Department of Neurology, Mayo Clinic College of Medicine, 200 First St. SW, Floor 8, Rochester, MN, 55905, USA.
Harvard Medical School, Boston, MA, USA.
Curr Pain Headache Rep. 2019 Aug 27;23(11):80. doi: 10.1007/s11916-019-0818-5.
A patient presenting with marked elevation in blood pressure and concurrent headache often presents a diagnostic challenge for even the most seasoned clinician. When marked hypertension and headache occur in a patient with a history of upper spinal cord injury, the patient should be presumed to have autonomic dysreflexia until proven otherwise. Autonomic dysreflexia can at times trigger headaches, hypertension, and variations in pulse, as well other autonomic signs and symptoms. Autonomic dysreflexia is a medical emergency for which appropriate treatment may be life-saving. In this review, we address the historical origins, risk factors, pathophysiology, diagnostic criteria, clinical presentation, differential diagnosis, and treatment of headache attributed to autonomic dysreflexia. Included are two case presentations from the authors' clinic, which illustrate the diagnosis and treatment of headache attributed to autonomic dysreflexia.
当患者出现明显的血压升高和同时伴有头痛时，即使是经验丰富的临床医生也常常面临诊断挑战。当有上脊髓损伤病史的患者出现明显的高血压和头痛时，应假定患者患有自主神经反射异常，除非有其他证据。自主神经反射异常有时会引发头痛、高血压和脉搏变化以及其他自主神经体征和症状。自主神经反射异常是一种医疗急症，适当的治疗可能会挽救生命。在这篇综述中，我们探讨了自主神经反射异常引起的头痛的历史渊源、危险因素、病理生理学、诊断标准、临床表现、鉴别诊断和治疗。其中包括来自作者诊所的两个病例介绍，这些病例说明了自主神经反射异常引起的头痛的诊断和治疗。
