The National Hospital for Neurology and Neurosurgery, University College London (UCL), Queen Square, Box 80, London, WC1N 3BG, UK.
J Neurol. 2020 May;267(5):1554-1566. doi: 10.1007/s00415-020-09728-0. Epub 2020 Mar 4.
This article reviews the disorders of thunderclap, cough, exertional and sexual headache. These are a group of paroxysmal and precipitated headaches, which often occur in bouts with prolonged remissions. Indometacin seems to be the most effective preventative. Each can occur in primary and secondary form. Thunderclap headache is the most frequently reported headache syndrome associated with a secondary pathology. Discussed are the complexities of whether all patients with thunderclap headache should have further investigation if timely computerised tomography is normal and, the relevance of abnormal imaging in these disorders, differentiating what is deemed to be secondary and managing the pain.
本文回顾了霹雳性头痛、咳嗽性头痛、运动性头痛和性头痛这几种发作性和加剧性头痛。这些头痛常成串发生,缓解期长。吲哚美辛似乎是最有效的预防药物。这些头痛既可原发,也可继发。霹雳性头痛是报告最多的与继发性疾病相关的头痛综合征。讨论的重点是,如果及时的计算机断层扫描正常,是否所有霹雳性头痛患者都应进一步检查,以及这些疾病中异常影像学的相关性、继发性头痛的鉴别诊断和疼痛处理。