Nadir görülen primer baş ağrısı sendromları

Primer baş ağrıları migren, gerilim tipi baş ağrısı ve daha az rastlanan küme baş ağrısını içermektedir. Ayrıca bazı sık rastlanmayan primer başağrıları da, Uluslar arası baş ağrısı sınıflamasında (ICHD-II, 2004) “ küme başağrısı ve diğer trigeminal otonomik nevraljiler” (3.bölüm) ve “diğer primer baş ağrıları” (bölüm 4) başlığı altında incelenmiştir. Bu nadir primer baş ağrılarının prevalansı oldukça düşük olduğundan klinik özellikleri, fizyopatolojileri ve tedavileri konusunda veriler yeterli olmayıp, tartışmalar devam etmektedir. ICHD-II’de paroksismal hemikranya (PH) ile konjunktival kızarıklık ve göz yaşarmasının eşlik ettiği, unilateral kısa süreli nevraljifom ağrılar (SUNCT) üçüncü bölümde yer alırken, hemikranya kontinua (HK) otonomik belirtilerin olmasına rağmen, bu belirtilerin ön planda olmaması nedeniyle dördüncü grupta sınıflandırılmıştır. Dördüncü bölümde ayrıca, az rastlanan diğer primer baş ağrısı sendromları da bulunmaktadır. Bu makalede nadir rastlanan bu primer başağrılarından bazıları ile ilgili bilgiler gözden geçirilecektir. Bu sendromlar seyrek olarak bildirilmelerine rağmen, sıklıkları olasılıkla bilinenden daha yüksektir. Tedavileri de diğer yaygın baş ağrısı sendromlarından farklı olduğundan tanınmaları önem taşımaktadır.

Rare primary headache syndromes

Primary headaches include common forms such as migraine, tension-type headache, and the less frequent cluster headache. Besides, several uncommon primary headaches were included in the section on ‘Cluster headache and other trigeminal autonomic neuralgias’ (section 3) and ‘Other primary headaches’ (section 4) in the second edition of the International Classification of Headache Disorders (ICHD-II, 2004). Since the prevalences of these uncommon headaches are quite low, datas related to clinical features, physiopathology and management are still controversial. While paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) are listed in the third section, hemicrania continua (HC) with not prominent autonomical signs are classified in the fourth section in the ICHD-II classification. The fourth section also includes other rare primary headache syndromes. In this review, some of the uncommon primary types of headache will be discussed. Even though these headaches are reported seldomly, the prevalences are possibly higher than known. It is of importance to recognize these uncommon disorders, since their management differs from common primary headaches.

Kaynakça

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Kaynak Göster