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[颈源性头痛的临床表现及影像学分析]

[Clinical manifestations and imaging analysis of cervicogenic headache].

作者信息

Shen Yi-Feng, Zhou Qiao-Yin, Li Shi-Liang, Jia Yan, Qiu Zu-Yun

机构信息

Department of Acupuncture and Moxibustion, China-Japan Friendship Hospital, Beijing, 100029, China;

出版信息

Zhongguo Gu Shang. 2019 Feb 25;32(2):130-135. doi: 10.3969/j.issn.1003-0034.2019.02.007.

Abstract

OBJECTIVE

To investigate the clinical characteristics and mechanism of cervicogenic headache.

METHODS

Fifty-seven patients with cervicogenic headache who were treated from May 2013 to December 2017 and had complete imaging data were selected, including 18 males and 39 females with an average age of(43.26±10.39) years old ranging from 20 to 63 years old. The duration of the disease was 4 months to 35 years with a mean of (11.74±9.47) years. The pain situation, iconography and Tinel sign were analyzed.

RESULTS

The patients with cervicogenic headache often had bilateral pain. The regions mainly concentrated in the temporal region, with occipital, head or orbit pains. The VAS scores decreased with the duration of the disease. There were many cases of disc herniation(91.30%), vertebral instability(73.91%), atlantoaxial displacement(56.52%), curvature change of cervicogenic vertebra(54.35%). The number of positive Tinel sign points was between 3 and 24 (13.58±5.8) per patient. The number and extent of Tinel sign were significantly different between the affected side and healthy side(<0.05). C₂,₃ facet joints(92.98%), post mastoid(89.47%), occipital concavity(89.47%), C₃,₄ facet joints(84.21%), third occipital nerve(80.70%) were the positive Tinel sign points in patients with cervicogenic headache.

CONCLUSIONS

The iconography changes of cervicogenic headache and Tinel sign may contribute to the clinical diagnosis and mechanism of the disease.

摘要

目的

探讨颈源性头痛的临床特点及发病机制。

方法

选取2013年5月至2017年12月间接受治疗且有完整影像学资料的57例颈源性头痛患者,其中男性18例,女性39例,年龄20~63岁,平均(43.26±10.39)岁。病程4个月至35年,平均(11.74±9.47)年。对疼痛情况、影像学表现及Tinel征进行分析。

结果

颈源性头痛患者多为双侧疼痛,部位主要集中在颞部,伴有枕部、头部或眼眶疼痛。视觉模拟评分(VAS)随病程延长而降低。椎间盘突出(91.30%)、椎体不稳(73.91%)、寰枢椎移位(56.52%)、颈椎曲度改变(54.35%)的病例较多。每位患者Tinel征阳性点数量为3~24个(13.58±5.8)。患侧与健侧Tinel征的数量及范围差异有统计学意义(<0.05)。C₂、₃关节突关节(92.98%)、乳突后(89.47%)、枕凹(89.47%)、C₃、₄关节突关节(84.21%)及第三枕神经(80.70%)是颈源性头痛患者Tinel征阳性点。

结论

颈源性头痛的影像学改变及Tinel征可能有助于该病的临床诊断及发病机制研究。

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