Klotz J M
Neurologische Klinik, Klinikum Fulda.
MMW Fortschr Med. 2004 Sep 30;146(40):37-40.
Although the elderly generally suffer less often from headache, symptomatic headache and concomitant diseases are more frequent. For the diagnostic work-up of newly occurring headaches in old age, imaging examinations of the head (CT or MRI), together with laboratory investigations are necessary. The treatment of symptomatic headache is oriented to the underlying disease, and should be applied promptly, with the aim of preventing serious complications. When considering the management strategy, account must be taken of possible changes in pharmacokinetics, pharmacodynamics and the therapeutic response in the elderly. Numerous medications often cause headache or other side effects in patients of advanced age. Most antiheadache drugs have not been adequately been investigated in the group of over 65-year-olds. This means that drug treatment for headache is often applied in accordance with the principle: start low, go slow.
虽然老年人一般较少患头痛，但有症状的头痛和伴随疾病却更为常见。对于老年人新出现头痛的诊断检查，头部影像学检查（CT或MRI）以及实验室检查都是必要的。症状性头痛的治疗以基础疾病为导向，应及时进行，以预防严重并发症。在考虑治疗策略时，必须考虑到老年人药代动力学、药效学和治疗反应可能发生的变化。许多药物在高龄患者中常引起头痛或其他副作用。大多数抗头痛药物在65岁以上人群中尚未得到充分研究。这意味着头痛的药物治疗通常遵循“从小剂量开始，缓慢增加剂量”的原则。
