头痛地国际分类第三版中文

A：A：符合B-D特征，至少发作5次发作B：头痛（未经治疗）发作持续4-72小时C：至少有以下特征中的2项单侧性、搏动性、中重度痛、日常活动会加重D：至少以下一项伴随症状：恶心和/或呕吐、畏光和畏声先兆性偏头痛的诊断标准：E：不能归因于其他A：符合B-C特征，至少发作2次发作B：完全可逆以下症状的1项或多项视觉、感觉、语言障碍（典型先兆）肢体无力症状（偏瘫型偏头痛）脑干症状（基底型偏头痛）视网膜症状（视网膜型偏头痛）C：至少有以下特征中的2项至少1个先兆逐渐发展的过程＞5min，和/或不同先兆接连发生过程＞5minTheinternationalClassificationofHeadachedisorders,3rdEditon头痛分类的国际标准（ICHD-III）概述：头痛分为三大组：原发性头痛；继发性头痛；脑神经痛、中枢和原发性颜面痛及其他头痛。每一种原发性头痛均视为一种独立的疾病；继发性头痛一般只是某种疾病的一种症状，该头痛称为“缘于”此种疾病的头痛，无先兆偏头痛的诊断标准：三大组头痛共分为14类：一、原发性头痛(theprimaryheadaches).偏头痛(Migraine)Migrainewithoutaura无先兆偏头痛Migrainewithaura有先兆偏头痛MigrainewithtypicalauraTypicalaurawithheadacheTypicalaurawithoutheadacheMigrainewithbrainstemauraHemiplegicmigraine偏瘫型偏头痛Familialhemiplegicmigraine(FHM)—家族性Familialhemiplegicmigrainetype1(FHM1)Familialhemiplegicmigrainetype2(FHM2)Familialhemiplegicmigrainetype3(FHM3)Familialhemiplegicmigraine,otherlociSporadichemiplegicmigraine—散发性RetinalmigraineChronicmigraine慢性偏头痛Complicationsofmigraine偏头痛并发症Statusmigrainosus偏头痛持续状态Persistentaurawithoutinfarction

Migrainousinfarction偏头痛脑梗死Migraineaura-triggeredseizureProbablemigraine很可能的偏头痛ProbablemigrainewithoutauraProbablemigrainewithauraEpisodicsyndromesthatmaybeassociatedwithmigraine可能与偏头痛有关的发作性综合征慢性偏头痛：偏头痛发作每月＞15慢性偏头痛：偏头痛发作每月＞15天，连续3个月以上偏头痛持续状态：单次发作持续72小时以上vomitingsyndrome周期性呕吐Abdominalmigraine腹型偏头痛Benignparoxysmalvertigo良性发作性眩晕Benignparoxysmaltorticollis良性发作性斜颈.紧张型头痛（Tension-typeheadache）每次发作持续30min-7d，慢性者可持续不缓解Infrequentepisodictension-typeheadache偶发性<1d/月，至少10次以上（<12d/年）Infrequentepisodictension-typeheadacheassociatedwithpericranialtendernessInfrequentepisodictension-typeheadachenotassociatedwithpericranialtendernessFrequentepisodictension-typeheadache频发性三1d/月，但<15d,至少发作10次以上（三12d/年但<180d）Frequentepisodictension-typeheadacheassociatedwithpericranialtendernessFrequentepisodictension-typeheadachenotassociatedwithpericranialtendernessChronictension-typeheadache慢性紧张型头痛每月发作三15d,3个月以上Chronictension-typeheadacheassociatedwithpericranialtendernessChronictension-typeheadachenotassociatedwithpericranialtendernessProbabletension-typeheadache很可能的紧张型头痛丛集性头痛的诊断标准:A：A：至少符合B-D的5次以上的发作Probablefrequentepisodictension-typeheadacheProbablechronictension-typeheadacheB：单侧、眼眶、上眼眶及/或颞部重度或极重度疼痛，Probablechronictension-typeheadache如不治疗持续15min-180min；

