Diferencijalna dijagnoza autonomne trigeminalne glavobolje

master's thesis

• Title (english): Differential diagnosis of trigeminal autonomic cephalgias
• Author: Dario Grbavac
• Mentor: Darija Mahović Lakušić (mentor)
• Committee member: Ervina Bilić (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Darija Mahović Lakušić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Autonomne trigeminalne glavobolje (TAG) čini grupa rijetkih primarnih glavobolja koje imaju karakterističnu unilateralnu trigeminalnu distribuciju intenzivne boli popraćene ipsilateralnim kranijalnim autonomnim simptomima (konjunktivalna injekcija, lakrimacija, edem vjeđe, rinoreja, kongestija nosa, Hornerov sindrom – ptoza i mioza). Klasificirane su zajedno na temelju slične kliničke prezentacije trigeminalne boli i aktivacije autonomnog sustava, pretpostavljene zajedničke patofiziološke osnove koja uključuje aktivaciju trigeminovaskularnog sustava i hipotalamičkih centara koji kontroliraju cirkadijane ritmove i moduliraju osjet boli. Autonomne trigeminalne glavobolje čini cluster glavobolja, paroksizmalna hemikranija, kratkotrajni unilateralni neuralgiformni napadaji glavobolje (SUNCT i SUNA) i hemicrania continua. Postoji značajna razina preklapanja u dijagnostičkim kriterijima ovih glavobolja. No unatoč tim sličnostima, ovi poremećaji mogu se razlikovati jedan od drugog na temelju nekih njihovih specifičnih individualnih kliničkih manifestacija, duljine, trajanja i učestalosti pojavljivanja napadaja, te na temelju njihovog relativno specifičnog odgovora na terapiju. Često se niz patoloških procesa (osobito u području hipofizne regije) može prezentirati kliničkom slikom autonomne trigeminalne glavobolje i stoga bi svi bolesnici trebali imati odgovarajuću neuroradiološku dijagnostiku. Cilj ovoga preglednog rada je dati pregled autonomnih trigeminalnih glavobolja, naglasiti njihove kliničke manifestacije i posebnosti i predstaviti nove diferencijalno-dijagnostičke kriterije (ICHD-3 2013).

Abstract (english)

Trigeminal autonomic cephalgias (TACs) are a group of rare primary headache disorders characterised by unilateral trigeminal distribution of severe pain that occurs in association with ipsilateral cranial autonomic features (conjunctival injection, lacrimation, eyelid ptosis, nasal rhinorrhea or congestion, Horner’s syndrome - ptosis with miotic pupil). Trigeminal autonomic cephalgias are classified together based on a similar clinical presentation of trigeminal pain and autonomic activation, suspected common pathophysiology involving the trigeminovascular system and hypothalamic centres controlling circadian rhythms and modulating pain. This group of headache disorders includes cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks (SUNCT and SUNA syndrome) and hemicrania continua. There is much overlap in the diagnostic features of individual TACs. Despite their similarities, these disorders can be distinguished from each other by their specific individual clinical features, attack length, duration, frequency of occurrence and their relatively specific response to therapy. TACs are often presentation of underlying pathology (especially pituitary region) and all patients should get proper neuroradiological examination. The aim of this review is to provide an overview of TACs, outline their clinical manifestations and introduce new differential diagnostic criteria (ICHD-3 2013).

• Keywords: autonomne trigeminalne glavobolje; cluster glavobolja; paroksizmalna hemikranija; kratkotrajni unilateralni neuralgiformni napadaji glavobolje; hemicrania continua
• Keywords (english): trigeminal autonomic cephalgias; cluster headache; paroxysmal hemicrania; short-lasting unilateral neuralgiform headache attacks; hemicrania continua
• Language: croatian
• URN:NBN: urn:nbn:hr:105:038699
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-12 14:56:08