丛集性头痛

最后审阅: 2 九月 2022
最后更新: 11 一月 2022

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
  • 剧痛
  • 流泪、流涕和局部霍纳氏综合征
  • 激越
  • 恶心、呕吐
  • 畏光、畏声
  • 偏头痛先兆
更多 关键诊断因素

危险因素

  • 男性
  • 家族史
  • 头部损伤
  • 吸烟
  • 酗酒
更多 危险因素

诊断性检查

首要检查

  • 头颅 MRI(使用或不使用静脉造影剂)
  • 红细胞沉降率
  • 垂体功能检查
更多 首要检查

需考虑的检查

  • 头颅 CT 扫描
  • 多导睡眠监测
  • 心电图 (ECG)
更多 需考虑的检查

治疗流程

急症处理

急性发作:无心血管疾病和未控制高血压

急性发作:有心血管疾病或未控制高血压

持续性治疗

复发性/慢性丛集性头痛

撰稿人

作者

Sarah Miller, MBBS, BSc, MRCP (Neuro)

Clinical Research Fellow

Headache Group

National Hospital for Neurology and Neurosurgery

London

UK

利益声明

SM declares that she has received an educational grant from St Jude Medical and Medtronic. SM has received payment for educational presentations from Allergan and Autonomic Technologies, Inc.

Alok Tyagi, MBBS, MD, DNB, MRCP, DM

Consultant Neurologist

Southern General Hospital

Glasgow

UK

利益声明

AT has been on advisory boards for Allergan and electroCore. AT has received organisational payments from eNeura, Allergan, and electroCore.

Manjit S. Matharu, BSc, MBChB, FRCP

Senior Lecturer and Honorary Consultant Neurologist

Headache Group

National Hospital for Neurology and Neurosurgery

London

UK

利益声明

MSM serves on the advisory board for Allergan, St Jude Medical, and Medtronic. MSM has received payment for the development of educational presentations from Allergan, MSD, Medtronic, and electroCore.

鸣谢

Dr Sarah Miller, Dr Alok Tyagi, and Dr Manjit S. Matharu would like to gratefully acknowledge the assistance of Dr Marc S. Husid and Dr Davis L. Mellick.

利益声明

MSH and DLM declare that they have no competing interests.

同行评议者

Juliana VanderPluym, MD, FRCPC, FAHS

Assistant Professor of Neurology and Consultant

Division of Headache

Mayo Clinic Arizona

Scottsdale

AZ

利益声明

JVP has received a research grant from Amgen.

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

    • 12 岁以上患者的头痛:诊断和管理
    • ACR 适合性标准:头痛
    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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