Leone M, D'Amico D, Moschiano F, Farinotti M, Filippini G, Bussone G
Centro Cefalee, Istituto Neurologico Carlo Besta, Milano, Italy.
Headache. 1995 Sep;35(8):461-4. doi: 10.1111/j.1526-4610.1995.hed3508461.x.
According to Sjaastad, the pain in cervicogenic headache, a form not recognized by the IHS, is long lasting and always side-locked unilateral. The frequency of side-locked unilateral pain (defined here as no change in side from onset) and other characteristics of cervicogenic headache were investigated in 300 outpatients using information collected on standard forms in structured interviews. Three hundred seventy-four headaches diagnosed according to IHS criteria were identified. Three hundred forty-eight of these headaches were long-lasting (duration of more than 4 hours); migraine (65%) followed by tension-type headache (25%) were the commonest forms. Side-locked unilaterality was present in 29% (101 of 348), and occurred most frequently in migrainous disorders not fulfilling the criteria (25 of 56, 44.6%). This group differed significantly from the other migraine conditions for longer pain duration (P < 0.02) and less frequent nausea, vomiting, photophobia, phonophobia (P < 0.0001), and aggravation by physical activity (P < 0.02). With these characteristics, this group resembled cervicogenic headache. However, in none of these patients was pain triggered by head or neck movements, and the frequency of head or neck trauma did not differ from other headaches. A more precise definition of clinical criteria for cervicogenic headache vs migraine is, therefore, required.
根据斯贾斯塔德的观点，颈源性头痛（一种国际头痛协会未认可的头痛类型）的疼痛持续时间长，且始终锁定在一侧，为单侧性。我们使用结构化访谈中标准表格收集的信息，对300名门诊患者的锁定一侧的单侧疼痛频率（此处定义为自发病起疼痛侧无变化）及颈源性头痛的其他特征进行了调查。共识别出374例符合国际头痛协会标准诊断的头痛病例。其中348例头痛持续时间长（超过4小时）；最常见的类型是偏头痛（65%），其次是紧张型头痛（25%）。348例中有29%（101例）存在锁定一侧的单侧性，最常出现在不符合标准的偏头痛性疾病中（56例中有25例，占44.6%）。该组与其他偏头痛情况在疼痛持续时间更长（P < 0.02）、恶心、呕吐、畏光、畏声频率更低（P < 0.0001）以及体力活动加重疼痛方面（P < 0.02）存在显著差异。具有这些特征，该组类似于颈源性头痛。然而，这些患者中没有一例疼痛由头部或颈部运动触发，头部或颈部外伤的频率与其他头痛并无差异。因此，需要对颈源性头痛与偏头痛的临床标准进行更精确的定义。
