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其他原发性头痛疾患。

Other Primary Headache Disorders.

出版信息

Continuum (Minneap Minn). 2021 Jun 1;27(3):652-664. doi: 10.1212/CON.0000000000000960.

Abstract

PURPOSE

This article provides an overview of a diverse group of primary headache disorders that are categorized in the International Classification of Headache Disorders, 3rd Edition (ICHD-3), as "other primary headache disorders." This article provides clinicians with a distilled understanding of the diagnoses and their epidemiology, pathophysiology, and management.

RECENT FINDINGS

Cough-induced headache requires neuroimaging to exclude posterior fossa pathology and recently has been reported as a common symptom in patients with CSF-venous fistula. Clinical overlap is observed between patients with primary exercise headache and primary headache associated with sexual activity. Patients with recurrent thunderclap headache associated with sexual activity should be presumed to have reversible cerebral vasoconstriction syndrome until proven otherwise. De novo external-pressure headache is a common sequela among health care workers using personal protective equipment during the COVID-19 pandemic. New daily persistent headache is an important mimicker of chronic migraine or chronic tension-type headache and is distinguished by a daily-from-onset progression of persistent headache; a treatment-refractory course is often observed, and early involvement of a multidisciplinary team, including a psychotherapist, is advised.

SUMMARY

Patients with primary headache disorders that are classified as "other primary headache disorders" have presentations with unique diagnostic and management considerations. The disorders are highly recognizable, and an appreciation of the diagnoses will aid clinicians in providing safe and effective care for patients presenting with headache.

摘要

目的

本文概述了国际头痛疾病分类,第 3 版(ICHD-3)中归类为“其他原发性头痛疾病”的一组不同的原发性头痛疾病。本文为临床医生提供了对诊断及其流行病学、病理生理学和管理的简明理解。

最近的发现

咳嗽诱发的头痛需要进行神经影像学检查以排除颅后窝病变,最近有报道称其为脑脊液静脉瘘患者的常见症状。原发性运动性头痛患者和与性行为相关的原发性头痛患者之间存在临床重叠。患有复发性霹雳性头痛并与性行为相关的患者应假定为可逆性脑血管收缩综合征,除非另有证明。新发的外部压迫性头痛是 COVID-19 大流行期间使用个人防护设备的医护人员的常见后遗症。新发每日持续性头痛是慢性偏头痛或慢性紧张型头痛的重要模拟头痛,其特征是持续性头痛从发作开始逐渐加重;通常观察到治疗难治性病程,建议尽早由多学科团队(包括心理治疗师)参与。

总结

归类为“其他原发性头痛疾病”的原发性头痛疾病患者的表现具有独特的诊断和管理注意事项。这些疾病具有高度可识别性,对这些诊断的了解将有助于临床医生为出现头痛的患者提供安全有效的治疗。

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