特发性颅内压增高的头痛特点分析*

ANALYSIS OF HEADACHE CHARACTERISTICS OF IDIOPATHIC INTRACRANIAL HYPERTENSION *

摘要:

目的：研究我国缘于特发性颅内压增高的头痛的临床特点,并与国外同类研究进行对比。方法：连续收集2015年9月至2019年2月期间,就诊于解放军总医院第一医学中心明确诊断为特发性颅内压增高并伴有头痛症状的患者31例。收集患者一般人口学特点、检查检验结果以及头痛临床特征等。结果：在31例IIH患者中,女性27例(87.1%),男性4例(12.9%),平均发病年龄34.2±9.6岁,平均BMI 26.6±4.8kg/m_²。头痛表型中,偏头痛14例(45.2%),/可能的偏头痛418例(1258.91%),紧张性头痛9例(29%),可能的紧张性头痛1例(3.2%),不能归类的头痛3例(9.7%)。；中、重度头痛25例(80.6%)；双侧/全头痛21例(67.7%)。颅压升高的程度与头痛程度、体重指数、性别分布无明显相关性。结论：我们发现,IIH的头痛异质性较大,偏头痛/可能的偏头痛是其主要表型,头痛程度以中-重度头痛为主,头痛部位以双侧/全头痛多见。IIH好发于超重及肥胖的育龄女性,但我国的IIH患者超重及肥胖比例明显低于欧美,IIH的诊疗中不能完全参照西方的诊断标准是不合理的。IIH的头痛异质性较大,头痛程度以中-重度头痛为主,头痛部位以双侧/全头痛多见,偏头痛/可能的偏头痛是其主要表型。颅内压高低与头痛程度、体重指数、性别分布无明显相关性。

Abstract:

Objective: To study the clinical characteristics of headache caused by idiopathic intracranial hypertension in China and compare it with similar studies abroad. Methods: From September 2015 to February 2019, 31 patients with idiopathic intracranial hypertension and headache were diagnosed in The First Medical Center of Chinese PLA General Hospital. The general demographic characteristics, test results and clinical characteristics of headache were collected.. Results: Among 31 IIH patients, 27 (87.1%) were female and 4 (12.9%) were male. The average age of morbidity was 34.2 ±9.6 year-old, and the average BMI was 26.6 ±4.8kg/m2. In the headache phenotype of IIH patients, there were 14 18 cases of migraine/possible migrain (45.2%), (58.1%)4 cases of possible migraine (12.9%),. 9 cases of tension headache (29%), 1 case of possible tension headache (3.2%) and 3 cases of unclassified headache (9.7%). Compared with the group of slightly elevated intracranial pressure and the group of highly elevated intracranial pressure, the headache intensity, there is no significant statistic difference. Conclusion: We found that IIH usually occurs in overweight and obese women of reproductive age, but the proportion of overweight and obesity in IIH patients in China is significantly lower than that in Europe and the United States, the diagnosis and treatment of IIH can not completely refer to the diagnostic standard of the West.so it is unreasonable to refer to western standards in the diagnosis and treatment of IIH. The headache heterogeneity of IIH is large, the mainly degree of headache is moderate to severe headache, the most common headache site is bilateral / total headache, migraine / possible migraine is the main phenotype. There was no significant correlation between intracranial pressure and the degree of headache, body mass index and sex distribution.