Aproximación diagnóstica a las Cefaleas después de los 65 años

[Diagnostic Approach to Headaches after age 65]

Luis Manuel Cornejo A1

1. Departamento de Medicina, Facultad de Medicina, Universidad de Panamá, Panamá, Rep de Panamá;

Publicado: 2024-01-01

Descargas

Archivos adicionales

Resumen

Con el objetivo de facilitar el diagnóstico diferencial de la queja de cefalea después de los 65 años de edad, se llevó a cabo una revisión de la literatura con respecto a las cefaleas primarias y secundarias de acuerdo a la Clasificación de la Sociedad Internacional de Cefaleas, seleccionándose las variedades más frecuentes en las personas mayores, describiéndose su condición aguda o crónica,  su frecuencia, características y particularidades, a manera de facilitar un diagnóstico presuntivo que oriente una intervención específica. Las cefaleas primarias más frecuentes en el adulto mayor son la cefalea tensional y la migraña. Entre las cefaleas secundarias más frecuentes se encuentran la cefalea cervicogénica, la cefalea por abuso de analgésicos, dolor craneal y las diferentes causas de cefaleas metabólicas. Se mencionan los estudios básicos y paraclínicos, así como los criterios para estudio por neuroimagen y las señales de alerta para cefaleas secundarias.


Abstract

A literature review was conducted to facilitate the differential diagnosis of headaches in individuals over the age of 65. The review focused on primary and secondary headaches according to the International Headache Society Classification, highlighting the most common types among older individuals. The review described the acute or chronic nature, frequency, characteristics, and specific features of these headaches to aid in making a presumptive diagnosis and guide appropriate interventions. The most common primary headaches in older adults are tension-type headache and migraine. Among the secondary headaches, the most frequent ones include cervicogenic headache, medication-overuse headache, cranial pain, and various metabolic causes of headaches. The review also mentioned basic and paraclinical studies, criteria for neuroimaging, and warning signs for secondary headaches.

Citas

[1] J Schwaiger 1, S Kiechl, K Seppi, M Sawires, H Stockner, T Erlacher, M L Mairhofer, H Niederkofler, G Rungger, A Gasperi, W Poewe, J Willeit. Prevalence of primary headaches and cranial neuralgias in men and women aged 55-94 years (Bruneck Study) Cephalalgia 2009,29(2)179-187. URL: https://doi.org/10.1111/j.1468-2982.2008.01705.x

[2] Walker R. Waldman M. Headache in the Elderly. Clin Geriatr Med 23,2007;291-305. URL: https://doi.org/10.1016/j.cger.2007.01.009

[3] Olesen J. ICHD-3 beta is published. Use it immediately. Cephalalgia 2013; 33(9):627-628. URL: https://doi.org/10.1177/0333102413487610

[4] Crystal SC, Grosberg BM. Tension-type headache in the elderly. Curr Pain Headache Rep 2009;13(6)474-478. URL: https://doi.org/10.1007/s11916-009-0076-z

[5] Tae Yong Song, K, Byung-Kun K, Byung-Su K, Jae-Moon K, Soo-Kyoung K, Heui-Soo M, Myoung-Jin C, Kwang-Yeol P, Jong-Hee S,Min Kyung C, Soo-Jin C. Characteristics of Elderly-Onset (≥65 years) Headache Diagnosed Using the International Classification of Headache Disorders, Third Edition Beta Version. J Clin Neurol 2016;12(4):419-425. URL: https://doi.org/10.3988/jcn.2016.12.4.419

[6] Vongvaivanich K, Lertakyamanee P, Silberstein SD, David Dodick. Late-life migraine accompaniments: A narrative review. Cephalalgia2015;35(10)894-911. URL: https://doi.org/10.1177/0333102414560635

[7] J W Swanson, T Yanagihara, P E Stang, W M O'Fallon, C M Beard, L J Melton 3rd, H A Guess. Incidence of cluster headaches: A population-based study in Olmsted Country, Minnesota. Neurology 1994; 44(3Pt1):433-437) URL: https://doi.org/10.1212/WNL.44.3_Part_1.433

[8] Leroux E, Ducrox A. Cluster headache. Orphanet Journal of Rare Diseases 2008, 3:20 URL: https://doi.org/10.1186/1750-1172-3-20

[9] Liang JF, Wang SJ. Hypnic headache: A review of clinical features, therapeutic options, and outcomes. Cephalalgia 2014; 34(10):795-805. URL: https://doi.org/10.1177/0333102414537914

[10] Gil-Gouveia R., Goadsby P. Secondary "hypnic headache". J Neurol 2007 May;254(5):646-54. URL: https://doi.org/10.1007/s00415-006-0424-4

[11] Weatherall M , Bahra A, Familial hemicrania continua. Cephalalgia. 2011 Jan;31(2):245-9. URL: https://doi.org/10.1177/0333102410383061

[12] Berk T., Ashina S., Martin V., Newman L. Vij B. Diagnosis and Treatment of Primary Headache Disorders in Older Adults. J Am Geriatr Soc 66: 2408-2416,2018.URL: https://doi.org/10.1111/jgs.15586

[13] Reuben DB, Herr KA, Pacala JT, et al. Geriatrics At Your Fingertips:2022.24th Edition. New York: The American Geriatrics Society;2022.

