确定自发性颅内低血压患者直立性头痛的典型特征。

IF 5 2区 医学 Q1 CLINICAL NEUROLOGY
Dwij Mehta, Sanjay Cheema, Sophie Glover, Ayman M Qureshi, Indran Davagnanam, Salwa Kamourieh, Parag Sayal, Ahmed Toma, Susie Lagrata, Clare Joy, Callum Duncan, Jane Anderson, Brendan Davies, Paul J Dorman, Heather Angus-Leppan, James Walkden, Jonathan Rohrer, Manjit S Matharu
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引用次数: 0

摘要

背景:直立性头痛(Orthostatic headache, OH)是包括自发性颅内低血压(spontaneous intracranial hyposion, SIH)在内的多种疾病的共同特征,但目前还没有明确的定义来描述典型的OH特征。这种模糊性有误诊的风险,造成不必要的调查和治疗机构的延误。本研究旨在对SIH患者的OH进行结构化表型分析,以概述其典型特征。方法:符合条件的临床放射学证实的SIH患者进行了结构化访谈,之后,专家兴趣小组利用改进的德尔菲过程分析数据,并就SIH中OH的典型特征达成共识。结果:共招募了137例患者。OH的存在率为75.9%。SIH的典型OH特征定义为:醒来时基线严重程度(平躺)≤3(0-10,言语反应量表),直立时头痛发作时间≤4.5 h,达到峰值严重程度的时间≤7.5 h,以及平躺后1.5 h内与基线严重程度的偏移。个体内发病时间和偏移时间的一致性被认为是必要的特征。结论:定义典型的OH特征具有增强SIH诊断和管理的潜力,同时最大限度地减少不必要的侵入性手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Defining the typical characteristics of orthostatic headache in patients with spontaneous intracranial hypotension.

Background: Orthostatic headache (OH) is a common feature of various conditions, including spontaneous intracranial hypotension (SIH), but no precise definition currently exists outlining the typical OH characteristics. This ambiguity risks misdiagnosis with unnecessary investigations and delay in institution of treatment. The present study aimed to carry out structured phenotyping of OH in patients with SIH with the aim of outlining its typical characteristics.

Methods: Eligible patients with clinico-radiological confirmed SIH underwent a structured interview, after which a specialist interest group utilised the modified Delphi process to analyse the data and achieve consensus on defining the typical characteristics of OH in SIH.

Results: In total, 137 patients were recruited. OH was present in 75.9%. Typical OH characteristics in SIH were defined as having a baseline severity (lying flat) on waking up of ≤3 (0-10, verbal response scale), headache onset-time of ≤4.5 h on becoming upright, time to peak severity of ≤7.5 h and an offset to baseline severity within 1.5 h of recumbency. Intra-individual consistency in the onset and offset-time was deemed a necessary characteristic.

Conclusions: Defining typical OH characteristics has the potential of enhancing SIH diagnostics and management, at the same time as minimising unwarranted invasive procedures.

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来源期刊
Cephalalgia
Cephalalgia 医学-临床神经学
CiteScore
10.10
自引率
6.10%
发文量
108
审稿时长
4-8 weeks
期刊介绍: Cephalalgia contains original peer reviewed papers on all aspects of headache. The journal provides an international forum for original research papers, review articles and short communications. Published monthly on behalf of the International Headache Society, Cephalalgia''s rapid review averages 5 ½ weeks from author submission to first decision.
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