颅内肿瘤患者的头痛特征及相关症状

Adhitya Riski Apriady, Yusuf Wibisono, Asep Nugraha Hermawan
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摘要

颅内肿瘤在头痛患者中很少见,而头痛在颅内肿瘤患者中很常见。这就限制了利用头痛症状进行诊断,而且了解颅内肿瘤患者是否有特定的头痛标准是至关重要的。其他研究不支持颅内肿瘤头痛的经典标准,如进行性、早晨加重、Valsalva动作加重。临床研究发现,头痛作为唯一症状是罕见的,仅发生在2%的患者中,因此本研究还调查了恶心/呕吐、癫痫发作、意识丧失和运动缺陷的患病率。本研究使用了在印度尼西亚西爪哇Hasan Sadikin中央综合医院神经内科诊断为颅内肿瘤并住院的患者的病历简历。本研究的抽样方法为全抽样,取2018年1 - 12月颅内肿瘤患者的所有病历简历。在本研究中,头痛是颅内肿瘤的常见症状,发生率为75.3%,通常伴有其他症状,尤其是运动障碍(64.5%)、意识丧失(60.2%)、恶心和呕吐(31.2%)以及癫痫发作(23.7%)。患者最可能有双侧头痛(62.5%),63.6%的单侧头痛患者在头痛的同一侧有单侧颅内肿瘤。有进行性头痛的患者占93.5%。而颅内肿瘤患者入院前最常见的头痛发作是;3-30天(40.4%)和> 30天- 6个月(38.5%)。
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HEADACHE PROFILE AND ASSOCIATED SYMPTOMS IN INTRACRANIAL TUMORS
Intracranial tumors are rare in headache sufferers, although headache is common in intracranial tumor patients. This limits the utility of headache symptoms to make a diagnosis, and it's crucial to know whether people with intracranial tumors have specific headache criteria. Other investigations do not support the classic criteria for headache in intracranial tumors, such as progressive, worse in the morning, and exacerbated by Valsalva maneuvers. Clinical studies found that headache as the sole symptom was rare, and only occurred in 2% of patients, hence this study also investigated the prevalence of nausea/vomiting, seizures, loss of consciousness, and motor deficits. This study uses resumes of medical records of patients diagnosed with intracranial tumors and hospitalized in the Department of Neurology, dr. Hasan Sadikin Central General Hospital West Java, Indonesia. While the sampling method in this study was total sampling, by taking all medical record resumes of patients with intracranial tumors from January to December 2018. Headache was a prevalent symptom of intracranial tumors in this study, occurring in 75,3 % of the subjects and was usually accompanied by other symptoms, especially motor deficits (64,5%), loss of consciousness (60,2%), nausea and vomiting (31) 2%), and seizures (23,7%). Patients were most likely to have bilateral headaches (62,5%), and 63,6% of patients who had unilateral headaches had a unilateral intracranial tumor on the same side of the headache. Patients who experienced progressive headaches were 93,5% of patients. While, the most common headache onset in patients with intracranial tumors before hospital admission were; 3-30 days (40,4%) and > 30 days - 6 months (38,5%).        
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