.三叉自主神经性头痛(Trigeminalautonomiccephalalgias)Clusterheadache丛集性头痛Episodicclusterheadache发作性丛集性头痛Chronicclusterheadache慢性丛集性头痛(复发作大于1年无缓解期，或缓解期＜1个月)ParoxysmalhemicraniaEpisodicparoxysmalhemicraniaChronicparoxysmalhemicraniaShort-lastingunilateralneuralgiformheadacheattacksShort-lastingunilateralneuralgiformheadacheattackswithconjunctivalinjectionandtearing(SUNCT)EpisodicSUNCTChronicSUNCTShort-lastingunilateralneuralgiformheadacheattackswithcranialautonomicsymptoms(SUNA)EpisodicSUNAChronicSUNAHemicraniacontinuaProbabletrigeminalautonomiccephalalgiaProbableclusterheadacheProbableparoxysmalhemicraniaProbableshort-lastingunilateralneuralgiformheadacheattacksProbablehemicraniacontinua.其它的原发性头痛Otherprimaryheadachedisorders)Primarycoughheadache原发性咳嗽头痛ProbableprimarycoughheadachePrimaryexerciseheadache原发性运动性头痛

ProbableprimaryexerciseheadachePrimaryheadacheassociatedwithsexualactivity原发性性活动伴随的头痛ProbableprimaryheadacheassociatedwithsexualactivityPrimarythunderclapheadache原发性霹雳头痛Cold-stimulusheadache冷刺激性头痛HeadacheattributedtoexternalapplicationofacoldstimulusHeadacheattributedtoingestionorinhalationofacoldstimulusProbablecold-stimulusheadacheHeadacheprobablyattributedtoexternalapplicationofacoldstimulusHeadacheprobablyattributedtoingestionorinhalationofacoldstimulusNDPH诊断标准：NDPH诊断标准：A：持续性头痛，符合B-C的标准B：Distinctandclearlyrememberedonset,withpainbecomingcontinuousandunremittingwithin24hoursC：Presentfor>3monthsD：除外其他疾患External-compressionheadacheExternal-tractionheadacheProbableexternal-pressureheadacheProbableexternal-compressionheadacheProbableexternal-tractionheadachePrimarystabbingheadacheProbableprimarystabbingheadacheNummularheadacheProbablenummularheadacheHypnicheadacheProbablehypnicheadacheNewdailypersistentheadache(NDPH)新症每日持续性头痛Probablenewdailypersistentheadach二、继发性头痛(thesecondaryheadaches)

.缘于头、颈部外伤的头痛(Headacheattributedtotraumaorinjurytotheheadand/orneck)AcuteheadacheattributedtotraumaticinjurytotheheadAcuteheadacheattributedtomoderateorseveretraumaticinjurytotheheadAcuteheadacheattributedtomildtraumaticinjurytotheheadPersistentheadacheattributedtotraumaticinjurytotheheadPersistentheadacheattributedtomoderateorseveretraumaticinjurytotheheadPersistentheadacheattributedtomildtraumaticinjurytotheheadAcuteheadacheattributedtowhiplashPersistentheadacheattributedtowhiplashAcuteheadacheattributedtocraniotomyPersistentheadacheattributedtocraniotomy.缘于头颈部血管疾病的头痛(Headacheattributedtocranialorcervicalvasculardisorder)HeadacheattributedtoischaemicstrokeortransientischaemicattackHeadacheattributedtoischaemicstroke(cerebralinfarction)Headacheattributedtotransientischaemicattack(TIA)Headacheattributedtonon-traumaticintracranialhaemorrhageHeadacheattributedtonon-traumaticintracerebralhaemorrhage非夕卜伤性脑出血Headacheattributedtonon-traumaticsubarachnoidhaemorrhage(SAH)Headacheattributedtonon-traumaticacutesubduralhaemorrhage供5口用急性硬膜下血肿Headacheattributedtounrupturedvascularmalformation未破裂的血管畸形Headacheattributedtounrupturedsaccularaneurysm囊性动脉瘤Headacheattributedtoarteriovenousmalformation(AVM)动静脉畸形Headacheattributedtoduralarteriovenousfistula(DAVF)硬膜动静脉屡Headacheattributedtocavernousangioma海绵窦血管瘤Headacheattributedtoencephalotrigeminalorleptomeningealangiomatosis(SturgeWebersyndrome)

