Summary
定义
病史和体格检查
关键诊断因素
- prolonged headache
- nausea and/or vomiting
- decreased ability to function
- headache worse with activity
- sensitivity to light
- sensitivity to noise
- unilateral
- throbbing sensation
- aura
危险因素
- family history of migraine
- female sex
- obesity
- stressful life events
- medication overuse
- sleep disorders
- low socioeconomic status
- allergies or asthma
- hypothyroidism
诊断性检查
首要检查
- clinical diagnosis
需考虑的检查
- erythrocyte sedimentation rate (ESR)
- c-reactive protein (CRP)
- lumbar puncture (LP)
- cerebrospinal fluid (CSF) culture
- MRI brain
- CT head
- angiography
治疗流程
presenting to the emergency department with persistent migraine
mild symptoms: nonpregnant
moderate to severe symptoms: nonpregnant
pregnant
frequent recurring severe/disabling symptoms not linked to menstrual cycle: nonpregnant
frequent recurring severe/disabling symptoms linked to menstrual cycle: nonpregnant
frequent recurring severe/disabling symptoms: pregnant
撰稿人
作者
Timothy A. Collins, MD
Associate Professor of Neurology
Chief
Headache Division
Department of Neurology
Duke University Medical Center
Durham
NC
利益声明
TAC provides expert testimony for legal cases regarding headache disorders and treatment (approximately one or two cases per year). TAC is an author of several references cited in this topic.
鸣谢
Dr Timothy Collins would like to gratefully acknowledge Dr Ann Donnelly, the previous contributor to this topic.
利益声明
AD declares that she has no competing interests.
同行评议者
Anne Walling, MD
Professor
Family and Community Medicine
University of Kansas School of Medicine
Wichita
KS
利益声明
AW declares that she has no competing interests.
Marc S. Husid, MD
Director
Walton Headache Center
Augusta
GA
利益声明
MSH declares that he has no competing interests.
参考文献
关键文献
Ailani J, Burch RC, Robbins MS, et al. The American Headache Society consensus statement: update on integrating new migraine treatments into clinical practice. Headache. 2021 Jul;61(7):1021-39.全文 摘要
Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol. 2021 Aug;17(8):501-14.全文 摘要
Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician. 2015 Aug;61(8):670-9.全文 摘要
Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Sep;40(5 suppl 3):S1-80.全文 摘要
VanderPluym JH, Halker Singh RB, Urtecho M, et al. Acute treatments for episodic migraine in adults: a systematic review and meta-analysis. JAMA. 2021 Jun 15;325(23):2357-69.全文 摘要
Orr SL, Friedman BW, Christie SC, et al. Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies. Headache. 2016 Jun;56(6):911-40.全文 摘要
Silberstein SD, Holland S, Freitag F, et al; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1337-45.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Tension-type headache (TTH)
- Cluster headache
- Medication overuse headache
Больше ОтличияРекомендации
- Prevention of episodic migraine headache using pharmacologic treatments in outpatient settings: a clinical guideline from the American College of Physicians
- The international classification of headache disorders, 3rd edition
Больше РекомендацииЛифлеты для пациента
Migraine
Migraines: questions to ask your doctor
Больше Лифлеты для пациентаVideos
Diagnostic lumbar puncture in adults: animated demonstration
Peripheral intravascular catheter: animated demonstration
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