最新对患者的头痛的医疗方法Approach to a patient with headache【国外优秀精品】教学讲义PPT.ppt

《最新对患者的头痛的医疗方法Approach to a patient with headache【国外优秀精品】教学讲义PPT.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、对患者的头痛的医疗方法Approachtoapatientwithheadache【国外优秀精品】,Aheadacheorcephalagiaispainanywhereintheregionofheadorneck.Itcanbeasymptomofanumberofdifferentconditionsofheadandneck.Thebraintissueitselfisnotsensitivetopainbecauseitlackspainreceptors.Rather,thepain

2、iscausedbydisturbanceofpainsensitivestructuresaroundtheheadandneck.PainSensitivityofCranialStructuresCranialvenoussinuseswithafferentveinsArteriesatbaseofbrainandtheirmajorbranchesArteriesoftheduraDuranearbaseofbrainandlargearteriesDural,Cranialandex

3、tracranialnervesAllextracranialstructuresBrainparenchymaEpendymaChoroidPiaArachnoidDuraoverconvexitySkullPain-SensitivePain-InsensitiveEpidemiologyTensionMigraineColdStimulusHeadacheCluster69%15%15%0.1%PrimaryHeadacheLifetimePrevalenceHangoverFeverMe

4、tabolicdisorderDisordersofnose/sinusesHeadtraumaDisordersofeyesVasculardisorders72%63%22%15%4%3%1%SecondaryHeadacheHeadacheintheEDTensionMigraineCluster32%22%<1%PrimaryHeadacheSubarachnoidHemorrhageMeningitisTemporalArteritisSubduralHematomaCNStumorM

5、iscellaneousillnessNospecificdiagnosis<1%<1%<1%<1%3%33%7%3%SecondaryHeadacheLeichtM,AnnEmergMed1980;9:404PrimaryHeadacheMigraineTensionClusterTensionHeadacheDuration30minto7daysPaincharacteristics(atleast2)Pressing/tighteningqualityMildtomoderateseve

6、rityBilaterallocationNoaggravationbyroutinephysicalactivityAssociatesymptoms(Musthaveboth)NovomitingNomorethanoneof:nausea,photophobia,phonophobiaH&PanddiagnostictestsdonotsuggestunderlyingorganicdiseaseInternationalHeadacheSocietyDiagnosticCriteriaM

7、igraineWithoutAuraAtleast6ormoreperiodicattacksDuration4-72hifuntreatedorunsuccessfullytreatedPaincharacteristics(atleast2)UnilaterallocationPulsatingqualityModeratetosevereintensityAggravationbywalkingstairsorsimilarphysicalactivityAssociatedsymptom

8、s(atleast1)Nausea,vomiting,orbothPhotophobiaorphonophobiaH&PanddiagnostictestsdonotsuggestunderlyingorganicdiseaseInternationalHeadacheSocietyDiagnosticCriteriaMigraineWithAuraAtleast3periodicattacksAuracharacertistics(Atleast3)Oneormorefullyreversib