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
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
- 经常使用镇痛药
- 焦虑和抑郁
- 躯体化
危险因素
- 精神紧张
- 压力
- 饮食不规律
- 疲劳
- 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
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 鼻窦CT扫描
- 颅脑 MRI 扫描
- 腰椎穿刺：
治疗流程
急性发作
慢性症状（>7~9个头痛日/月）
撰稿人
作者
Mark W. Green, MD, FAAN
Professor of Neurology, Anesthesiology and Rehabilitation Medicine
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
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.
Marc S. Husid, MD
Director
Walton Headache Center
Augusta
GA
利益声明
MSH declares that he has no competing interests.
Paul Davies, MA, MD, FRCP
Consultant Neurologist
Northampton General Hospital
Northampton
UK
利益声明
PD declares that he has no competing interests.
鉴别诊断
- 慢性偏头痛
- 药物滥用性头痛
- 蝶窦炎
更多 鉴别诊断指南
- 妊娠期和产后头痛：ACOG 临床实践指南第 3 号
- 12 岁以上患者的头痛：诊断和管理
更多 指南患者教育信息
紧张型头痛
更多 患者教育信息
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