目的:本回顾性病例系列研究旨在调查原发性刺伤性头痛(PSH)的人口统计学和临床模式。此外,我们试图在葡萄牙一家三级医院的神经科门诊会诊中确定治疗反应的亚组.
方法:对符合头痛疾病国际分类标准的患者的临床记录进行回顾性分析,第3版,PSH的标准从2014年1月至2020年12月确定。我们收集了有关人口统计特征的数据,头痛的临床特征,原发性头痛合并症,和有关治疗相关的DoPSH的信息。
结果:在1857名患者中,32(1.7%;平均[SD]发病年龄56[3.5]岁)最终诊断为PSH。关于头痛的特点,20例(62.5%)患者报告在固定位置发生刺伤,12例(37.5%)在多个区域发生刺伤;每次发作的持续时间≤5秒(7[21.9%]),5-60秒(20[62.5%]),和≥60秒(五[15.6%])。总之,18例患者(56.3%)有一个偶发病程(vs.急性病程32[18.8%]中的6个和慢性病程32[25%]中的8个)。总之,17名患者开始接受治疗(53.1%),其中10例(58.8%)全部或部分改善。结果发现,与多个位置的患者相比,固定位置的疼痛患者对治疗的反应更好。以统计上显著的方式(11人中有8人与六个中的两个,p=0.023)。
结论:在我们的样本中,PSH的平均发病年龄>50岁,PSH持续时间范围很广.每次攻击的持续时间(>5秒),固定位置的疼痛,每次发作的非每日疼痛发作,间歇性头痛是最常见的临床特征。最后,在局部区域发生刺伤的患者对治疗有更好的反应.
OBJECTIVE: This retrospective
case series study aimed to investigate the demographic and clinical patterns of primary stabbing headache (PSH). In addition, we tried to identify subgroups of treatment responses in a neurology outpatient consultation at a Portuguese tertiary hospital.
METHODS: Clinical records were retrospectively reviewed and patients meeting the International Classification of Headache Disorders, 3rd edition, criteria for PSH were identified from January 2014 to December 2020. We collected data regarding demographic characteristics, clinical features of the headache, primary headache comorbidities, and information about treatment-related do PSH.
RESULTS: Of 1857 patients, 32 (1.7%; mean [SD] age of onset 56 [3.5] years) had the final diagnosis of PSH. Regarding headache characteristics, 20 patients (62.5%) reported episodes of stabbing in fixed locations and 12 (37.5%) in multiple areas; the duration of each attack was between ≤5 s (seven [21.9%]), 5-60 s (20 [62.5%]), and ≥60 s (five [15.6%]). In all, 18 patients (56.3%) had an episodic course (vs. six of 32 [18.8%] an acute course and eight of 32 [25%] a chronic course). In all, 17 patients started medical treatment (53.1%), with total or partial improvement in 10 (58.8%) of them. It was found that patients with pain in fixed locations had a better response to treatment when compared to patients with multiple locations, in a statistically significant way (eight of 11 vs. two of six, p = 0.023).
CONCLUSIONS: In our sample, the mean age of onset of PSH was >50 years and there was a wide range of PSH duration. The duration of each attack (>5 s), the pain in fixed locations, non-daily episodes of the pain in each attack, and the intermittent course of headache were the most prevalent clinical features. Finally, patients with stabbing in localized areas had a better response to treatment.