Dr. James C. Watson offered his tips to pick up “can’t miss” headaches. Migraine is the most common primary headache disorder that disrupts someone’s life. Cluster headaches — which tend to occur in a headband pattern — are more common. But they tend to be mild-to-moderate. Primary headache syndrome including migraines, tension, and cluster headaches accounts for more than 90% of headaches. They are not life-threatening, recurrent, with no known cause. Secondary headache syndrome can be caused by dangerous conditions like hemorrhage, tumor, and meningitis. Headache red flags are identified by the “2SNOOP4” mnemonic: Systemic symptoms; Secondary risk factor; Neurologic signs and symptoms; Onset (e.g., “thunderclap” headache); Older age (>50); Prior headaches; Positional headache, e.g., cervicogenic; Papilledema; Precipitants (e.g., valsalva, cough, sexual activity). It is important to consider temporal arteritis in the elderly. A new headache, significant and limiting, or with significant change could be a sign of a secondary headache syndrome such as a brain tumor. A patient with severe and episodic headaches is most likely migraine. Migraines may last 4-72 hours. A migraine may or may not be accompanied by aura; aura can even occur without migraine. If it does occur, aura should go away within an hour. Migraines can cause new phenomenon to occur; they’re not like a stroke that “takes something away.” There are special kind of migraines. Medication overuse can increase headache frequency such that it converts from episodic to chronic migraine. Source: http://www.medpagetoday.com/
詹姆斯·沃森大夫提出了关于鉴别“不可错过”的头痛的提示。偏头痛是扰乱某人生活的最常见的原发性头痛。集群性头痛，往往呈头箍式，更常见，但往往是轻度至中度。原发性头痛综合征包括偏头痛，紧张性和集群性头痛占头痛的90％以上。它们没有生命危险，复发性，原因不明。继发性头痛综合征可由诸如脑溢血，肿瘤和脑膜炎等危险状况引起。危险的头痛可由下列因素帮助识别：系统性症状;继发性危险因素;神经系统体征和症状;发作（例如，“雷霹”性头痛）;年龄（> 50）;先前头痛史;位置性头痛，例如，颈部所致;视乳头水肿;诱发因素（例如，憋气，咳嗽，性活动等）。老年人重要的是要考虑到颞动脉炎。新的头痛，显着和限制性的，或变化显着可能是继发性头痛综合征如脑肿瘤的征兆。患有严重和发作性头痛的患者最大可能性是偏头痛。偏头痛可持续4-72小时。偏头痛可伴有或不伴有光环先兆; 甚至可发生光环先兆而无偏头痛。如果发生光环先兆，应该在一小时内消失。偏头痛可引起新现象的出现; 而不像中风一样“失去什么”。有些偏头痛特殊。用药过度可增加头痛的频率，使其从发作性转变为慢性偏头痛。来源：http://www.medpagetoday.com/
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