Shimizu Toshihiko
Fujisawa District, Ebara Corporation.
Brain Nerve. 2020 Apr;72(4):303-309. doi: 10.11477/mf.1416201529.
Headache is one of the most common symptoms in clinical practice. Classification and diagnosis of headache are based on the International Classification of Headache Disorders (ICHD) published by the International Headache Society. Currently, the third edition of the International Headache Classification (ICHD-3) -published in 2018- is used for headache medical treatment. In the ICHD-3, headaches are classified as part 1 "the primary headaches," part 2 "the secondary headaches," or part 3 "painful cranial neuropathies, other facial pain and other headaches." Primary headaches, also called chronic headaches, include migraines, tension-type headaches, and cluster headaches. There are no useful biomarkers for the diagnosis of primary headaches. Failing to confirm certain diagnostic criteria during the patient interview may result in headache misdiagnosis. A 45-year-old male presented with what was initially considered a tension headache. He exhibited a bilateral and non-pulsating headache, but was later diagnosed with a migraine headache. We will review this case in order to better illustrate pitfalls for the medical treatment of headache.
头痛是临床实践中最常见的症状之一。头痛的分类和诊断基于国际头痛协会发布的《国际头痛疾病分类》（ICHD）。目前，用于头痛医学治疗的是2018年发布的《国际头痛分类》第三版（ICHD-3）。在ICHD-3中，头痛被分为第1部分“原发性头痛”、第2部分“继发性头痛”或第3部分“疼痛性颅神经病变、其他面部疼痛和其他头痛”。原发性头痛，也称为慢性头痛，包括偏头痛、紧张型头痛和丛集性头痛。目前尚无用于诊断原发性头痛的有效生物标志物。在患者问诊过程中未能确认某些诊断标准可能导致头痛误诊。一名45岁男性最初被诊断为紧张型头痛。他表现为双侧非搏动性头痛，但后来被诊断为偏头痛。我们将回顾该病例，以便更好地说明头痛医学治疗中的陷阱。
