小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 单侧疼痛反复发作
- 持续时间短
- 剧痛
- 流泪、鼻溢和部分 Horner 综合征
- 激越和不安
危险因素
- 男性
- 家族史
- 头部损伤
- 吸烟
- 酗酒
诊断性检查
首要检查
- 平扫和增强脑部和垂体 MRI
- 红细胞沉降率
需考虑的检查
- 垂体功能检查
- 平扫或增强头颈部磁共振血管成像（MRA）
- 头颅 CT 扫描
- 多导睡眠监测
- 心电图 (ECG)
治疗流程
急性发作：无心血管疾病、脑血管疾病或未控制高血压
急性发作：患有心血管疾病、脑血管疾病或未控制高血压
发作性丛集性头痛的预防性治疗
慢性丛集性头痛的预防性治疗
撰稿人
作者
Juliana VanderPluym, MD, FRCPC, FAHS
Associate Professor of Neurology
Department of Neurology
Mayo Clinic Arizona
Scottsdale
AZ
利益声明
JVP has received a research grant from Amgen. She has previously acted as a consultant for Teva and is on the editorial board of the American Migraine Foundation. JVP is a co-editor of the Headache section for Current Neurology and Neuroscience Reports.
Amaal J. Starling, MD
Associate Professor of Neurology
Department of Neurology
Mayo Clinic Arizona
Scottsdale
AZ
利益声明
AJS serves on the Board of Directors for the American Headache Society, the Alliance for Headache Disorders Advocacy, and the United Council for Neurologic Subspecialties. AJS has received consulting fees from AbbVie, Allergan, Amgen, Axsome Therapeutics, Eli Lilly & Company, Everyday Health, Impel, Lundbeck, Med-IQ, Medscape, Neurolief, Novartis, Satsuma, Teva, and Theranica. None are directly related to the topic of cluster headache.
Christoper C. Anderson, MD
Headache Medicine Fellow Physician
Mayo Clinic Arizona
Scottsdale
AZ
利益声明
CCA declares that he has no competing interests.
鸣谢
Dr Juliana VanderPluym, Dr Amaal J. Starling, and Dr Christopher C. Anderson would like to gratefully acknowledge Dr Sarah Miller, Dr Alok Tyagi, Dr Manjit S. Matharu, Dr Marc S. Husid, and Dr Davis L. Mellick, previous contributors to this topic.
利益声明
SM received an educational grant from St Jude Medical and Medtronic, and received payment for educational presentations from Allergan and Autonomic Technologies, Inc. AT was on advisory boards for Allergan and electroCore, and received organisational payments from eNeura, Allergan, and electroCore. MSM served on the advisory board for Allergan, St Jude Medical, and Medtronic, and received payment for the development of educational presentations from Allergan, MSD, Medtronic, and electroCore. MSH and DLM declare that they have no competing interests.
同行评议者
Mark W. Green, MD, FAAN
Director of Headache and Pain Medicine
Professor of Neurology, Anesthesiology, and Rehabilitation Medicine
Icahn School of Medicine at Mount Sinai
New York
NY
利益声明
MWG declares that he has no competing interests.
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.
Christian Lampl, MD, PhD
Department Head
Department of Neurology and Pain Medicine
Konventhospital Barmherzige Brüder Linz
Linz
Austria
利益声明
CL declares that he has no competing interests.
鉴别诊断
- 偏头痛
- 阵发性偏头痛
- 短暂性偏侧神经痛样头痛发作伴结膜充血和流泪（SUNCT综合征）
更多 鉴别诊断指南
- ACR 适用标准：头痛
- 妊娠和产后头痛：ACOG 临床实践指南（第 3 号）
更多 指南患者教育信息
何为丛集性头痛？
丛集性头痛：现有哪些治疗选择？
更多 患者教育信息
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