Pascual J, Berciano J
Department of Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.
J Neurol Neurosurg Psychiatry. 1994 Oct;57(10):1255-7. doi: 10.1136/jnnp.57.10.1255.
The diagnoses of the 193 patients aged 65 and over who attended the service of neurology in the past 15 years with de novo headache as their initial and main symptom were specifically analysed. Headaches beginning in elderly people represented only 5.4% of headaches in all ages, whereas 12.1% of the population in this health area was 65 or over. Head pain appeared more often in women (63%), although post-traumatic, cluster, and benign cough headaches were almost restricted to men. Tension type headache (83 patients, 43% of the aged patients) and idiopathic trigeminal neuralgia (36, 19%) were the most frequent diagnoses. Fifteen per cent of the elderly patients v 1.6% of patients under 65 presented headache secondary to serious conditions, such as stroke, temporal arteritis, or intracranial neoplasm. Only one patient over 65 met migraine criteria. It is concluded that whereas the incidence of patients with headache attending a general hospital decreases with age, the risk of headaches due to serious conditions increases 10-fold after 65.
对过去15年里因新发头痛作为初始和主要症状前来神经科就诊的193名65岁及以上患者的诊断进行了具体分析。老年人中起始的头痛仅占所有年龄段头痛患者的5.4%，而该健康区域65岁及以上的人口占12.1%。头痛在女性中更为常见（63%），尽管创伤后头痛、丛集性头痛和良性咳嗽性头痛几乎仅见于男性。紧张型头痛（83例，占老年患者的43%）和特发性三叉神经痛（36例，占19%）是最常见的诊断。15%的老年患者与1.6%的65岁以下患者出现了继发于严重疾病的头痛，如中风、颞动脉炎或颅内肿瘤。65岁以上仅有1例患者符合偏头痛标准。得出的结论是，虽然综合医院头痛患者的发病率随年龄下降，但65岁以后因严重疾病导致头痛的风险增加了10倍。
