Department of Medicine/Neurology, The Aga Khan University, Karachi, Pakistan.
J Headache Pain. 2010 Apr;11(2):137-9. doi: 10.1007/s10194-010-0186-3. Epub 2010 Jan 29.
We analyzed the incidence, pattern and location of headache in consecutive 200 patients with proven diagnosis of CVT to identify an association between localization of headache and site of sinus involvement. Headache was present in 136 (68%) patients. The duration of headache (reported in 128 patients) was reported as acute (1-3 days), 81 patients (60%); sub-acute (4-14 days), 33 patients (24%); and chronic (more than 14 days), 14 patients (10%). The quality of headache (reported in 72 patients) was reported as throbbing 12 (9%), band like 27 (20%), thunderclap 7 (5%), and other (pounding, exploding, stabbing, etc.) 26 (20%). The location of headache (reported in 101 patients) was reported as unilateral (one side of head) 48 (37%), localized (frontal, temporal, occipital, and neck) 25 (19%), and diffuse (whole head) 28 (20%). 43 (32%) patients had normal neurological examination (normal mental status, cranial nerves, motor and sensory examination with down going planters). 93 (68%) patients have abnormal findings on neurological examination including papilledema 29 (15%) patients, altered mental status 38 (19%), and focal neurological deficit 45 (22%) patients. There was no association between headache and presence of hemorrhage on CT and MRI (P = 0.1) or hydrocephalus (P = 0.09). There was no association between localization of headache and site of sinus thrombosis except sigmoid sinus thrombosis, where 17 out of 28 patients with involvement of sigmoid sinus alone or in combination with transverse sinus had pain in the occipital and neck region (P < 0.05). There was no association between lateralization of pain and site of thrombosis (P = 0.66).
我们分析了 200 例确诊 CVT 患者的头痛发生率、类型和部位，以确定头痛定位与窦受累部位之间的关系。136 例（68%）患者存在头痛。头痛的持续时间（在 128 例患者中报告）为急性（1-3 天）81 例（60%）；亚急性（4-14 天）33 例（24%）；慢性（超过 14 天）14 例（10%）。头痛的性质（在 72 例患者中报告）为搏动性 12 例（9%）、带状 27 例（20%）、霹雳样 7 例（5%）和其他（搏动性、爆裂性、刺痛性等）26 例（20%）。头痛部位（在 101 例患者中报告）为单侧（头部一侧）48 例（37%）、局限性（额部、颞部、枕部和颈部）25 例（19%）和弥漫性（整个头部）28 例（20%）。43 例（32%）患者的神经系统检查正常（神志正常，颅神经、运动和感觉检查均为下行性跖反射）。93 例（68%）患者的神经系统检查存在异常，包括视乳头水肿 29 例（15%）、意识改变 38 例（19%）和局灶性神经功能缺损 45 例（22%）。头痛与 CT 和 MRI 上的出血（P=0.1）或脑积水（P=0.09）之间无相关性。头痛定位与窦血栓形成部位之间无相关性，但单独或合并横窦血栓形成的乙状窦血栓形成患者中有 17 例（28 例）出现枕部和颈部疼痛（P＜0.05）。疼痛的偏侧与血栓形成部位之间无相关性（P=0.66）。
