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人群中有10～20%将以头痛为原发症状而就诊.头痛可以是全身性内科疾病或影响神经系统及头部各结构疾病的一种表现.但在大多数病例,头痛可以认为是原发的.本文主要论述原发性头痛的症状学、诊断、病理生理防治措施等方面.由于许多疾病都可加重或引起需与紧张性或血管性头痛相鉴别的头痛(特别是代谢性疾病、内分泌疾病、感染性疾病、结缔组织疾病和高血压等),因此增加了诊断上的困难.特别是颞动脉炎常引起老年的头痛,并可能伴有失明或眼肌麻痹.如果全部特征符合原发性头痛,可不需再进行进一步的诊断试验.相反,如为高度局限性的新近发作的持续性头痛,体检有异常体征或对相应治疗无效时就要进一步检查:头颅平片、CT、CSF、颞动脉活检,以及五官、口腔外科等检查.如有必要,也可行全身性内科检查.目前对原发性头痛性疾病的病理生理了
10 to 20% of the population will be treated with headache as the primary symptom.Headache may be a systemic medical condition or a manifestation of various structural diseases affecting the nervous system and the head, but in most cases, headache can be considered as the original This article mainly discusses the symptoms of primary headache, diagnosis, pathophysiology and other prevention and treatment measures, etc. Because many diseases can aggravate or cause headache that needs to be distinguished from tension or vascular headache (especially metabolic diseases, Endocrine diseases, infectious diseases, connective tissue diseases and high blood pressure, etc.), thereby increasing the diagnostic difficulties .Especially temporal arteries inflammation often cause senile headaches and may be associated with blindness or ophthalmoplegia.If all the features are consistent with the original Concomitant headaches may require no further diagnostic tests, but conversely, if there is any persistent headache with a very limited recent episode, an abnormal physical examination or failure to respond to the appropriate treatment, a further examination will be performed: skull radiography, CT, CSF , Temporal artery biopsy, as well as facial features, oral surgery and other tests.If necessary, is also feasible for systemic medical examination.At present, the pathophysiology of primary headache-related diseases