HEADACHE ASSOCIATED WITH ASEPTIC-MENINGITIS
HEADACHE ASSOCIATED WITH ASEPTIC-MENINGITIS
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DOI：
10.1111/j.1526-4610.1995.hed3509520.x
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发表时间：
1995-10-01
期刊：
影响因子：
5
通讯作者：
MARCELIS, JF
中科院分区：
文献类型：
--
作者：
LAMONTE, M;SILBERSTEIN, SD;MARCELIS, JF
回顾性分析了3年来在蜂巢机构中所有诊断为无菌性或病毒性脑膜炎的患者。我们分析了41例脑脊液确诊为无菌性脑膜炎的患者（蛋白质增加，白色计数增加，革兰氏染色阴性，真菌、结核和细菌培养阴性），所有患者都有头痛，其中39例为典型的重度和双侧头痛。24名患者的头痛是突然发作或患者一生中最严重的。头痛的性质，当描述时，通常是悸动（11/14）。19例患者有前驱症状，包括不适、肌痛、胃肠道症状和尿路感染。所有患者都有相关症状，包括恶心（25例）、呕吐（23例）、恐惧症（18例）、落枕（25例）和背痛（11例）。30例患者发热。30例患者因全身性疾病无法解释的头痛和发热进行腰椎穿刺，15例患者因脑膜症状进行腰椎穿刺，24例患者因突然发作的头痛或最严重的头痛进行腰椎穿刺。神经系统体征或症状12例，其他原因2例。所有病例的计算机断层扫描均为阴性。5例患者存在局灶性神经学结果。意识水平下降6例，视神经乳头水肿1例。突然发作的严重头痛，或者是病人一生中最严重的头痛，可能是由于无菌性脑膜炎、细菌性脑膜炎或蛛网膜下腔出血。虽然不是普遍存在，脑膜体征，发热和神经系统体征或症状应警告一个可能的中枢神经系统感染。
A retrospective analysis of all patients admitted with the diagnostic codes of aseptic or viral meningitis was performed at hive institutions over 3 years. Forty-one patients with cerebrospinal fluid confirmation of aseptic meningitis (increased protein; increased white count; negative gram stain; and negative fungal, tuberculosis, and bacterial cultures) were analyzed.All the patients had headache, which was typically severe and bilateral in 39 of the 41 patients. The headache was of abrupt onset or the worst of the patient's life in 24 of the patients. The quality of the headache, when described, was usually throbbing (11 of 14). Nineteen patients had prodromal symptoms, including malaise, myalgia, gastrointestinal symptoms, and urinary tract infections. All had associated symptoms, including nausea (25), vomiting (23), photophobia (18), stiff neck (25), and back pain (11). Thirty patients were febrile. Lumbar puncture was performed for headache and fever unexplained by systemic illness in 30 patients, meningeal signs in 15, headache of abrupt onset or the worst headache ever in 24. neurologic signs or symptoms in 12, and for other reasons in 2. Computerized tomography, when performed, was negative in all cases. Focal neurologic findings were present in 5 patients. a decreased level of consciousness in 6, and papilledema in 1.A severe headache that worsens, is abrupt in onset, or is the worst of the patient's life could be due to aseptic meningitis, bacterial meningitis, or a subarachnoid hemorrhage. Although not universally present, meningeal signs, fever, and neurologic signs or symptoms should alert one to a possible central nervous system infection.