脑三叉神经或软脑膜血管瘤病HeadacheattributedtoarteritisHeadacheattributedtogiantcellarteritis(GCA)颞动脉炎Headacheattributedtoprimaryangiitisofthecentralnervoussystem(PACNS)Headacheattributedtosecondaryangiitisofthecentralnervoussystem(SACNS)颗动脉炎诊断标准：美国风湿学会1990年.50岁以上发病：50岁以上发现症状.新发的头痛：出现新发的局限性头痛.颗动脉异常：颗动脉压痛或者与颈动脉的动脉硬化无关的搏动减弱.血沉值升高：50mm/h以上 Headacheattributedtocervicalcarotidorvertebralarterydisorder颈动脉或锥动脉疼痛Headacheorfacialorneckpainattributedtocervicalcarotidorvertebralarterydissection动脉夹层Post-endarterectomyheadache内膜剥脱术后头痛Headacheattributedtocarotidorvertebralangioplasty颈动脉血管成型术头痛Headacheattributedtocerebralvenousthrombosis(CVT)脑静脉血栓形成HeadacheattributedtootheracuteintracranialarterialdisorderHeadacheattributedtoanintracranialendovascularprocedureAngiographyheadacheHeadacheattributedtoreversiblecerebralvasoconstrictionsyndrome(RCVS)Headacheprobablyattributedtoreversiblecerebralvasoconstrictionsyndrome(RCVS)Headacheattributedtointracranialarterialdissection颅内动脉夹层HeadacheattributedtogeneticvasculopathyCerebralAutosomalDominantArteriopathywithSubcorticalInfarctsandLeukoencephalopathy(CADASIL)

MitochondrialEncephalopathy,LacticAcidosisandStroke-likeepisodes(MELAS)HeadacheattributedtoanothergeneticvasculopathyHeadacheattributedtopituitaryapoplexy垂体卒中.缘于非血管性颅内疾病的头痛(Headacheattributedtonon-vascularintracranialdisorder)Headacheattributedtoincreasedcerebrospinalfluidpressure颅内压增高Headacheattributedtoidiopathicintracranialhypertension(IIH)Headacheattributedtointracranialhypertensionsecondarytometabolic,toxicorhormonalcausesHeadacheattributedtointracranialhypertensionsecondarytohydrocephalusHeadacheattributedtolowcerebrospinalfluidpressure颅内压低下Post-duralpunctureheadache腰穿后CSFfistulaheadache脑脊液漏Headacheattributedtospontaneousintracranialhypotension自发性低颅压Headacheattributedtonon-infectiousinflammatorydisease非感染性炎性疾病HeadacheattributedtoneurosarcoidosisHeadacheattributedtoaseptic(non-infectious)meningitisHeadacheattributedtoothernon-infectiousinflammatorydiseaseHeadacheattributedtolymphocytichypophysitisSyndromeoftransientHeadacheandNeurologicalDeficitswithcerebrospinalfluidLymphocytosis(HaNDL)Headacheattributedtointracranialneoplasia颅内新生物HeadacheattributedtointracranialneoplasmHeadacheattributedtocolloidcystofthethirdventricleHeadacheattributedtocarcinomatousmeningitis癌性脑膜炎Headacheattributedtohypothalamicorpituitaryhyper-orhyposecretionHeadacheattributedtointrathecalinjection鞘内注射Headacheattributedtoepilepticseizure