[14] Wijeratne T, Wijeratne Ch, Korajkic N, Bird S, Sales C, Riedererf, F. Secondary headaches - red and green flags and their significance for diagnostics. eNeurologicalSci v.32; 2023. URL: https://doi.org/10.1016/j.ensci.2023.100473

[15] JuYo-El S, Schwedt T. Abrupt-Onset Severe Headaches. Seminars in Neurology,2010,30(2):192-200. URL: https://doi.org/10.1055/s-0030-1249229

[16] Mansoureh Togha, Mohammad Javad Karimitafti, Zeinab Ghorbani, Fatemeh Farham, Fereshteh Naderi-Behdani, Somayeh Nasergivehchi, Zahra Vahabi, Shadi Ariyanfar, Elham Jafari. Characteristics and comorbidities of headache in patients over 50 years of age: a cross-sectional study. BMC Geriatr. 2022; 22: 313. URL: https://doi.org/10.1186/s12877-022-03027-1

[17] Simone Nüssle, Thomas Reinhard, Jan Lübke. Acute Closed-Angle Glaucoma-an Ophthalmological Emergency. Dtsch Arztebl Int 2021 Nov 12;118(Forthcoming):771-780. URL: https://doi.org/10.3238/arztebl.m2021.0264

[18] Kim J, Parish A, Polypharmacy and Medication Management in Older Adults. Nurs Clin North Am 2017 Sep;52(3):457-468. URL: https://doi.org/10.1016/j.cnur.2017.04.007

[19] M Ruiz, M I Pedraza, C de la Cruz, J Barón, I Muñoz , C Rodríguez , M Celorrio , P Mulero , S Herrero , A L Guerrero. Headache in the elderly: characteristics in a series of 262 patients. Neurologia 2014 Jul-Aug;29(6):321-6. URL: https://doi.org/10.1016/j.nrleng.2013.07.004

[20] M Borchelt, [Potential side-effects and interactions in multiple medication in elderly patients: methodology and results of the Berlin Study of Aging], abstract, Z Gerontol Geriatr. 1995 Nov-Dec;28(6):420-8

[21] H Rasmussen 1, H T Sørensen, J Møller-Petersen, F V Mortensen, B Nielsen. Bacterial meningitis in elderly patients: clinical picture and course. Age & Ageing, Volume 21, Issue 3, May 1992, Pages 216-220. URL: https://doi.org/10.1093/ageing/21.3.216

[22] Amaal J Starling, Diagnosis and Management of Headache in Older Adult, Mayo Clin Proc. 2018 ;93(2):252-262

[23] Gwendolen Jull, Cervicogenic Headache. Musculoskeletal Science and Practice, Volume 66, August 2023, 102787. URL: https://doi.org/10.1016/j.msksp.2023.102787

[24] Mazya A., Garvin P.,Ekdahl A. Outpatient comprehensive geriatric assessment: effects on frailty and mortality in old people with multimorbidity and high health care utilization. Aging Clin Exp Res 2019 Apr;31(4):519-525. URL: https://doi.org/10.1007/s40520-018-1004-z

[25] Medina López, Alberto Mimenza, Cefalea. En: Alberto Mimenza Alvarado, Sara Aguilar Navarro, J Alberto Ávila Fuentes, Guillermo García Ramos: Neurología Geriátrica. Editora Corinter, México, 2012, p. 151.

[26] Olivia Begasse de Dhaem, Matthew S. Robbins. Cognitive Impairment in Primary and Secondary Headache Disorders. Current Pain and Headache Reports (2022) 26:391-404. URL: https://doi.org/10.1007/s11916-022-01039-5

[27] Soo-Jin Cho, Byung-Kun Kim, Byung-Su Kim, Jae-Moon Kim, Soo-Kyoung Kim, Heui-Soo Moon, Myoung-Jin Cha,Kwang-Yeol Park,Jong-Hee Sohn, Min Kyung Chu10, Tae-Jin Song. Associations of Elderly Onset Headache with Occurrence of Poor Functional Outcome, Cardiovascular Disease, and Cognitive Dysfunction During Longterm Follow-up. Annals of Geriatric Medicine and Research 2018;22(4):176-183. URL: https://doi.org/10.4235/agmr.18.0032

[28] J A Yesavage, T L Brink, T L Rose, O Lum, V Huang, M Adey, V O Leirer. Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, Volume 17, Issue 1, 1982-1983, Pages 37-49. URL: https://doi.org/10.1016/0022-3956(82)90033-4

[29] De Luca G, Bartleson JD. When and how to investigate the patient with headache. Seminars in Neurology 2010; 30(2): 131-44. URL: https://doi.org/10.1055/s-0030-1249221

×