（记者乔军伟摄）

(Reporter Qiao Junwei perturbation)

    ●继发性头痛约占头痛的75%，往往由器质性病变导致，需及时就医

    Low secondary headaches accounted for about 75% of the headaches,Is often caused by organic disease,Need timely treatment

    ●头痛首诊神经内科，看病时应向医生描述清楚头痛的发作时间及持续时间、疼痛部位、有无诱因、有无规律等

    Second-ranking headache first clinical neurology,A doctor should be described to the doctor when clear time and duration of headache attacks/The area/With or without cause/There is irregular, etc.

    头痛再常见不过，几乎每个人都遭遇过头痛，但是能及时、正确就医的却为数不多，很多人都选择忍一忍了事。专家提醒，有的头痛是不能忍的，一忍就会出大问题，比如，一用力咳嗽或一用力大便就会头痛，很可能是颅内病变，可能存在肿瘤或脑炎等疾病，必须尽快就医；再比如，突然发作头痛，同时伴有一边手脚麻痹、讲话不灵活、视物不清楚等，很可能是中风的先兆，也必须尽快就医。“在临床上，有六种头痛一定要引起重视，及早治疗。”广东省人民医院神经内科副主任医师袁彦伯说。

    Headache, common but again,Almost everyone has encountered a headache,But in a timely manner/Correct treatment of but a few,A lot of people choose to endure a endure.The expert reminds,Some headache can't endure,A bear will be a big problem,Such as the,A cough or a hard piece of shit would have a headache,Is likely to be intracranial lesions,There may be a tumor or diseases such as encephalitis,Have to go to a doctor as soon as possible;Again for instance,Sudden onset headache,At the same time accompanied by side limbs paralysis/Speech is not flexible/Don't see things clearly, etc,Are likely to be the aura of stroke,Also have to go to a doctor as soon as possible."In the clinic,Six kinds of headache must be caused take seriously,Early treatment."Guangdong province people's hospital of nerve internal medicine of doctor of vice director of Yuan Yanbo said.

    医学指导/广东省人民医院神经内科副主任医师袁彦伯

    Medical guide/nerve internal medicine of doctor of vice director of the guangdong people's hospital Yuan Yanbo

    原发性头痛相对良性     Primary headaches are relatively benign

    头痛，是临床上常见的症状之一，99%的人都会遭遇头痛，但是能及时、正确就医的却为数不多。相关调查显示，37%的白领每月头痛超过5天，而超过60%的受访者表示并不采取任何治疗行为，选择以“忍痛”来处理头痛困扰，仅有10%的受访者去医院就诊，其余则采取自行服药等方式缓解头痛。

    Have a headache,Is one of the common clinical symptoms,99% of people will encounter a headache,But in a timely manner/Correct treatment of but a few.相关survey显示,37% of white-collar workers headache for more than 5 days per month,And more than 60% of respondents said they did not take any treatment,Choose to"Bite the bullet"To deal with the headaches,Only 10% of respondents go to hospital,The rest to take medicine on their own way to relieve headaches, etc.

    袁彦伯介绍，临床上，头痛主要分为两大类，一类是原发性头痛，约占24%，包括偏头痛、紧张性头痛和丛集性头痛。其中偏头痛病人约占9%左右，这种疼痛比较好判断，患者头痛发作前有时会出现短暂性看东西模糊，或弯腰、上下楼梯时头痛加剧；比较怕光、怕声音，发作后喜欢找安静、黑暗的地方待着；很多女性偏头痛患者发作时间往往跟来例假有关，经前期会比较容易发作，但很少连续痛超过3天，或者睡一觉起来就会缓解。丛集性头痛的比例不到1%，也特别容易辨别，“这种头痛非常典型，呈阵发性密集性发作，非常剧烈，常伴有流泪、鼻塞、流涕等症状，眼球像要掉出来一样，一般见过一次就会终生难忘。”而原发性头痛中最常见的是紧张性头痛，比例超过10%，这类头痛跟紧张、疲劳、压力大等有关，常与焦虑、抑郁障碍共病。

    Yuan Yanbo introduction,The clinical,Headache is mainly divided into two broad categories,One kind is of primary headache,Accounted for about 24% of,Including migraine/Tension headache and cluster headache.Accounts for about 9% of migraine patients,This pain is better judgment,Sometimes before the onset of headache in patients with transient blurred at things,Or bend over/Headaches worse when up and down the stairs;More afraid of the light/Afraid of the sound,Like looking for a quiet after seizures/The darkness of the place to stay;A lot of women patients with migraine headache often associated with period in time,Premenstrual will be relatively easy to attack,But few of them hurt more than 3 consecutive days,Or sleep up will ease.The proportion of cluster headache (ch) is less than 1%,Also particularly easy to discern,"This is a very typical headache,Paroxysmal intensive attacks,Is very severe,Often accompanied by tears/A stuffy nose/Runny nose and other symptoms,Eye like to fall out,Commonly seen a will be unforgettable."And the most common type of primary headaches is tension headaches,More than 10%,This kind of headache with tension/fatigue/Pressure and so on,Often associated with anxiety/Comorbid depression disorder.

