Headache prevalence and clinical features in patients with idiopathic intracranial hypertension (IIH)
Headache prevalence and clinical features in patients with idiopathic intracranial hypertension (IIH)
复制标题
DOI：
10.1007/s10072-013-1388-7
复制
发表时间：
2013-05-01
影响因子：
3.3
通讯作者：
Marzoli, S. Bianchi
中科院分区：
文献类型：
--
作者：
D'Amico, D.;Curone, M.;Marzoli, S. Bianchi
头痛是特发性颅内高压(IIH)的重要症状。“IIH引起的头痛”的手术诊断标准包括在头痛疾病的国际分类ICHD-2中。几份报告证实了IIH与肥胖之间的联系。我们在IIH患者的临床样本中调查头痛的患病率及其主要临床特征。在一系列的临床病例中，研究了头痛的存在与体重指数(BMI)和颅内压(ICP)水平的可能相关性，其中IIH的诊断是通过排除继发性形式和颅内压升高的证据而得到证实的。用Mann-Whitney U检验评估有头痛和无头痛的患者之间以及男性和女性之间的年龄、体重指数和颅内压的差异。使用Spearman的相关性分析来评估年龄、BMI和颅内压之间的关系。采用P值<；0.05进行统计学处理。40例患者进入研究(男性9例，女性31例；平均年龄39岁，8岁，SD 13.2)。75%的患者报告头痛。这些特征包括在目前的国际诊断标准中的“由于IIH引起的头痛”，有相当比例的研究患者报告了这些特征，但并不是所有患者都报告了这些特征。另一方面，一些通常归因于偏头痛形式的头痛特征在一些患者中出现，这些特征不在所要求的标准之列：大约20%的患者出现搏动性和单侧分布的疼痛，以及超过40%的样本出现偏头痛相关症状。经统计学分析，头痛与不头痛患者的年龄、体重指数、颅内压差异无统计学意义。我们的结果证实了头痛和IIH之间的强烈联系。尽管在这项研究中没有发现IIH的一些关键特征之间的显著相关性，但我们建议需要对更大的系列进行进一步的研究--可能需要进行纵向评估--以帮助临床医生对IIH患者的不同亚群进行分类，并确定影响这种疾病预后的主要因素。
Headache is a key symptom of idiopathic intracranial hypertension (IIH). Operational diagnostic criteria for "Headache attributed to IIH" are included in the international classification of headache disorders, the ICHD-2. The association of IIH with obesity was established by several reports. We investigate the prevalence of headache and its main clinical features in a clinical sample of IIH patients. The possible correlations between the presence of headache and body mass index (BMI) and intracranial pressure (ICP) levels were studied in a consecutive clinical series of patients, in whom diagnosis of IIH was confirmed by exclusion of secondary forms and by the evidence of increased ICP. Differences for age, BMI, and ICP between patients with and without headache and between males and females were assessed with Mann-Whitney U test. Spearman's correlation analysis was used to assess relationships between age, BMI, and ICP. P value < 0.05 was used to set statistical significance. 40 patients entered the study (9 males, 31 females; mean age 39, 8 years, SD 13.2). Headache was reported by 75 % patients. Those characteristics which are included in the present international diagnostic criteria for "Headache attributed to IIH" were reported by a remarkable proportion of the studied patients, but not by all. On the other hand, some headache features usually attributed to migraine forms, and which are not among the required criteria were present in some patients: pulsating quality and unilateral distribution of pain in around 20 %, and migrainous associated symptoms in more than 40 % of the sample. According to statistical analyses, no differences were found for age, BMI, and ICP between patients with and without headache. Our results confirmed the strong association between headache and IIH. Although no significant correlations between some of the key features of IIH were found in this study, we suggest that further studies on larger series-possibly with a longitudinal evaluation-are needed, to help clinicians in categorizing different subgroups among IIH patients as well as in identifying the main factors influencing the prognosis of this disorder.