Geisinger Wyoming Valley/Geisinger Health System, Department of Neurology, Wilkes-Barre, PA 18711, USA.
Headache. 2012 Jan;52(1):99-113. doi: 10.1111/j.1526-4610.2011.02028.x. Epub 2011 Nov 11.
To present results from the United States (US) Cluster Headache Survey including data on cluster headache demographics, clinical characteristics, suicidality, diagnostic delay, triggers, and personal burden.
There are few large-scale studies looking at cluster headache patients and none from the USA. This manuscript will present data from The US Cluster Headache Survey, the largest survey ever completed of cluster headache patients living in the USA.
The total survey was composed of 187 multiple-choice questions that dealt with issues related to cluster headache including demographics, clinical characteristics, comorbid medical conditions, family history, triggers, smoking history, and personal burden. The survey was placed on a Web site from October through December 2008.
A total of 1134 individuals completed the survey (816 male, 318 female). Some key highlights from the survey include the following: (1) diagnostic delay: there remains a significant diagnostic delay for cluster headache patients on average 5+ years with only 21% receiving a correct diagnosis at time of initial presentation. (2) Suicidality: suicidal ideations are substantial, occurring in 55%. (3) Eye color: the predominant eye color in cluster headache patients is brown and blue, not hazel as suggested in previous descriptions. (4) Laterality: cluster headache has a right-sided predominance. (5) Attack profile: in US cluster headache sufferers, most attacks occur between early evening and early morning hours with peak time of headache onset between midnight and 3 am; the circadian periodicity for cluster headache is present but is not as predominant in the population as previously thought. (6) Triggers: beer is the most common type of alcohol trigger in US cluster headache patients; noted migraine triggers such as weather changes and smells are also very common cluster headache triggers. (7) Medical comorbidities: peptic ulcer disease does not have a high prevalence in US cluster headache patients as suggested by previous literature; cluster headache is associated with a low prevalence of cardiac disease as well as cerebrovascular disease even though the majority of patients are chronic heavy smokers. In US cluster headache sufferers, there appears to be comorbidity with restless leg syndrome, and this has not been demonstrated in non-US cluster headache populations. (8) Personal burden: cluster headache is disabling to the individual as almost 20% of cluster headache patients have lost a job secondary to cluster headache, while another 8% are out of work or on disability secondary to their headaches.
Some findings from the US Cluster Headache Survey expound on what is currently known about cluster headache, while some of the results contradict what has been previously written, while other information is completely new about this fascinating headache disorder.
介绍来自美国的集群性头痛调查结果，包括集群性头痛的人口统计学、临床特征、自杀意念、诊断延迟、诱因和个人负担方面的数据。
很少有大规模的研究关注集群性头痛患者，也没有来自美国的研究。本文将介绍来自美国集群性头痛调查的结果，这是迄今为止完成的最大规模的美国集群性头痛患者调查。
整个调查由 187 个多项选择题组成，涉及集群性头痛相关的问题，包括人口统计学、临床特征、合并的医疗状况、家族史、诱因、吸烟史和个人负担。该调查于 2008 年 10 月至 12 月在一个网站上进行。
共有 1134 人完成了调查（816 名男性，318 名女性）。调查的一些重要发现包括：（1）诊断延迟：集群性头痛患者的平均诊断延迟时间仍为 5 年以上，只有 21%的患者在首次就诊时得到正确诊断。（2）自杀意念：自杀意念相当普遍，发生率为 55%。（3）眼睛颜色：集群性头痛患者的主要眼睛颜色是棕色和蓝色，而不是以前描述的淡褐色。（4）偏侧性：集群性头痛以右侧偏侧性为主。（5）发作模式：在美国集群性头痛患者中，大多数发作发生在傍晚至清晨之间，头痛发作的高峰时间在午夜至凌晨 3 点之间；集群性头痛的昼夜节律存在，但不如以前认为的那么普遍。（6）诱因：啤酒是美国集群性头痛患者最常见的酒精诱因；以前认为的偏头痛诱因，如天气变化和气味，也是常见的集群性头痛诱因。（7）合并症：消化性溃疡病在美国集群性头痛患者中的发病率并不像以前的文献所表明的那么高；集群性头痛与心脏病和脑血管病的发病率较低有关，尽管大多数患者是慢性重度吸烟者。在美国集群性头痛患者中，似乎与不安腿综合征有关，而在非美国集群性头痛患者中尚未发现这种情况。（8）个人负担：集群性头痛对个人有很大的致残性，近 20%的集群性头痛患者因集群性头痛而失业，另有 8%的患者因头痛而失业或残疾。
美国集群性头痛调查的一些结果阐述了目前对集群性头痛的了解，而一些结果与以前的观点相矛盾，而其他信息则是关于这种引人入胜的头痛障碍的全新信息。
