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1、Headache 头痛概述 Headache（cephalalgia）isacommonsymptom,oftenassociatedwithdisability,butrarelylifethreatening.Headachesmaybeaprimarydisorder（migraine,cluster,ortensionheadache）orasecondarysymptomofsuchdisordersasacutesystemicorintracranialinfection,intracranialtumor,headinjuries,seve
2、rehypertension,cerebralhypoxia,andmanydiseasesoftheeyes,nose,throat,teeth,ears,andcervicalvertebrae.Sometimesnocauseisfound. 头痛是一种常见症状，常常与功能障碍有关，但很少危及生命。头痛可能是一种原发性疾病（如偏头痛，丛集性头痛或紧张型头痛），也可能是某些疾病的继发症状，如急性全身性感染或颅内感染、颅内肿瘤、头外伤、严重的高血压、脑缺氧、及眼、耳、鼻、喉、口腔牙齿和颈椎等多种疾病，有时找不到任何病因。 Headachesmayresu
3、ltfromstimulationof,tractionof,orpressureonanyofthepain-sensitivestructuresofthehead:alltissuescoveringthecranium;the5th,9th,and10thcranialnerves;theuppercervicalnerves;thelargeintracranialvenoussinuses;thelargearteriesatthebaseofthebrain;thelargeduralarteries;andtheduramateratthe
4、skullbase.Dilationorcontractionofbloodvesselwallsstimulatesnerveendings,causingheadache.Thecauseofmostheadachesisextracranialratherthanintracranial.Stroke,vascularabnormalities,andvenousthrombosesareuncommoncausesofheadache. 对头部任何疼痛敏感结构的刺激、牵引或压迫都能引起头痛，这些结构包括覆盖头颅的所有组织；第5、9、10颅神经；上部
5、颈神经；颅内大静脉窦；颅底大动脉；硬脑膜大动脉以及颅底硬脑膜。血管壁的扩张或收缩刺激神经末梢，引起头痛。大多数头痛的病因为颅外性而非颅内性。因脑卒中、血管畸形与静脉血栓形成引起的头痛并不常见。 DiagnosisThefrequency,duration,location,andseverityoftheheadache;thefactorsthatmakeitbetterorworse;associatedsymptomsandsigns,suchasfever,stiffneck,nausea,andvomiting;andspecialstudies
6、helpidentifythecauseofheadache. 诊断 诊断内容包括：头痛的发生频率、持续时间、部位、严重程度；改善或加剧头痛的因素；相关症状与体征（如发热、颈项强直、恶心与呕吐）；及辅助头痛病因检查的特殊检查。 Secondaryheadachesmayhavespecificcharacteristics.Anacutewhole-cranial,severeheadacheassociatedwithfever,photophobia,andstiffneckindicatesaninfectiousprocess,suchasmen
7、ingitis,untilprovedotherwise.Subarachnoidhemorrhagealsocausesacuteheadachewithsymptomsandsignsofmeningealirritation.Space-occupyinglesionsoftencausesubacute,progressiveheadache.New-onsetheadacheinanadult>40yralwaysrequiresthoroughevaluation.Withspace-occupyinglesions,thefollowingm
8、ayoccur:headacheonawakeningoratni