Hemicraniaepileptica癫痫半颅痛Post-ictalheadache癫痫发作后头痛HeadacheattributedtoChiarimalformationtypeI(CM1)Headacheattributedtoothernon-vascularintracranialdisorder.缘于物质或物质戒断的头痛(Headacheattributedtoasubstanceoritswithdrawal)Headacheattributedtouseoforexposuretoasubstanceoritswithdrawal缘于某种物质的应用或戒断Nitricoxide(NO)donor-inducedheadache一化氮诱发ImmediateNOdonor-inducedheadacheDelayedNOdonor-inducedheadachePhosphodiesterase(PDE)inhibitor-inducedheadache磷酸二酯酶抑制剂Carbonmonoxide(CO)-inducedheadache一氧化碳诱发Alcohol-inducedheadache酒精诱发Immediatealcohol-inducedheadacheDelayedalcohol-inducedheadacheHeadacheinducedbyfoodand/oradditive由于食物成分/添加剂诱发Monosodiumglutamate(MSG)-inducedheadache谷氨酸单钠盐(味精)Cocaine-inducedheadache可卡因诱发Histamine-inducedheadache组织胺诱发Immediatehistamine-inducedheadacheDelayedhistamine-inducedheadacheCalcitoningene-relatedpeptide(CGRP)-inducedheadache降钙素基因相关多肽诱发ImmediateCGRP-inducedheadacheDelayedCGRP-inducedheadacheHeadacheattributedtoexogenousacutepressoragentHeadacheattributedtooccasionaluseofnon-headachemedication

Headacheattributedtolong-termuseofnon-headachemedicationHeadacheattributedtoexogenoushormoneHeadacheattributedtouseoforexposuretoothersubstanceMedication-overuseheadache(MOH)药物过度使用性头痛MOH诊断标准.符合3-4项的头痛表现三15天.规律使用1种或多种用于头痛急性期的止痛药超过3个月.在药物过度使用期间，头痛进展或明显加重4,停用所用过度使用药物之后的2个月内，头痛必需改善(缓解或重归于之前的头痛模式 Ergotamine-overuseheadache麦角胺类Triptan-overuseheadache曲普坦类Simpleanalgesic-overuseheadache单纯止痛药类Paracetamol(acetaminophen)-overuseheadache对乙酰氨基酚Acetylsalicylicacid-overuseheadache乙酰水杨酸/阿司匹林Othernon-steroidalanti-inflammatorydrug(NSAID)-overuseheadacheOpioid-overuseheadache鸦片类Combination-analgesic-overuseheadache复合制剂过度应用Medication-overuseheadacheattributedtomultipledrugclassesnotindividuallyoverused联合用药所致Medication-overuseheadacheattributedtounverifiedoveruseofmultipledrugclassesMedication-overuseheadacheattributedtoothermedicationHeadacheattributedtosubstancewithdrawal物质戒断Caffeine-withdrawalheadache咖啡因Opioid-withdrawalheadache鸦片类Oestrogen-withdrawalheadache雌激素

