Stevens M B
San Jose Medical Center, California.
Am Fam Physician. 1993 Mar;47(4):799-806.
Tension-type headaches are generally characterized by slowly progressive, dull, constant, nonpulsatile pain in the occipital and posterior neck or in a "headband" distribution. Episodic tension-type headaches occur fewer than 15 times a month, and chronic tension-type headaches occur more than 15 times a month for at least six months. Cranial radiography, computed tomographic scanning, electroencephalography and other adjunctive tests are unnecessary if the presentation is typical and the headache is not associated with seizure activity, mental status changes, neurologic deficits and other markers of potentially serious underlying disease. Treatment of episodic tension-type headaches may include topical heat or cold packs, exercise and other stress-reduction techniques, mild analgesics, muscle relaxants and trigger-point injections. Some patients may benefit from antidepressants and individual or family counseling.
紧张型头痛通常的特点是枕部和后颈部或呈“束带样”分布区域出现缓慢进展的、钝痛、持续性、非搏动性疼痛。发作性紧张型头痛每月发作少于15次，慢性紧张型头痛每月发作超过15次且至少持续6个月。如果临床表现典型且头痛与癫痫活动、精神状态改变、神经功能缺损及其他潜在严重基础疾病的标志物无关，则无需进行头颅X线摄影、计算机断层扫描、脑电图及其他辅助检查。发作性紧张型头痛的治疗可能包括局部热敷或冷敷、运动及其他减压技巧、轻度镇痛药、肌肉松弛剂及触发点注射。一些患者可能受益于抗抑郁药及个体或家庭咨询。
