Leone M, Cecchini A P, Mea E, Tullo V, Bussone G
Istituto Neurologico Carlo Besta, Milano, Italy.
Cephalalgia. 2008 Jul;28 Suppl 1:8-11. doi: 10.1111/j.1468-2982.2008.01607.x.
A fixed location unilateral headache suggests involvement of a precise nervous structure, and neuroimaging investigations are essential to seek to identify it. Nevertheless, side-locked primary headaches also occur, although they are rare. Side-locked primary headaches are more frequently found in the group of the short-lasting (</= 4 hours) headaches but long-lasting headache forms may also present with the pain always on the same side, including migraine, tension-type headache, new daily persistent headache and cervicogenic headache. Future studies should address the issue whether patients with side-locked headache form differ from those with non-side-locked form both in terms of natural history and biological markers. Among 63 consecutive chronic cluster headache patients seen by us from 1999 to 2007, 32 (51%) had side shift. We also found that the duration of the chronic condition was significantly longer in those with side shift than those without. The high frequency of side shift in chronic cluster headache should be considered when proposing surgical treatment for severe intractable forms of the disease.
固定部位的单侧头痛提示精确的神经结构受累，神经影像学检查对于试图识别该结构至关重要。然而，尽管侧锁性原发性头痛很少见，但也会发生。侧锁性原发性头痛在短期（≤4小时）头痛组中更常见，但长期头痛形式也可能表现为疼痛始终在同一侧，包括偏头痛、紧张型头痛、新发性每日持续性头痛和颈源性头痛。未来的研究应探讨侧锁性头痛形式的患者在自然病史和生物学标志物方面是否与非侧锁性形式的患者不同。在1999年至2007年我们诊治的63例连续慢性丛集性头痛患者中，32例（51%）有侧移。我们还发现，有侧移的患者慢性病程的持续时间明显长于无侧移的患者。在为该病的严重难治性形式提出手术治疗方案时，应考虑慢性丛集性头痛侧移的高发生率。
