Kronične višednevne glavobolje

master's thesis

• Title (english): Chronic daily headaches
• Author: Marin Marcikić
• Mentor: Darija Mahović Lakušić (mentor)
• Committee member: Branko Malojčić (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Darija Mahović Lakušić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Kronične višednevne glavobolje (engl. chronic daily headaches, CDH) skupina su neuroloških poremećaja koji često nastaju kao komplikacija epizodičnih glavobolja te mogu u velikoj mjeri ometati svakodnevno funkcioniranje. Relativno su česta pojava i zahvaćaju 4-5% svjetske populacije, s najvećom pojavnošću u četvrtom i petom desetljeću života. Točni uzroci nastanka CDH do danas još nisu poznati, no postoje teorije o određenim patofiziološkim mehanizmima koji bi mogli biti odgovorni za ove izrazito limitirajuće poremećaje. Kronična tenzijska glavobolja (CTTH) najčešći je kronični tip višednevnih glavobolja, međutim, kronična migrena jest medicinski najznačajnija jer najviše utječe na pacijentovo fizičko i mentalno zdravlje. Točnu dijagnozu nekad je teško postaviti s obzirom na preklapanje simptoma između pojedinih tipova CDH, što dodatno otežava liječenje istih. Postoji nekoliko terapijskih pristupa, farmakoloških i nefarmakoloških, koji su uvriježeni kao prva linija terapije, kako za suzbijanje simptoma, tako i za prevenciju njihove pojave. Unatoč tomu, u nekim slučajevima ni različite terapijske opcije ne daju pozitivne rezultate. Ipak, u posljednjih nekoliko godina sve više se u terapiji naglašava važnost lijekova koji djeluju na CGRP, što proizlazi iz njihove učinkovitosti i sigurnosti. Prognoza CDH varira od pacijenta do pacijenta pa kod nekih dolazi do potpune remisije, dok kod drugih nastupa rezistencija na terapiju. Zbog izrazito jake i dugotrajne boli, CDH dugoročno narušavaju kvalitetu života te mogu zahvatiti i narušiti i druge aspekte čovjekovog života, poput obiteljskih i prijateljskih odnosa ili radne sposobnosti. Upravo zbog potonjeg, CDH predstavljaju značajan javnozdravstveni, ali i ekonomski problem, stoga je nužan sveobuhvatan pristup liječenju ove skupine dijagnoza imajući u vidu sve moguće posljedice.

Abstract (english)

Chronic daily headaches (CDH) represent a group of neurological disorders that often evolve from their episodic precursors which can greatly disrupt everyday functioning. They are relatively common with a global prevalence of 4-5%, with highest incidence in thirties and forties. The exact roots of CDH still remain unknown, however there are theories about specific pathophysiological mechanisms that seem to be responsible for these extremely disabling disorders. Chronic tension-type headache is the most common type of CDH, but chronic migraine is the most medically significant one, since it impacts one's physical and mental health the most. Correct diagnosis is sometimes difficult to set, considering the overlap of symptoms across different headache subtypes, which only complicates their treatment. Currently, there are several different pharmacological and non-pharmacological approaches that are considered as first-line treatment, both symptomatic and preventive, although sometimes that's not enough. Nevertheless, in the last few years, more importance is being put on CGRP-targeting therapies, which arises from their efficacy and lack of side-effects. CDH have a variable prognosis and can sometimes be unpredictable. Some patients reach full remission, while others do not react to treatment at all. Because of long-lasting, high-intensity pain, CDH negatively affect patients' health in the long term. Furthermore, they can influence other aspects of patients' lives, such as friends and family or their working ability. Because of the latter, CDH represent both a notable economic and public health issue, which is exactly why comprehensive approach to treatment is mandatory, bearing in mind all possible outcomes.

• Keywords: kronične višednevne glavobolje; neurološki poremećaji; kronična migrena; kronična tenzijska glavobolja
• Keywords (english): chronic daily headache; neurological disorders; chronic migraine; chronic tension-type headache
• Language: croatian
• URN:NBN: urn:nbn:hr:105:735291
• 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: 2024-09-04 18:33:13