Cefalea (III)cefalea en racimos, secundarias, farmacológicas y respondedoras a indometacina

  1. Higes Pascual, Félix
  2. Cubilla Salinas, M. A.
  3. Yusta Izquierdo, Antonio
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2015

Título del ejemplar: Enfermedades del sistema nervioso (I): Cefaleas

Serie: 11

Número: 70

Páginas: 4167-4183

Tipo: Artículo

DOI: 10.1016/S0304-5412(15)70895-4 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

El diagnóstico de la cefalea en racimos es clínico, con un cuadro bien definido. El tratamiento sintomático de elección es el oxígeno inhalado a alto flujo. La cefalea aparece asociada a una gran variedad de procesos, lo que exige cuando el patrón no se ajusta al de una cefalea primaria realizar los estudios oportunos. Es frecuente la presencia de cefalea asociada al uso de fármacos como efecto adverso de los mismos. Algunas cefaleas responden a indometacina y es un criterio diagnóstico en la hemicránea paroxística y la hemicránea continua. La cefalea tiene especial consideración en determinados rangos de edad, pues modifica la expresión clínica de algunas cefaleas primarias y la prevalencia y la etiología cambian. En el tratamiento en ancianos se debe tener en cuenta la fragilidad de este grupo de edad (pluripatilogía, polimedicación). En mujeres hay una relación entre la influencia de las hormonas sexuales y la expresión clínica de cefaleas primarias como la migraña, lo que condiciona el tratamiento. El embarazo provoca cambios hormonales que influyen en el curso clínico de las cefaleas primarias y la posibilidad de teratogenicidad limita el tratamiento. Hay cefaleas de escasa prevalencia cuyo conocimiento es imprescindible.

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