Abstract:
PURPOSE FOR REVIEW:Subarachnoid hemorrhage is a serious and life-threatening medical condition which commonly presents with an acute headache. Unfortunately, it remains frequently misdiagnosed at initial presentation with dire consequences in terms of patient morbidity and mortality. The goal of this paper is to review salient features in the clinical history, as well as recently developed clinical decision rules, which can help determine which patients warrant further investigation for subarachnoid hemorrhage when the initial presentation is that of an acute headache. RECENT FINDINGS:A recent prospective observational study showed that occipital location, stabbing quality, presence of meningism, and onset of headache during exertion were characteristics in the clinical history that can distinguish the headache of SAH from other causes. The Ottawa headache rule is a clinical decision tool which was developed to help identify patients presenting to the ED with acute non-traumatic headache who require investigation to rule out subarachnoid hemorrhage. Using this tool, it is recommended that patients who meet any one of the following 6 criteria are investigated further: Onset greater than or equal to 40 years, presence of neck pain or stiffness, witnessed loss of consciousness, onset during exertion, thunder clap headache (pain peaking within 1 s), or limited neck flexion on exam. An informed and thoughtful approach that takes into account the timing, presentation, risk factors, and resources, as discussed here, should help distinguish between the patient that warrants further evaluation and intervention for SAH and one who does not. The Ottawa SAH rule is a useful clinical decision tool for young inexperienced clinicians in order to avoid missed diagnoses. However, its clinical value is limited by its low specificity. Clinical decision tools with higher specificity are needed.
journal_name
Curr Pain Headache Repjournal_title
Current pain and headache reportsauthors
Ogunlaja OI,Cowan Rdoi
10.1007/s11916-019-0785-xsubject
Has Abstractpub_date
2019-05-23 00:00:00pages
44issue
6eissn
1531-3433issn
1534-3081pii
10.1007/s11916-019-0785-xjournal_volume
23pub_type
杂志文章,评审abstract::Cervicogenic headache is a chronic, hemicranial pain syndrome in which the source of pain is located in the cervical spine or soft tissues of the neck but the sensation of pain is referred to the head. The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibers in the descend...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-001-0026-x
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journal_title:Current pain and headache reports
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abstract::Hyperprolactinemia is a condition characterised by an increase of prolactin blood levels (more than 100-200 ng/ml). It is the most common endocrine disorder of the hypothalamic-pituitary axis. The clinical characteristics of the headache-hyperprolactinemia-hypophyseal-adenoma association are discussed, the various dia...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-005-0047-y
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abstract::Migraine and tension-type headache (TTH) are highly prevalent primary headaches that remain underdiagnosed and undertreated in clinical practice. The similarities and differences between migraine and TTH may impose diagnostic challenges as well as management difficulties. In addition, the possibility of migraine chron...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-007-0232-2
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abstract::Neuropathic pain is a debilitating chronic pain condition, which remains difficult to treat. The current mainstays of treatment include physical therapy, interventional procedures and medications. Among medications, ion channel blockers and gabapentinoids are the 2 classes of drugs commonly used to treat neuropathic p...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-013-0359-2
更新日期:2013-09-01 00:00:00
abstract::Pediatric and adolescence headache is one of the most common causes of access in emergency departments (ED). Primary headache and headache secondary to self-limited conditions are the majority of cases. Secondary life-threatening headaches are less frequent and may be recognized by a careful history and physical exami...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-015-0480-5
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-002-0056-z
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abstract:PURPOSE OF REVIEW:To identify the efficacy of radiofrequency ablation of pericranial nerves in treating headache. RECENT FINDINGS:Recent studies by the same group showed promising results in treating headache using radiofrequency ablation. Pericranial nerves can be a therapeutic target for treating headache. Our resul...
journal_title:Current pain and headache reports
pub_type: 杂志文章
doi:10.1007/s11916-020-0843-4
更新日期:2020-03-12 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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abstract::Opiate analgesics have been widely used for severe acute pain and chronic cancer-related pain. Individual differences in the effectiveness of opiates and their side effects limit the clinical benefits and increase risks of drug abuse. Genetic factors might affect variations of opiate sensitivity. The mu opioid peptide...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-007-0008-8
更新日期:2007-04-01 00:00:00
abstract::Over the last few years, attention has increasingly been focused on the evolution of cluster headache over time. Predictive factors have been identified that are correlated with an increased risk of unfavorable evolution from the episodic form to the chronic form of cluster headache. Late onset, the presence of sporad...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-002-0026-5
更新日期:2002-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on recent developments in the understanding, diagnosis, and treatment of CSF-venous fistula (CVF). RECENT FINDING:CVF is a recently recognized cause of spontaneous intracranial hypotension (SIH), an important secondary headache, in which an aberrant connection is formed between t...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-020-00921-4
更新日期:2021-01-21 00:00:00
abstract::Cluster headache was first described over 300 years ago, but in the last century our knowledge of the disorder has exploded through both clinical observation and epidemiological data. Although some of the data are conflicting and more need to be obtained, much is known about the disorder. This article reviews the data...
journal_title:Current pain and headache reports
pub_type: 历史文章,杂志文章,评审
doi:10.1007/s11916-009-0024-y
更新日期:2009-04-01 00:00:00
abstract::Myofascial pain syndrome (MPS) is caused by myofascial trigger points (MTrPs) located within taut bands of skeletal muscle fibers. Treating the underlying etiologic lesion responsible for MTrP activation is the most important strategy in MPS therapy. If the underlying pathology is not given the appropriate treatment, ...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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更新日期:2006-10-01 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-002-0046-1
更新日期:2002-08-01 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-002-0078-6
更新日期:2002-10-01 00:00:00
abstract::Weight gain is a common side effect of drugs used for headache prevention. Weight gain can adversely affect patient health, exacerbate comorbid metabolic disorders, and encourage noncompliance. Additionally, obesity may promote the chronification of episodic migraine. Few studies have looked specifically at the effect...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-008-0035-0
更新日期:2008-06-01 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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更新日期:2001-02-01 00:00:00
abstract::Paroxysmal hemicrania (PH) is an underreported and underdiagnosed primary headache disorder. It usually begins in the third or fourth decade of life. The recent observations indicate that it is equally prevalent in both males and females. PH is characterized by severe, strictly unilateral head pain attacks that occur ...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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更新日期:2014-04-01 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-018-0736-y
更新日期:2018-10-05 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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更新日期:2018-02-23 00:00:00
abstract:: ...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-019-0746-4
更新日期:2019-01-19 00:00:00
abstract::Treatment for patients who are dying from cancer and are suffering with physiologic and existential symptoms is an important and valuable skill for health care providers. However, the treatment for suffering at the end of life and the use of sedation for comfort often are misunderstood. The following is a discussion o...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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更新日期:2002-06-01 00:00:00
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
doi:10.1007/s11916-008-0077-3
更新日期:2008-12-01 00:00:00
abstract::Trigger points play a part in the development and maintenance of chronic headache states. This article reviews the physiology of trigger points, with a focus on the -latest understanding of their biochemistry. The importance of facial muscle and extraocular muscle trigger points is only beginning to be understood; the...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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更新日期:2013-03-01 00:00:00
abstract::The clinical features of trigeminal autonomic cephalalgias (TACs), such as trigeminal distribution of pain, circadian/circannual rhythmicity, and ipsilateral cranial autonomic features, suggest a crucial role of the hypothalamus in the underlying pathophysiology of these primary headache disorders. Hypothalamic involv...
journal_title:Current pain and headache reports
pub_type: 杂志文章,评审
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