A PATIENT WITH AN ACUTE HEADACHE AT A DOCTOR'S APPOINTMENT: DOCTOR'S TACTICS

Cover Page

Cite item

Full Text

Abstract

Headache is one of the most common complaints made by patients at an outpatient appointment or in emergency department. More than 250 types of headaches have been described, and if you look at the formal diagnostic criteria for them, you may get the impression that the diagnosis and treatment of these disorders is an extremely difficult task. Especially difficult situations when doctor deals with a patient with an acute headache, when the decision on treatment and diagnostic measures must be taken as soon as possible. The information presented in the article contains the key points of diagnosis, classification, and features of treatment approaches in such situations. The article describes in detail indications, procedure and timing of diagnostic procedures, algorithms for selecting drugs, including non-steroidal anti-inflammatory drugs, serotonergic receptor agonists, dopaminergic receptor antagonists, magnesium preparations, both in the most typical and rare cases. This will help in the daily clinical practice of doctors who are faced with the problem of acute headache.

About the authors

Ada R. Artemenko

Sechenov First Moscow State Medical University (Sechenov University)

Email: aartemenko@gmail.com
д-р мед. наук, доц. каф. нервных болезней Москва, Россия

Vera V. Osipova

Soloviev Scientific and Practical Psychoneurological Center; University Headache Clinic

д-р мед. наук, вед. науч. сотр. Москва, Россия

Aleksei B. Danilov

Sechenov First Moscow State Medical University (Sechenov University)