    “患者因为头痛需要就诊时，我们除了询问病史外，还要对患者进行神经系统的体格检查，如体格检查发现问题，再做CT、脑电图或MRI等辅助检查。”袁彦伯介绍，一般来说，体格检查、辅助检查没发现什么问题，排除引起继发性头痛的因素，又符合原发性头痛特点的，一般诊断为原发性头痛。

    "Because headache patients need to see a doctor,We in addition to the history,还要对患者进行神经Department of统的Physical check,Such as medical examination found that the problem,To do CT/Electroencephalogram (eeg) or magnetic resonance imaging (MRI) and other auxiliary examination."Yuan Yanbo introduction,In general,Physical check/Auxiliary examination did not discover what problem,Rule out causes of secondary headaches,And accord with the characteristics of primary headache,General diagnosis of primary headache.

    “从临床经验来看，原发性头痛相对良性，也有相应的治疗手段，一般不会产生严重后果，只是会对患者的生活质量产生一定的影响，需要特别警惕的是继发性头痛。”

    "From clinical experience,Primary headaches are relatively benign,Also has the corresponding treatment,General won't produce serious consequences,Just can produce certain influence to the patient's quality of life,Need special vigilance is secondary headaches."

   

    继发性头痛往往由器质性病变所致  Secondary headaches are often caused by organic disease

    据介绍，继发性头痛约占头痛的75%，通常有如下几种原因：

    According to introducing,Secondary headaches accounted for about 75% of the headaches,Usually there are several reasons as follows:

    1.神经系统疾病：如脑血管病、脑肿瘤、颅内感染、脑外伤、某些类型的癫痫、睡眠呼吸障碍等。

    1.神经Department of统疾病:Such as cerebrovascular disease/Brain tumor/Intracranial infection/Traumatic brain injuries/Certain types of epilepsy/Sleep apnea, etc.

    2.内科疾病：如高血压、卵圆孔未闭、贫血、感染（包括感冒）、中毒等导致的头痛。

    2. Internal medicine diseases:Such as high blood pressure/Patent foramen ovale/anemia/infection(Including cold)/Headache caused by poisoning, etc.

    3.五官疾病：如青光眼、鼻窦炎、牙痛、中耳炎等也会引起头痛。

    3. The facial disease:Such as glaucoma/sinusitis/A toothache/Otitis media, could also cause a headache.

    4.颈椎疾病：颈椎退行性病变、椎间盘突出导致神经受压，也会导致头痛。

    4. The cervical vertebra disease:Cervical degenerative diseases/Intervertebral disc herniation cause nerve compression,Also can lead to headaches.

    5.精神科疾病：焦虑症、抑郁症患者常有头痛症状，也易与原发性头痛共病，常因头痛到神经科就诊，需要注意鉴别。

    5. Psychiatric disease:Anxiety disorders/Depressed patients often have a headache symptoms,Are also prone to disease with primary headaches,Often have a headache to the neurologist doctor,Need to pay attention to identify.

    “继发性头痛往往由器质性病变所致，如果不加重视，往往会导致疾病快速进展，如脑血管病、脑肿瘤、脑炎等导致的头痛，如不及时治疗，患者往往会丧失工作和生活能力，甚至危及生命。”袁彦伯说。

    "Secondary headaches are often caused by organic disease,If you don't add value,Rapid progress often lead to disease,Such as cerebrovascular disease/Brain tumor/Headache caused by encephalitis,If not treated,Patients tend to lose the capacity to work and life,And even life threatening."Yuan Yanbo said.

   

    六种头痛一定要看医生  Six kinds of headache have to see the doctor

    袁彦伯介绍，以下六种疼痛，一定要引起患者的高度重视，尽早就医：

    Yuan Yanbo introduction,The following six kinds of pain,Must has drawn great attention of patients,Go to a doctor as soon as possible:

    1.有生以来第一次或最痛的一次头痛、性质发生变化的头痛、进行性加重的头痛，一定要高度重视，马上就医。

    1. Or for the first time in my life the most painful headache at a time/Change properties of headache/Progression of a headache,Must be highly valued,Go to a doctor right away.

    2.伴有恶心、呕吐，或用力咳嗽、用力大便时疼痛加重的头痛。因为这种头痛往往预示着颅内压增高，提示颅内器质性疾病，如急性脑膜炎和脑炎、脑出血、蛛网膜下腔出血、静脉窦血栓形成、脑肿瘤或脑寄生虫病等。

    2. Nausea and/vomiting,Or cough forcefully/Is the pain worse forcibly defecate headache.Because of the headache often herald increased intracranial pressure,Hint of intracranial organic disease,Such as acute meningitis and encephalitis/Bleeding in the brain/Subarachnoid hemorrhage/Venous sinus thrombosis/Brain tumors or brain parasitic diseases, etc.

