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KMID : 0911820170180020027
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Korean Journal of Headache
2017 Volume.18 No. 2 p.27 ~ p.32
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Clinical Predictors for Secondary Headaches in First-Visit Headache Patients:
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Kim Byung-Su
Kim Byung-Kun
Kim Soo-Kyung
Kim Jae-Moon
Moon Heui-Soo
Park Kwang-Yeol
Sohn Jong-Hee
Song Tae-Jin
Chu Min-Kyung
Cha Myoung-Jin
Cho Soo-Jin
Park Jeong-Wook
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Abstract
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Background: Identification of secondary headaches is of clinical importance in an evaluation of headache patients. We sought to investigate clinical characteristics associated with secondary headaches in first-visit patients.
Methods: We analyzed data of consecutive first-visit headache patients from 11 educational referral hospitals. Headache diagnosis was made based on the International Classification of Headache Disorders, third edition, beta version (ICHD-3β). Study patients were dichotomously divided into primary and secondary headaches groups. Logistic regression analysis was conducted to determine factors independently associated with secondary headaches.
Results: Among 1,627 patients, 135 (8.3%) met the criterion of the secondary headaches in the ICHD-3β. Secondary headaches were caused by diverse etiologies, and secondary headache due to infection was the most common subtype (26.7%). In univariate analyses, male sex, referred by medical doctor, age at headache onset, headache onset-to-visit time, headache intensity, and neuroimaging were associated with secondary headaches. These predictors remained significant in multivariate analysis. Male sex, referred by medical doctor, early visit time, headache intensity, and performance of magnetic resonance imaging were strong predictors for secondary headaches (p<0.01).
Conclusion: In this study, several clinical characteristics were associated with secondary headaches among firstvisit patients. Given the diversity of secondary headaches causes, neuroimaging studies are required for precise headache diagnosis. Headache physicians may consider these findings at clinical practice.
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KEYWORD
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Headache, Differential diagnosis, Secondary headache disorders, Primary headache disorders, Neuroimaging
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