д-р мед. наук, проф., зав. каф. нервных болезней Москва, Россия

References

  1. Stovner L, Hagen K, Jensen R et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007; 27 (3): 193-210.
  2. Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache 2015;55:21-34.
  3. Goldstein JN, Camargo CA, Pelletier AJ, Edlow JA. Headache in United States emergency departments: demographics, work-up and frequency of pathological diagnoses. Cephalalgia 2006; 26: 684-90. http://dx.doi.org/10.1111/j.1468-2982.2006.01093.x
  4. Pari E, Rinaldi F, Gipponi S et al. Management of headache disorders in the Emergency Department setting. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol 2015.
  5. Боль: руководство для врачей и студентов. Под ред. Н.Н.Яхно. М.: МЕДпресс-информ, 2009. @@Pain: a guide for doctors and students. Ed. N.N. Yahno. Moscow: MEDpress-inform, 2009 (in Russian).
  6. Moisset X, Mawet J, Guegan-Massardier E et al. French Guidelines For the Emergency Management of Headaches. Rev Neurol (Paris) 2016; 172 (6-7): 350-60.
  7. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38 (1): 1-21.
  8. Mitsikostas DD, Ashina M, Craven A et al; EHF committee. European Headache Federation consensus on technical investigation for primary headache disorders. J Headache Pain 2015; 17: 5.
  9. Болевые синдромы в неврологической практике. Под ред. В.Л.Голубева. 3-е изд., перераб. и доп. М.: МЕДпресс-информ, 2010. @@Pain syndromes in neurological practice. Pod red. V.L.Golubeva. 3-e izd., pererab. i dop. Moscow: MEDpress-inform, 2010 (in Russian).
  10. Осипова В.В, Табеева Г.Р. Первичные головные боли: диагностика, клиника, терапия. Практическое руководство. M.: Медицинское информационное агентство, 2014. @@Osipova V.V., Tabeeva G.R. Primary headaches: diagnosis, clinic, therapy. A practical guide. Moscow: Medical News Agency, 2014 (in Russian).
  11. Артеменко А.Р., Куренков А.Л., Беломестова К.В. Принципы опроса в постановке диагноза хронической мигрени. Журн. неврологии и психиатрии им. С.С.Корсакова. 2014; 114 (9): 81-7. @@Artemenko A.R., Kurenkov A.L., Belomestova K.V. Printsipy oprosa v postanovke diagnoza khronicheskoi migreni. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2014; 114 (9): 81-7 (in Russian).
  12. Lanteri-Minet M, Demarquay G, Alchaar H et al. Management of chronic daily headache in migraine patients: medication overuse headache and chronic migraine. French guidelines (French Headache Society, French Private Neurologists Association, French Pain Society). Rev Neurol (Paris) 2014; 170: 162-76.
  13. Donnet A, Demarquay G, Ducros A et al. French guidelines for diagnosis and treatment of cluster headache. Rev Neurol (Paris) 2014; 170: 653-70.
  14. Edlow JA, Panagos PD, Godwin SA et al, American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. Ann Emerg Med 2008; 52: 407-36.
  15. Клинические рекомендации (протокол) по оказанию скорой медицинской помощи при острой головной боли. Утверждены на заседании Правления общероссийской общественной организации «Российское общество скорой медицинской помощи» 23 января 2014 г.
  16. Connolly ES, Rabinstein AA, Carhuapoma JR et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Asso-ciation/american Stroke Association. Stroke J Cereb Circ 2012; 43: 1711-37.
  17. Edjlali M, Rodriguez-Regent C, Hodel J et al. Subarachnoid hemorrhage in ten questions. Diagn In-terv Imaging 2015; 96: 657-66.
  18. Артеменко А.Р., Куренков А.Л., Беломестова К.В. Классификация, диагностика и лечение хронической мигрени: обзор новых данных. Журн. неврологии и психиатрии им. С.С.Корсакова. 2013; 113 (11-1): 91-6. @@Artemenko A.R., Kurenkov A.L., Belomestova K.V. Klassifikatsiia, diagnostika i lechenie khronicheskoi migreni: obzor novykh dannykh. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2013; 113 (11-1): 91-6 (in Russian).
  19. Мамедова З.Д., Фатеева Т.Г., Парфенов В.А. Головные боли у пациентов с артериальной гипертензией и гипертоническими кризами. Неврологический журн. 2013; 2: 28-31. @@Mamedova Z.D., Fateeva T.G., Parfenov V.A. Golovnye boli u patsientov s arterial'noi gipertenziei i gipertonicheskimi krizami. Nevrologicheskii zhurn. 2013; 2: 28-31 (in Russian).
  20. Осипова В.В., Азимова Ю.Э., Табеева Г.Р. и др. Диагностика головных болей в России и странах постсоветского пространства: состояние проблемы и пути ее решения. Анналы клинической и экспериментальной неврологии. 2012; 6 (2): 16-21. @@Osipova V.V., Azimova Iu.E., Tabeeva G.R. et al. Diagnostika golovnykh bolei v Rossii i stranakh postsovetskogo prostranstva: sostoianie problemy i puti ee resheniia. Annaly klinicheskoi i eksperimental'noi nevrologii. 2012; 6 (2): 16-21 (in Russian).
