Speciali José Geraldo, Eckeli Alan Luiz, Dach Fabíola
Department of Neurology, University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, São Paulo 14049 900, Brazil.
Expert Rev Neurother. 2008 May;8(5):839-53. doi: 10.1586/14737175.8.5.839.
Tension-type headache (TTH) is the most prevalent of all headaches and also represents one of the most expensive clinical conditions for the health system. Despite the high impact of this disorder and the existence of well-established diagnostic criteria, knowledge about TTH is still quite limited. In most cases in which crises are quite sporadic, the patients call this normal headache. However, there is a group of patients with the chronic subtype of this headache whose quality of life is greatly compromised. According to the second edition of the International Classification of Headache Disorders, TTH is a bilateral headache of the tight band of pressure type of mild-to-moderate intensity that does not worsen with routine physical activities and whose associated symptoms are less intense than those observed in migraine. Its physiopathology still awaits better elucidation but the existence of central and peripheral mechanisms is already recognized. From a therapeutic viewpoint, simple analgesics are used for the acute treatment of the condition, and tricyclic antidepressants are the most effective class of drugs for its prevention. Follow-up of these patients over the years has demonstrated that the course of TTH is quite favorable in most cases.
紧张型头痛（TTH）是所有头痛类型中最常见的，也是卫生系统中最昂贵的临床病症之一。尽管这种疾病影响重大且存在成熟的诊断标准，但对紧张型头痛的了解仍然相当有限。在大多数发作相当零星的情况下，患者将其称为普通头痛。然而，有一组患有这种头痛慢性亚型的患者，他们的生活质量受到极大影响。根据《国际头痛疾病分类》第二版，紧张型头痛是一种双侧性头痛，呈轻度至中度强度的紧箍样压迫感，不会因日常体力活动而加重，且其相关症状比偏头痛中观察到的症状轻。其病理生理学仍有待进一步阐明，但中枢和外周机制的存在已得到认可。从治疗角度来看，简单的镇痛药用于该病症的急性治疗，而三环类抗抑郁药是预防该病最有效的一类药物。多年来对这些患者的随访表明，在大多数情况下，紧张型头痛的病程相当良好。
