Departments of Neurology and Neurotherapeutics and Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas.
J Neuroophthalmol. 2019 Mar;39(1):82-93. doi: 10.1097/WNO.0000000000000777.
Headache is the most common symptom of idiopathic intracranial hypertension (IIH) and may not resolve with intracranial pressure-lowering treatments. Many patients with IIH have a pre-existing history of migraine. Approximately two-thirds of patients with IIH continue to experience headaches after the other manifestations of the disorder resolve. There are no evidence-based guidelines for treating IIH-related headaches.
This review proposes mechanisms by which IIH produces both acute and ongoing headache. The article analyzes the literature regarding medical and procedural therapies for IIH, apropos to their effectiveness for treating headaches. It then proposes strategies to use in clinical practice, incorporating treatments used for the primary headache disorders of migraine and tension-type headache, the most common phenotypes of IIH-associated headache.
Treatments used to manage primary headache disorders may be effective in the management of IIH-associated headache, although none have been specifically studied in this condition.
Recommendations provided consider a holistic approach to the problem based on existing guidelines and clinical experience.
头痛是特发性颅内高压（IIH）最常见的症状，且可能不会因降低颅内压的治疗而缓解。许多 IIH 患者有偏头痛的既往病史。大约三分之二的 IIH 患者在该疾病的其他表现消退后仍继续出现头痛。目前尚无 IIH 相关头痛治疗的循证指南。
本综述提出了 IIH 引起急性和持续性头痛的机制。文章分析了有关 IIH 的药物和程序治疗的文献，根据其治疗头痛的有效性进行分析。然后提出了在临床实践中使用的策略，纳入了用于偏头痛和紧张型头痛等原发性头痛障碍的治疗方法，这是 IIH 相关头痛最常见的表型。
用于治疗原发性头痛障碍的治疗方法可能对 IIH 相关头痛的管理有效，尽管尚未对此病症进行专门研究。
所提供的建议考虑了基于现有指南和临床经验的整体方法来解决这一问题。
Zotero 插件