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紧张型头痛

最后审阅: 23 Nov 2024
最后更新: 13 Dec 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 广泛头部疼痛
  • 额部或枕部头痛
  • 非搏动性头痛
  • 紧缩样疼痛
  • 神经系统体格检查正常
完整详情

其他诊断因素

  • 颅周压痛
  • 胸锁乳突肌压痛
  • 斜方肌压痛
  • 颞肌压痛
  • 翼外肌压痛
  • 咬肌压痛
  • 畏光或畏声
  • 恶心
  • 经常使用镇痛药
  • 焦虑和抑郁
  • 躯体化
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危险因素

  • 精神紧张
  • 压力
  • 饮食不规律
  • 疲劳
  • 睡眠不足
  • 躯体化
  • 女性
  • 年龄20~39岁
  • 社会经济状况较差
  • 过度使用镇痛药
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诊断性检查

首要检查

  • 临床诊断
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需考虑的检查

  • 鼻窦CT扫描
  • 颅脑 MRI 扫描
  • 腰椎穿刺:
  • 多导睡眠图
完整详情

治疗流程

急症处理

急性发作

持续性治疗

慢性症状(>7~9个头痛日/月)

撰稿人

作者

Mark W. Green, MD, FAAN
Mark W. Green

Professor of Neurology, Anesthesiology and Rehabilitation Medicine

Emeritus Director of Headache and Pain Medicine

Icahn School of Medicine at Mount Sinai

New York

NY

利益声明

MWG declares that he has no competing interests.

Rachel Colman, MD

Assistant Professor of Neurology

Icahn School of Medicine at Mount Sinai

New York

NY

利益声明

RC declares that she has no competing interests.

同行评议者

Sait Ashina, MD

Assistant Professor of Neurology and Anesthesia

Harvard Medical School

Director of Comprehensive Headache Center

Beth Israel Deaconess Medical Centre

Boston

MA

利益声明

SA has received honoraria from and is a consultant for Abbvie/Allergan, Eli Lilly, Linpharma, Lundbeck, Satsuma, Teva, Theranica, Percept, and Impel NeuroPharma. SA is an author of one of the references in this topic.

Giles Elrington, MBBS (Hons), MD, FRCP

Consultant Neurologist

Barts Health NHS Trust

London

UK

利益声明

GE is involved in a number of clinical trials on multiple sclerosis sponsored by Genzyme, Roche, Teva, Novartis, Biogen, as well as one funded by the MRC. He is also involved in clinical trials sponsored by Allergan, NMT Medical, GlaxoSmithKline (GSK), Bristol-Myers, the UK's Parkinson's Disease Research Group, and Pharmacia. In addition, he has attended lectures, conferences, and symposia with the following companies: GSK, AstraZeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, BMJ.

Paul Davies, MA, MD, FRCP

Consultant Neurologist

Northampton General Hospital

Northampton

UK

利益声明

PD declares that he has no competing interests.

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