University of Washington Medical Center, Seattle, WA, USA.
Elli Lilly and Company, Indianapolis, IN, USA .
Headache. 2018 Jun;58(6):873-882. doi: 10.1111/head.13311. Epub 2018 May 8.
There are currently no accepted therapies for posttraumatic headache (PTH). In order to meet the urgent need for effective therapies for PTH, we must continue to address fundamental gaps in our understanding of the clinical course and impact of PTH. Here we examine the existing schema used to characterize the clinical characteristics of PTH, including the International Classification of Headache Disorders (ICHD). There remain unresolved questions about whether to classify patients based on the extent of brain injury or on clinical symptom profiles. There also remain problematic issues of definition such as continuous headache, and chronic daily headache with features of "embedded" migraine-type within these headaches, which will need to be studied further. We make the case that a symptom-based classification is needed to begin an examination of these unresolved questions, and to establish clinically relevant endpoints for research and clinical trials for effective therapies.
目前尚无公认的创伤后头痛 (PTH) 治疗方法。为了满足对 PTH 有效治疗方法的迫切需求，我们必须继续解决对 PTH 的临床病程和影响的理解中的基本差距。在这里，我们研究了用于描述 PTH 临床特征的现有方案，包括国际头痛疾病分类 (ICHD)。关于是否根据脑损伤程度或临床症状特征对患者进行分类，仍然存在未解决的问题。在这些头痛中，还存在持续头痛和慢性每日头痛伴有“嵌入”偏头痛样特征等定义问题，需要进一步研究。我们认为，需要进行基于症状的分类，以开始研究这些未解决的问题，并为有效的治疗方法建立研究和临床试验的临床相关终点。
