文章摘要
许佳，张海峰，陈媛，连亚军.伴自主神经症状的心脏源性头痛1例报告并文献复习[J].神经损伤功能重建,2022,17(知网首发):
伴自主神经症状的心脏源性头痛1例报告并文献复习
Cardiac Cephalalgia with Autonomic Nerve Symptoms: A Case Report and Literature Review
  
DOI：
中文关键词: 心脏源性头痛  头痛  心肌缺血  自主神经症状
英文关键词: cardiac cephalalgia  headache  myocardial ischemia  autonomic symptoms
基金项目:
作者单位
许佳，张海峰，陈媛，连亚军 郑州大学第一附属 医院神经内科 
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中文摘要:
      目的：总结心脏源性头痛（CC）的临床特点，以提高临床医生对本病的认识和早期诊断率。方法：报 道1例就诊于我院的伴自主神经症状的CC患者，并检索1997年1月至 2021年10月医学文献中报道的CC 患者进行总结。结果：本院收治的1例CC患者表现为双侧颞顶枕部胀痛，视觉模拟评分（VAS）7～8分，同 时伴随恶心、畏光、畏声、胸闷、呼吸困难及流涎、流泪、流涕等自主神经症状。动态心电图示头痛发作时快 心律依赖性广泛心肌缺血，冠状动脉CT血管成像提示三支病变。抗心绞痛治疗有效。搜索既往报道的CC 患者45例，临床表现为活动诱发的中重度头痛，部位多样，以搏动样、压迫性为主，伴随胸部不适、恶心、心 悸和出汗，持续时间多在1 h内，休息或服用硝酸甘油缓解。结论：CC是一种少见疾病，对于超过50岁，活 动诱发的中、重度头痛患者，如伴典型心血管病危险因素，应想到CC的可能。尽早确诊和规范的抗心绞痛 治疗可改善患者预后。
英文摘要:
      To analyze the clinical characteristics of cardiac cephalalgia (CC) and improve the understanding and diagnosis accuracy of this disease. Methods: A case of CC with autonomic symptoms from our hospital was reported. Medical literature from January 1997 to October 2021 was searched for patients diagnosed with CC, and the findings were summarized. Results: The patient in this case report presented bilateral temporoparietal pulsating headaches and a visual analog scale (VAS) score of 7～8 accompanied by nausea, photophobia, phonophobia, chest tightness, dyspnea, and autonomic symptoms such as salivation, tearing, and runny nose. Homomorphic ECG showed rapid rhythm-dependent extensive myocardial ischemia during headache attacks. Coronary artery CTA suggested three-vessel disease. Anti-angina pectoris treatment was effective. Forty-five cases of CC were reviewed. The clinical manifestations were mainly activity-induced, moderate to severe headaches in various locations, mostly pulsating and compressive, and accompanied by chest discomfort, nausea, palpitations, and sweating. The duration was mostly under 1 hour, and symptoms were relieved by rest and nitroglycerin. Conclusion: CC is a rare disease. Patients over 50 years old with activity-induced, moderate to severe headache combined with typical cardiovascular disease risk factors should be highly suspected of having CC. Early diagnosis and anti-angina therapies could contribute to good prognosis.
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