  21. Diamanti S, Longoni M, Agostoni EC. Leading symptoms in cerebrovascular diseases: what about headache? Neurol Sci 2019; 40 (Suppl. 1): 147-52.
  22. Chinthapalli K, Logan AM, Raj R, Nirmalananthan N. Assessment of acute headache in adults -what the general physician needs to know. Clin Med (Lond) 2018; 18 (5): 422-7.
  23. Chu KH, Howell TE, Keijzers G et al. Acute Headache Presentations to the Emergency Department: A Statewide Cross-sectional Study Acad Emerg Med 2017; 24 (1): 53-62.
  24. Linn FH, Rinkel GJ, Algra A, van Gijn J. Headache characteristics in subarachnoid haemorrhage and benign thunderclap headache. J Neurol Neurosurg Psychiatry 1998; 65 (5): 791-3.
  25. Bellolio MF, Hess EP, Gilani WI et al. External validation of the Ottawa subarachnoid hemorrhage clinical decision rule in patients with acute headache. Am J Emerg Med 2015; 33: 244-9.
  26. Perry JJ, Stiell IG, Sivilotti MLA et al. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA 2013; 310: 1248-55.
  27. Steiner T, Juvela S, Unterberg A et al. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis Basel Switz 2013; 35: 93-112.
  28. Stewart H, Reuben A, McDonald J. LP or not LP, that is the question: gold standard or unnecessary procedure in subarachnoid haemorrhage? Emerg Med J 2014; 31: 720-3.
  29. Vivancos J, Gilo F, Frutos R et al. Clinical management guidelines for subarachnoid haemorrhage. Diagnosis and treatment. Neurol Barc Spain 2014; 29: 353-70.
  30. Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol 2012; 11: 906-17.
  31. Cheng Y-C, Kuo K-H, Lai T-H. A common cause of sudden and thunderclap headaches: reversible cerebral vasoconstriction syndrome. J Headache Pain 2014; 15: 13.
  32. Mawet J, Boukobza M, Franc J et al. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. Neurology 2013; 81: 821-4.
  33. Сергеев А.В., Осипова В.В., Табеева Г.Р., Снопкова Е.В. Синдром обратимой церебральной вазоконстрикции. Неврол. журн. 2012; 17 (3): 4-11. [Sergeev A.V., Osipova V.V., Tabeeva G.R., Snopkova E.V. Sindrom obratimoi tserebral'noi vazo-konstriktsii. Nevrol. zhurn. 2012; 17 (3): 4-11 (in Russian).]
  34. Sveinsson O, Love A, Vilmarsson V, Olafsson I. Reversible cerebral vasoconstriction syndrome -a common cause of thunderclap headache. Laeknabladid 2020; 106 (2): 79-83.
  35. Yang CW, Fuh JL. Thunderclap headache: an update. Expert Rev Neurother 2018; 18 (12): 915-24.
  36. Peng K-P, Fuh J-L, Wang S-J. High-pressure headaches: idiopathic intracranial hypertension and its mimics. Nat Rev Neurol 2012; 8: 700-10.
  37. Urbach H. Intracranial hypotension: clinical presentation, imaging findings, and imaging-guided therapy. Curr Opin Neurol 2014; 27: 414-24.
  38. Winkler A, True D. Giant Cell Arteritis: 2018 Review. Mo Med 2018; 115 (5): 468-70.
  39. Осипова В.В., Филатова Е.Г., Артеменко А.Р. и др. Диагностика и лечение мигрени: рекомендации российских экспертов. Журн. неврологии и психиатрии им. СОКорсакова. 2017; 117 (1-2): 28-42. @@Osipova V.V., Filatova E.G., Artemenko A.R. et al. Diagnostika i lechenie migreni: rekomendatsii rossiiskikh ekspertov. Zhurn. nevrologii i psikhiatrii im. C.C.Korsakova. 2017; 117 (1-2): 28-42 (in Russian).
  40. Kelley NE, Tepper DE. Rescue therapy for acute migraine, part 1: triptans, dihydroergotamine, and magnesium. Headache 2012; 52: 114-28.
  41. Friedman BW, Garber L, Yoon A. et al. Randomized trial of IV valproate vs metoclopramide vs ketorolac for acute migraine. Neurology 2014; 82: 976-83.
  42. Panerai AE, Lanata L, Ferrari M et al. A new ketoprofen lysine salt formulation: 40 mg orodispersible granules. Trends Med 2012; 12 (4): 159-67.
  43. Woldeamanuel Y, Rapoport A, Cowan R. The place of corticosteroids in migraine attack management: a 65-year systematic review with pooled analysis and critical appraisal. Cephalalgia 2015.
  44. Khazaei M, Hosseini Nejad Mir N et al. Effectiveness of intravenous dexamethasone, metoclopramide, ketorolac, and chlorpromazine for pain relief and prevention of recurrence in the migraine headache: a prospective double-blind randomized clinical trial. Neurol Sci 2019; 40 (5): 1029-33.
  45. Loder E, Weizenbaum E, Frishberg B, Silberstein S, American Headache Society Choosing Wisely Task Force. Choosing wisely in headache medicine: the American Headache Society’s list of five things physicians and patients should question. Headache 2013; 53: 1651-9.
  46. Ахмадеева Л.Р., Азимова Ю.Э., Каракулова Ю.В. и др. Клинические рекомендации по диагностике и лечению головной боли напряжения. РМЖ. 2016; 7: 411-9. @@Akhmadeeva L.R., Azimova Iu.E., Karakulova Iu.V. et al. Klinicheskie rekomendatsii po diagnostike i lecheniiu golovnoi boli napriazheniia. RMZh. 2016; 7: 411-9 (in Russian).

Copyright (c) 2020 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies