提供科学依据和崭新思路。