Near the end of the year, I was so busy with headaches and sometimes severe headaches that it was normal to go to the hospital for CT and MRI. What is going on? Yu Shengyuan, chief physician of the Department of Neurology, the First Medical Center of the PLA General Hospital (formerly 301 Hospital), said that in most cases, this kind of disease is a rare disease-cluster headache. "In fact, doctors are also very 'headache' Headache disease, with rare cluster headaches as an example, has a clinical misdiagnosis rate of nearly 90%. "Currently, 90% of cluster patients are not optimally treated.
■ How many headaches are there?
There are two types of headaches, primary headache and secondary headache. Among them, craniocerebral tumors and encephalitis may have secondary headaches, and they can find a clear cause; but people often say migraine headaches and cluster headaches and tension. Sexual headaches are all primary headaches, and even doctors don't know the cause.
What is cluster headache?
Cluster headache is a rare disease in terms of incidence, and the degree of pain is also rare. "Of the various headaches, the most severe is cluster headache." Cluster headaches have a relatively short duration and have "clustering". Phenomenon, that is, the onset of the disease at a certain time, "Some patients may have the disease once a day for a period of time, but may not have another episode after two or three months." Most patients have the onset during the cluster period, and current research proves that This phenomenon may be related to the biological clock.
■ Why is it difficult to diagnose cluster headaches?
The cluster headache group is mainly male, "more than 90% are men, and women are very rare." Cluster headache patients have normal CT and MRI, so the misdiagnosis rate is very high. Yu Shengyuan has done statistics for outpatients. Nearly 90% of the patients with cluster headaches were misdiagnosed, and it was only for the first time that they were diagnosed at 301 Hospital.
■ How to identify cluster headaches?
Patients will experience severe headaches, like a knife cut; if they do not interfere, the headaches will improve on their own after 15 minutes to 180 minutes; the pain is mainly concentrated in the posterior orbit and the forehead. At the same time, cluster headaches are also accompanied by autonomic symptoms. On the side of the headache, there will be symptoms of conjunctival congestion and tears, eyelid edema, and runny nose.
■ How to treat cluster headache?
Cluster headaches can be treated symptomatically to reduce pain after diagnosis; for patients who have just entered the cluster stage, preventive interventions can be performed to reduce seizures.
(Responsible editor: Zhi Yanrong)