动脉瘤下关节出血后持续性头痛:患病率,特征和偏头痛史作为预后因素
Laura Gómez-Dabó1, Víctor J Gallardo2, Daniel Campos-Fernández3
1Headache Clinic, Neurology Department, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
Headache
|September 15, 2025
概括
持续性头痛影响了近一半的患者在动脉瘤下arachnoid出血 (aSAH). 偏头痛史增加了患持续头痛的风险,但也与aSAH后的生存率提高有关.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 流行病学 流行病学
背景情况:
- 动脉瘤下关节出血 (aSAH) 后持续性头痛 (PH) 和其与偏头痛 (MH) 史的关联尚未得到充分了解.
- 在aSAH后调查PH流行,特征和预后因素对于患者管理至关重要.
- 了解个人MH对PH和aSAH预后的影响,可以为临床实践提供信息.
研究的目的:
- 为了确定发生率,特征和预后因素 持续性头痛 (PH) 后动脉瘤下关节出血 (aSAH).
- 调查个人偏头痛史 (MH) 对PH发展和aSAH预后的影响.
主要方法:
- 已确认aSAH的成年人的回顾性队列研究 (2019年1月 - 2021年9月).
- 数据包括人口统计,并发症 (包括MH),动脉瘤特征和临床/功能尺度 (GCS,WFNS,亨特和赫斯,费舍尔,瓦索格雷德,阿帕奇II,mRS).
- 根据国际头痛疾病分类第3版定义的PH;通过电话采访评估特征;统计分析包括回归模型.
主要成果:
- 在66名aSAH患者中,持续性头痛 (PH) 患病率为47.0%,平均随访时间为3.12年.
- 偏头痛史 (MH) 是PH的唯一风险因素 (aOR 3.9),但与aSAH临床严重程度的降低 (亨特和赫斯,WFNS),更好的功能结果 (mRS) 和更好的生存率 (aOR 3.3) 相联系.
- 在超过60%的受影响个体中,PH显著影响了日常活动.
结论:
- 持续性头痛 (PH) 影响近一半的人长期经历动脉瘤下关节出血 (aSAH),显著影响生活质量.
- 偏头痛 (MH) 的病史在aSAH患者中更为常见,作为PH的危险因素,但也独立地与生存率增加三倍相关.
- 需要进一步的研究来阐明偏头痛史,持续性头痛和aSAH后的结果之间的复杂关系.
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