顱內(nèi)血腫英文ppt課件-資料下載頁(yè)
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【正文】 n the head, but in practice its application is restricted to disfort in the region of cranial vault. Facial pains are put aside as something different. ? is a syndrome induced by different causes. When the pain receptors in sensitive structure are stimulated, it occurs. The causes of headache ? intracranial diseases ? extracranial diseases ? systemic diseases ? psychogenic diseases MIGRAINE ? MIGRAINE is a disorder characterized by periodic, monly unilateral or bilateral, throbbing headaches. ETIOLOGY AND MECHANISMS ? The specific cause is unknown. ? Key factors include: (1)Hereditary factorsfamilial history 60% (2)EEG depression (3)Decrease of CBF(5HT1b receptor) (4)Increase of platelet aggregation KEY FACTORS (5)Dietetic factors: chocolate, fatty foods, oranges, tomatoes, onions and alcohol, etc. (6)Endocritic factors: The incidence of migraine in females is about twice than that in males, and the headaches tend to occur during period of premenstrual tension. (7)Inducement: overwork, hunger, climate, sleeplessness CLINICAL PICTURE 1. Migraine with aura (classic,typical) ? ushered in by a disturbance of neurologic function (photopsia, central blindness, etc.) followed in a few minutes by hemicranial or, occasionally, bilateral headache, nausea, vomiting, all of which last for hours or as long as a day or two. CLINICAL PICTURE 2. Migraine without aura (mon, atypical) ? unheralded onset of hemicranial or generalized headache with or whihout nausea and vomiting. CLINICAL PICTURE variant of migraine (1) ophthalmoplegic migraine (2) hemiplegic migraine (3) basalartery migraine (4) migraine equivalent DIAGN0OSIS (1)Headaches begin in adolescence or early adult life. FM. (2)Hemicranial or bilateral headache with nausea and vomiting, last for 4 hours to 3days. (3)Between attacks the ‘patient’ is normal. (4)Ergotamine is effective to relieve the headaches. Differential diagnosis ? TENSION HEADACHE CHRONIC DAILY HEADACHE attack longer, lasting longer but releasing shorter ? CLUSTER HEADACHE attack shorter, lasting longer and releasing longer TREATNENT attack (1)Ergotamine (2)Asprin (3)Valproate, diazepam (4)Tricyclic antidepressive (5)5HT1 receptor activator (Sumatriptan, Zolmitriptan) TREATMENT attack ? Betablockers ? Calcium channel blockers ? Tricyclic antidepressive
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