Li Shi-Liang, Han Feng, Zhang Chen-Yu
Department of Acupuncture, China-Japan Friendship Hospital, Beijing 100029, China.
Zhongguo Gu Shang. 2010 Mar;23(3):208-11.
To improve the diagnostic criteria of cervicogenic headache by summary the clinical features of cervicogenic headache in patients.
Among 448 patients with the chief complaint of headache for the first visit from October 2008 to June 2009, 399 cases meet the diagnostic criteria, 330 cases were diagnosed as cervicogenic headache. There were 97 males and 233 females, ranging in age from 14 to 76 years, with an average of 46.1 years. The duration of the disease ranged from 0.33 to 50 years, with an average of 13.4 years. The gender, age, occupation, headache characteristics of the patients were recorded, and the tenderness point position and the range of diffuse pain were summarized for analysis.
There were 89.1% headache patients were cervicogenic headache, the male to female ratio was 1:2.4, 78.8% (260 cases) patients aged 21 to 60 years old, especially those 41 to 50 years old was the majority. There were 97.3% (321 cases) patients with paroxysmal headache, and only 2.7% (9 cases) patients had persistent headache. Majority patients had swelling pain (181 cases, accounting for 54.8%) or pulsatile pain (135 cases, accounting for 40.9%). Above two types pain may coexist, and other types were few. The position of headache concentrated at occiput, corona capitis and tempus, and could spread to the forehead, fossa orbitalis, or eye (about 1/3 patiens), very few spread to the ears, nasal wing or bridge of the nose, etc. There were 76.4% (252 cases) patients with full or bilateral headache, and only 12.1% (40 cases) with unilateral headache. Almost all the patients had symptoms of occipital nerve entrapment, among which about 73.3% (242 cases) patients had greater and lesser occipital large involved. There were 82.7% (273 cases) patients showing radiating pain by pressing the special point of occiput.
(1) Cervicogenic headache patients accounted for a higher proportion; (2) The existing diagnostic criteria is not perfect, and need to be improved; (3) Radiating pain occurred when pressing the specific location is an important diagnosis criteria.
通过总结颈源性头痛患者的临床特征，完善颈源性头痛的诊断标准。
选取2008年10月至2009年6月首次因头痛就诊的448例患者，其中399例符合诊断标准，330例被诊断为颈源性头痛。男性97例，女性233例，年龄14～76岁，平均46.1岁。病程0.33～50年，平均13.4年。记录患者的性别、年龄、职业、头痛特点，总结压痛部位及疼痛扩散范围进行分析。
头痛患者中颈源性头痛占89.1%，男女比例为1∶2.4，78.8%（260例）患者年龄在21～60岁，尤以41～50岁者居多。97.3%（321例）患者为阵发性头痛，仅2.7%（9例）患者为持续性头痛。多数患者为胀痛（181例，占54.8%）或搏动性痛（135例，占40.9%）。上述两种疼痛可并存，其他类型较少。头痛部位集中在枕部、头顶和颞部，可扩散至前额、眶窝或眼部（约1/3患者），极少扩散至耳部、鼻翼或鼻梁等部位。76.4%（252例）患者为全头痛或双侧头痛，仅12.1%（40例）为单侧头痛。几乎所有患者均有枕神经卡压症状，其中约73.3%（242例）患者枕大、小神经均受累。82.7%（273例）患者按压枕部特定点时有放射痛。
（1）颈源性头痛患者所占比例较高；（2）现有诊断标准不完善，需进一步完善；（3）按压特定部位出现放射痛是重要的诊断标准。
Zotero 插件