Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Rehabilitation Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Cephalalgia. 2022 Aug;42(9):926-932. doi: 10.1177/03331024221088993. Epub 2022 Mar 25.
To investigate the clinical characteristics of cardiac cephalalgia and determine whether there is a more suitable alternative criterion.
Patients with cardiac cephalalgia diagnosed and treated from May 2019 to April 2021 in the First Affiliated Hospital of Zhengzhou University (Zhengzhou, China) were prospectively and consecutively collected, their clinical manifestations were analyzed, and compared with the 2018 diagnostic criteria.
A total of 30 patients were collected, including 16 males and 14 females. The onset age ranged from 31 to 84 years old, with a mean of 64.6 ± 11.9 years. Headache was more common in unilateral or bilateral frontotemporal, and the nature of pain includes pulsating, dull, stuffy pain, throbbing and so on. 80.0% were moderate to severe, 70% lasted less than half an hour, 76.6% had chest pain, 70% had chest tightness, 63.3% had sweating, and 36.6% had nausea. After treatment with drugs or coronary angiogenesis, except for one death, headache was fully or partially relieved in 29 patients.
Cardiac cephalalgia is generally located in frontotemporal region, of moderate or severe intensity, with a pulsating or throbbing sensation, abating within 30 minutes, and has a good prognosis. Accompanying chest pain, chest tightness, and sweating should be included in the diagnostic criteria.
探讨心因性头痛的临床特点,寻找更合适的替代诊断标准。
收集 2019 年 5 月至 2021 年 4 月郑州大学第一附属医院(郑州)诊治的心因性头痛患者,进行前瞻性连续收集,分析其临床表现,并与 2018 年诊断标准进行比较。
共纳入 30 例患者,男 16 例,女 14 例;发病年龄 31~84 岁,平均 64.6±11.9 岁;头痛多单侧或双侧额颞部,性质呈搏动性、闷痛、胀痛、跳痛等;中重度疼痛占 80.0%,疼痛持续时间<30 分钟占 70.0%,胸痛占 70.0%,胸闷占 70.0%,出汗占 63.3%,恶心占 36.6%;经药物或冠状动脉血运重建治疗后,29 例头痛完全或部分缓解,除 1 例死亡外。
心因性头痛多位于额颞部,程度多为中重度,呈搏动性或跳痛,持续 30 分钟内缓解,预后良好;诊断标准中应包含胸痛、胸闷和出汗等伴随症状。