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[神经科门诊中的慢性紧张性头痛]

[Chronic tension headache in the neurological outpatient clinics].

作者信息

Gracia-Naya M

机构信息

Servicio de Neurología, Hospital Miguel Servet, Avda. Isabel la Católica, 1 y 3. E-50009 Zaragoza.

出版信息

Rev Neurol. 2000;31(10):929-32.

Abstract

INTRODUCTION

Headache is the commonest cause of neurological consultation in Spain. Chronic tension headache is a common reason for consultation, although diagnosis is difficult.

OBJECTIVES

To emphasize the profile of a patient with chronic tension headache and analyze the differences from other groups of neurology patients.

PATIENTS AND METHODS

We selected chronic tension headaches on the criteria of the International Headache Society, in patients who were seen for the first time in one of 18 Neurology Clinics of the Communidad Autonoma de Aragon during a three month period in 1995. We analysed age, sex, place of origin, provisional diagnosis made by the referring doctor, whether the referral was correct or had to be reviewed. These variables were compared with groups made up of all the patients, the other patients and headaches in general.

RESULTS

A total of 3,489 patients were seen: 889 had headache (25.5% of the total number of patients) and 268 had chronic tension headache (7.6% of all the patients). The average age was 47.4 years (SD: +/- 18.7) and 72% were women. Family doctors referred 89.5%. The provisional diagnosis was correct in 52.6% and 17% required further visits.

CONCLUSIONS

Chronic tension headache leads to frequent neurological consultation. This was only exceeded by cerebral vascular pathology (12%) and migraine (10.5%), making up 29.4% of all headaches. There was a marked predominance of women, who were younger than patients with other neurological disorders. In spite of the frequency, the family doctors were correct in their provisional diagnosis less often than in other neurological conditions. Although the condition is chronic, the neurologist acted mainly as a consultant and saw few follow-up cases.

摘要

引言

在西班牙,头痛是神经科会诊最常见的原因。慢性紧张性头痛是会诊的常见原因,尽管诊断困难。

目的

强调慢性紧张性头痛患者的特征,并分析与其他神经科患者群体的差异。

患者与方法

我们根据国际头痛协会的标准,选取了1995年三个月内在阿拉贡自治区18家神经科诊所首次就诊的慢性紧张性头痛患者。我们分析了年龄、性别、出生地、转诊医生做出的初步诊断、转诊是否正确或是否需要复查。将这些变量与由所有患者、其他患者和一般头痛患者组成的群体进行比较。

结果

共诊治3489例患者:889例有头痛(占患者总数的25.5%),268例有慢性紧张性头痛(占所有患者的7.6%)。平均年龄为47.4岁(标准差:±18.7),72%为女性。89.5%由家庭医生转诊。初步诊断正确的占52.6%,17%需要进一步就诊。

结论

慢性紧张性头痛导致频繁的神经科会诊。这一比例仅次于脑血管疾病(12%)和偏头痛(10.5%),占所有头痛的29.4%。女性明显占优势,且比其他神经疾病患者年轻。尽管就诊频繁,但家庭医生初步诊断的正确率低于其他神经疾病。尽管该病为慢性疾病,但神经科医生主要起咨询作用,随访病例较少。

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