Headacheattributedtowithdrawalfromchronicuseofothersubstance.缘于感染的头痛(Headacheattributedtoinfection)Headacheattributedtointracranialinfection颅内感染Headacheattributedtobacterialmeningitisormeningoencephalitis细菌性脑膜炎/脑膜脑炎AcuteheadacheattributedtobacterialmeningitisormeningoencephalitisChronicheadacheattributedtobacterialmeningitisormeningoencephalitisPersistentheadacheattributedtopastbacterialmeningitisormeningoencephalitisHeadacheattributedtoviralmeningitisorencephalitis病毒性脑膜炎或脑炎HeadacheattributedtoviralmeningitisHeadacheattributedtoviralencephalitisHeadacheattributedtointracranialfungalorotherparasiticinfection真菌或寄生虫感染AcuteheadacheattributedtointracranialfungalorotherparasiticinfectionChronicheadacheattributedtointracranialfungalorotherparasiticinfectionHeadacheattributedtobrainabscess月囱脓月中Headacheattributedtosubduralempyema硬膜下积脓Headacheattributedtosystemicinfection系统感染Headacheattributedtosystemicbacterialinfection系统细菌感染AcuteheadacheattributedtosystemicbacterialinfectionChronicheadacheattributedtosystemicbacterialinfectionHeadacheattributedtosystemicviralinfection系统病毒感染AcuteheadacheattributedtosystemicviralinfectionChronicheadacheattributedtosystemicviralinfectionHeadacheattributedtoothersystemicinfection其他系统感染AcuteheadacheattributedtoothersystemicinfectionChronicheadacheattributedtoothersystemicinfection

.缘于内环境紊乱的头痛(Headacheattributedtodisorderofhomoeostasis)Headacheattributedtohypoxiaand/orhypercapnia缺氧和/或高碳酸血症High-altitudeheadache高海拔头痛Headacheattributedtoaeroplanetravel飞行头痛Divingheadache潜水头痛Sleepapnoeaheadache睡眠呼吸暂停性头痛DialysisheadacheHeadacheattributedtoarterialhypertension高血压性头痛Headacheattributedtophaeochromocytoma嗜络细胞瘤Headacheattributedtohypertensivecrisiswithouthypertensiveencephaffip高血压脑病的高血压危象Headacheattributedtohypertensiveencephalopathy高血压脑病Headacheattributedtopre-eclampsiaoreclampsia先兆子痫Headacheattributedtoautonomicdysreflexia自主反射障碍Headacheattributedtohypothyroidism甲状腺低下Headacheattributedtofasting禁食Cardiaccephalalgia心源性头痛Headacheattributedtootherdisorderofhomoeostasis其他内环境稳定失调疾患.缘于头、颈、眼、耳、鼻、鼻窦、牙、口或其他头面部结构病变的头面痛(Headacheorfacialpainattributedtodisorderofthecranium,neck,eyes,ears,nose,sinuses,teeth,mouthorotherfacialorcervicalstructure)Headacheattributedtodisorderofcranialbone颅骨Headacheattributedtodisorderoftheneck颈部CervicogenicheadacheHeadacheattributedtoretropharyngealtendonitisHeadacheattributedtocraniocervicaldystoniaHeadacheattributedtodisorderoftheeyes眼睛

Headacheattributedtoacuteglaucoma急性青光眼Headacheattributedtorefractiveerror屈光不正Headacheattributedtoheterophoriaorheterotropia(latentorpersistentsquint斜视HeadacheattributedtoocularinflammatorydisorderHeadacheattributedtotrochleitisHeadacheattributedtodisorderoftheears耳朵Headacheattributedtodisorderofthenoseorparanasalsinuses鼻子或鼻窦Headacheattributedtoacuterhinosinusitis急性鼻窦炎HeadacheattributedtochronicorrecurringrhinosinusitisHeadacheattributedtodisorderoftheteethorjawHeadacheattributedtotemporomandibulardisorder(TMD)HeadorfacialpainattributedtoinflammationofthestylohyoidligamentHeadacheorfacialpainattributedtootherdisorderofcranium,neck,eyes,ears,nose,sinuses,teeth,mouthorotherfacialorcervicalstructure.缘于精神疾病的头痛(Headacheattributedtopsychiatricdisorder)Headacheattributedtosomatizationdisorder躯体化障碍Headacheattributedtopsychoticdisorder精神疾病三、脑神经痛、中枢和原发性颜面痛及其他头痛(painfulcranialneuropathies,otherfacialpainsandotherheadaches).脑神经痛和中枢性颜面痛(Painfulcranialneuropathiesandotherfacialpain