Ferro J M, Costa I, Melo T P, Canhão P, Oliveira V, Salgado A V, Crespo M, Pinto A N
Serviço de Neurologia, Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Portugal.
Headache. 1995 Oct;35(9):544-8. doi: 10.1111/j.1526-4610.1995.hed3509544.x.
Sixty (29%) of 205 consecutive patients with transient ischemic attacks registered in a hospital stroke data base had headache within 72 hours of onset. Headache was significantly more common in nonsmokers (odds ratio = 2.8; 95% confidence interval = 6.7 to 1.2). Headache was infrequent in patients with amaurosis fugax, and was not significantly associated with any other particular clinical presentation of transient ischemic attack. Headache was more common in vertebrobasilar (33%) than in carotid distribution (24%) episodes, and was not rare in transient ischemic attacks presenting as lacunar syndromes (29%). Headache was less frequent in patients whose computerized tomograms showed an infarct appropriate to the symptoms (odds ratio = 0.2; 95% confidence interval = 0.02 to 1.4). A diffuse headache was more common in patients with lacunar events than in patients with cortical attacks (odds ratio = 3.0; 95% confidence interval = 13 to 0.07). No other association was found between headache location and the presumed involved vascular territory. Headache in patients with transient ischemic attacks is poorly related/explained by the clinical characteristics of the ischemic event.
在某医院卒中数据库登记的205例连续短暂性脑缺血发作患者中,60例(29%)在发病72小时内出现头痛。头痛在不吸烟者中明显更常见(比值比=2.8;95%置信区间=6.7至1.2)。一过性黑矇患者头痛不常见,且与短暂性脑缺血发作的任何其他特定临床表现无显著关联。头痛在椎基底动脉供血区发作(33%)比在颈动脉供血区发作(24%)中更常见,在表现为腔隙综合征的短暂性脑缺血发作中也不少见(29%)。计算机断层扫描显示有与症状相符梗死灶的患者头痛较少见(比值比=0.2;95%置信区间=0.02至1.4)。弥漫性头痛在腔隙性事件患者中比在皮质发作患者中更常见(比值比=3.0;95%置信区间=13至0.07)。未发现头痛部位与推测的受累血管区域之间有其他关联。短暂性脑缺血发作患者的头痛与缺血事件的临床特征关联不大/难以用其解释。