机动车碰撞后迟发性创伤后头痛：一例报告
Delayed-onset post-traumatic headache after a motor vehicle collision: a case report.
作者信息
Stupar Maja, Kim Peter S Y
机构信息
Canadian Memorial Chiropractic College, Division of Clinical Education, 6100 Leslie Street, Toronto, ON, Canada.
出版信息
J Can Chiropr Assoc. 2007 Jun;51(2):83-90.
INTRODUCTION
Headaches are common after a motor vehicle accident (MVA). Post-traumatic headaches share many clinical symptoms including the clinical course of primary headaches. Secondary headaches (including those resulting from a subdural hematoma) are not as common, but should be considered in cases of post-traumatic events particularly if clinical symptoms progress.
CLINICAL FEATURES
A case of a patient with a post-traumatic subdural hematoma demonstrates the importance of carefully examining, properly diagnosing and managing patients that experience headaches after MVAs. This patient presented with uncomplicated low back pain, neck pain and headache which progressed at one month to include focal neurological deficits. Since clinical examination alone may not be sufficient to diagnose secondary headaches, immediate referral to the emergency department may be required.
CONCLUSION
Primary contact practitioners should be aware of the various causes of headaches that result after a MVA. Headaches, which do not respond or progress, should be followed aggressively to determine their source.
引言
机动车事故（MVA）后头痛很常见。创伤后头痛有许多临床症状，包括原发性头痛的临床病程。继发性头痛（包括硬膜下血肿引起的头痛）不太常见，但在创伤后事件中应予以考虑，尤其是临床症状进展时。
临床特征
一例创伤后硬膜下血肿患者的病例表明，仔细检查、正确诊断和处理机动车事故后头痛患者非常重要。该患者最初表现为单纯的下背痛、颈部疼痛和头痛，一个月后病情进展，出现局灶性神经功能缺损。由于仅靠临床检查可能不足以诊断继发性头痛，可能需要立即转诊至急诊科。
结论
初级接触医生应了解机动车事故后头痛的各种原因。对无反应或病情进展的头痛应积极追踪以确定其病因。
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