    3. 50岁以后出现的头痛。因为这个年龄段是很多疾病，尤其是肿瘤的高发年龄段，患者一定要警惕，查明原因。

    3. A headache after age 50.Because this age is a lot of disease,Especially the tumor incidence age group,Patients must be vigilant,Find out why.

    4.头痛的同时伴有一边手脚麻痹、讲话不灵活、看东西不清楚等，也需尽早就医，因为这有可能是中风的先兆，也可能预示着肿瘤，提示着脑里有病灶。

    4. A headache accompanied by side limbs paralysis at the same time/Speech is not flexible/See not clear, etc,Also need to go to a doctor as soon as possible,Because this is probably the aura of stroke,May herald a tumor,Prompted the brain lesions.

    5.伴有发烧的头痛，如果体温降低，但头还是痛，并且痛得越来越严重，一定要引起重视，这种情况往往提示可能有颅内感染。

    5. Accompanied by fever headache,If the temperature is lower,But the head is pain,And the pain is more and more serious,Must be caused take seriously,This often prompts may have intracranial infection.

    6.伴有情绪问题的头痛。调查显示，有40%左右的抑郁症患者都会伴有头痛症状。这类患者往往会有自杀、自伤等倾向，因此需及时就医，及早治疗。

    6. A headache accompanied by emotional problems.survey显示,About 40% of patients with depression is accompanied by headache symptoms.These patients tend to have committed suicide/Self-harm tendency,Therefore need timely medical treatment,Early treatment.

   

    看病时向医生说什么？  When the doctor said to the doctor?

    头痛应该看什么科？当然是神经内科。

    Headache should look at what?Neurology, of course.

    袁彦伯介绍，因为头痛是神经系统常见症状，属于神经科疾病范畴，因此头痛的诊断与鉴别是神经科医生的基本功。

    Yuan Yanbo introduction,因为Have a headache是神经Department of统常见症状,Belong to the category of neurological diseases,So headache for diagnosis and identification is the basic skill in the neurologist.

    就诊时，患者应该怎样向医生描述病情？

    When to see a doctor,How should patients describe condition to the doctor?

    袁彦伯表示，主要应描述以下几点：

    Yuan Yanbo said,Should mainly describes the following points:

    1.发作时间：什么时候开始痛的，痛了多久；是急性起病的，还是慢慢起病的；是持续的痛，还是一阵阵的痛；

    1. The onset time:When did the pain start,How long did the pain;Is acute episode,Or slow onset;Is a constant pain,Or a twinge of pain;

    2.头痛的部位：是前、后、两侧、一侧痛，还是游走性痛；

    2. A headache:Is the former/after/On both sides of the/On one side of the pain,Still wandering;

    3.头痛的性质：怎样痛，是血管一跳一跳的痛，还是针扎样痛；是触电样痛，还是钻孔样痛；是打击样痛，还是爆炸样痛；是胀痛，还是闷闷的痛；

    3. The nature of the headache:How to pain,Blood vessels is a jump jump,Sample or needle pain;Sample is electrocuted pain,Or drilling samples;Pain is the sample,Sample pain or explosion;Is the pain,Or a feeling of tightness in the pain;

    4.有没有诱因：比如感冒、拉肚子、吹空调、暴晒等，跟睡眠、情绪、来月经等有没有关系；

    4. Do you have any incentive:Such as a cold/Have loose bowels/Blow air conditioning/Sun, etc.,With sleep/mood/来月经等有没有关Department of;

    5.有没有规律：比如上午痛、下午痛还是半夜痛；有什么办法可以缓解或加重，比如，是不是跟体位有关，躺下来不痛站起来痛；吃不吃药或吃什么药能够减轻疼痛；深呼吸或咳嗽时疼痛是不是会加重或缓解等。

    5. Is there any rule:Such as pain in the morning/Pain or pain in the middle of the afternoon;What method can alleviate or worse,Such as the,Is related to position,Lie down and not pain pain;Eat not to take medicine and eat what medicine to relieve pain;Deep breathing or coughing when whether can aggravate or pain relief, etc.

    6.另外，患者的既往病史、外伤史、服药史、中毒史、家族史等情况也应主动向医生说明。

    6. In addition,The patient's medical history/History of trauma/History of medicine/History of poisoning/Family history, and so on and so forth should also take the initiative to tell the doctor.

    “因为头痛是个症状，医生往往要根据患者的描述来判断疾病，因此，患者提供的信息越详细，医生指向性的判断就会越准确。”袁彦伯说。

    "Because headache is a symptom,Doctors tend to be judged from the patient's description of the disease,so,Patient information is more detailed,The doctor directed judgment will be more accurate."Yuan Yanbo said.