Neurological Institute Cleveland Clinic, Cleveland, OH, USA.
Headache. 2018 Mar;58(3):479-484. doi: 10.1111/head.13252. Epub 2018 Jan 11.
OBJECTIVE/BACKGROUND: Headache in the elderly, defined as individuals aged 65 and older, although less prevalent than younger individuals, can present as a diagnostic challenge, given the increase in potentially fatal diseases within this population.
These individuals require a complete history, neurological examination, and assessment of potential secondary causes of headaches.
Secondary causes include temporal or giant cell arteritis, subdural hematomas, central nervous system (CNS) tumors, strokes, and CNS infections. Once secondary conditions are ruled out, then primary causes of headache are considered such as tension-type headache, migraine, cluster headache, or hypnic headache.
This article reviews the distinguishing characteristics of the most common types of headache in patients over the age of 65 years old, along with potential diagnostic tests and treatment.
目的/背景:老年人头痛(定义为年龄在 65 岁及以上的个体)虽然不如年轻个体常见,但由于该人群中潜在致命疾病的增加,可能会成为诊断难题。
这些个体需要进行完整的病史、神经系统检查以及对头痛潜在继发性原因的评估。
继发性原因包括颞动脉炎或巨细胞动脉炎、硬膜下血肿、中枢神经系统 (CNS) 肿瘤、中风和 CNS 感染。一旦排除继发性疾病,就会考虑原发性头痛的原因,如紧张型头痛、偏头痛、丛集性头痛或睡眠性头痛。
本文回顾了 65 岁以上患者最常见类型头痛的特征,以及潜在的诊断测试和治疗方法。