 ■■連載３ ➁≪英字原文・新旧比較■『■新「国際頭痛分類第３版（ICHD-III）」基準』■各条文の新旧比較≪英字原文・新第３版（ICHD-III）≫の何処が変わったのか■交通事故等「脳脊髄液減少症」
連載 1 ≪英字原文・新第３版（ICHD-III）≫ https://blogs.yahoo.co.jp/kikitata3/35663082.html
連載 3➀≪英字原文・各条文の新旧比較≫ https://blogs.yahoo.co.jp/kikitata3/35663224.html
連載 3➁≪英字原文・各条文の新旧比較≫ このブログです。 ■交通事故等「脳脊髄液減少症」
■■国内初の和訳資料『■新「国際頭痛分類第３版（ICHD-III）」基準』
■■■≪英字原文≫直接関連の条文≪その他の関連は別途記載予定≫
■■■『■新「国際頭痛分類第３版（ICHD-III）」基準』
■■■各条文の新旧比較≪英字原文・新第３版（ICHD-III）≫の何処が変わったのか
■≪英字原文・新第３版（ICHD-III）≫
■≪英字原文・旧第３版（ICHD-III）beta版≫ ■■国内初の和訳資料■■■各条文の新旧比較
■≪英字原文・新第３版（ICHD-III）≫ ■≪英字原文・旧第３版（ICHD-III）beta版≫
≪新≫ 第３版（ICHD-III）
7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure
≪旧≫
7.2 Headache attributed to low cerebrospinal fluid pressure
≪新≫ Description: Orthostatic headache caused by low cerebrospinal fluid (CSF) pressure (either spontaneous or secondary), or CSF leakage, usually accompanied by neck pain, tinnitus, changes in hearing, photophophia and/or nausea. It remits after normalization of CSF pressure or successful sealing of the CSF leak.
≪旧≫
Description:
Orthostatic headache in the presence of low cerebrospinal fluid (CSF) pressure (either spontaneous or secondary), or CSF leakage, usually accompanied by neck pain, tinnitus, changes in hearing, photophobia and/ or nausea. It remits after normalization of CSF pressure or successful sealing of the CSF leak.
≪新≫ Diagnostic criteria: A. Any headache1 fulfilling criterion C B. Either or both of the following:
1. low cerebrospinal fluid (CSF) pressure (<60 mm CSF)
2. evidence of CSF leakage on imaging2
C. Headache has developed in temporal relation to the low CSF pressure or CSF leakage, or led to its discovery3
D. Not better accounted for by another ICHD-3 diagnosis.
≪旧≫
Diagnostic criteria:
A. Any headache fulfilling criterion C B. Low CSF pressure (<60 mm CSF) and/or evidence of CSF leakage on imaging
C. Headache has developed in temporal relation to the low CSF pressure or CSF leakage, or led to its discovery
D. Not better accounted for by another ICHD-3 diagnosis.
≪新≫ Notes:
1. 7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure is usually but not invariably orthostatic. Headache that significantly worsens soon after sitting upright or standing and/or improves after lying horizontally is likely to be caused by low CSF pressure, but this cannot be relied upon as a diagnostic criterion.
（Notes 1.）（7.1.4 Headache attributed to intracranial hypertension secondary to hydrocephalus）・・
（Diagnostic criteria:）・・（A. New headache, or a significant worsening1）
2. Brain imaging showing brain sagging or pachymeningeal enhancement, or spine imaging (spine MRI, or MRI, CT or digital subtraction myelography) showing extradural CSF.
（Notes 2.）（7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure）・・（Diagnostic criteria:）・・（2. evidence of CSF leakage on imaging2 ）
3. Evidence of causation may depend upon onset in temporal relation to the presumed cause, together with exclusion of other diagnoses.
（Notes 3）（7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure）・・（Diagnostic criteria:）・・（C. Headache has developed in temporal relation to the low CSF pressure or CSF leakage, or led to its discovery3 ）
≪旧≫
Comment:
7.2 Headache attributed to low cerebrospinal fluid pressure is usually but not invariably orthostatic. Headache that significantly worsens soon after sitting upright or standing and/or improves after lying horizontally is likely to be caused by low CSF pressure, but this cannot be relied on as a diagnostic criterion.
Evidence of causation may depend on onset in temporal relation to the presumed cause together with exclusion of other diagnoses.
≪新≫ 第３版（ICHD-III）
7.2.1 Post-dural puncture headache
Previously used term: Post-lumbar puncture headache ≪旧≫
7.2.1 Post-dural puncture headache
Previously used term: Post-lumbar puncture headache.
≪新≫ Description:
Headache occurring within five days of a lumbar puncture, caused by cerebrospinal fluid (CSF) leakage through the dural puncture. It is usually accompanied by neck stiffness and/or subjective hearing symptoms. It remits spontaneously within two weeks, or after sealing of the leak with autologous epidural lumbar patch.
≪旧≫
Description:
Headache occurring within 5 days of a lumbar puncture, caused by cerebrospinal fluid (CSF) leakage through the dural puncture. It is usually accompanied by neck stiffness and/or subjective hearing symptoms. It remits spontaneously within 2 weeks, or after sealing of the leak with autologous epidural lumbar patch.
≪新≫ Diagnostic criteria:
A. Headache fulfilling criteria for 7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure, and criterion C below
B. Dural puncture has been performed
C. Headache has developed within five days of the dural puncture
D. Not better accounted for by another ICHD-3 diagnosis.
≪旧≫
Diagnostic criteria:
A. Any headache fulfilling criterion C B. Dural puncture has been performed
C. Headache has developed within 5 days of the dural puncture
D. Not better accounted for by another ICHD-3 diagnosis.
≪新≫ Comment:
Independent risk factors for 7.2.1 Post-dural puncture headache have recently been demonstrated: female gender, age between 31 and 50 years, a previous history of 7.2.1 Post-dural puncture headache and orientation of the needle bevel perpendicular to the long axis of the spinal column at the time of the dural puncture.
≪旧≫
Comment:
Independent risk factors for 7.2.1 Post-dural puncture headache have recently been demonstrated: female gender, age between 31 and 50 years, a previous history of 7.2.1 Post-dural puncture headache and orientation of the needle bevel perpendicular to the long axis of the spinal column at the time of the dural puncture.
≪新≫ 第３版（ICHD-III）
7.2.2 Cerebrospinal fluid (CSF) fistula headache
≪旧≫
7.2.2 CSF fistula headache
≪新≫ Description:
Orthostatic headache occurring after a procedure or trauma causing a persistent cerebrospinal fluid (CSF) leakage resulting in low intracranial pressure. It remits after successful sealing of the CSF leak.
≪旧≫
Description: Orthostatic headache occurring after a procedure or trauma causing a persistent cerebrospinal fluid (CSF) leakage resulting in low intracranial pressure. It remits after successful sealing of the CSF leak.
≪新≫ Diagnostic criteria:
A. Headache fulfilling criteria for 7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure, and criterion C below
B. A procedure has been performed, or trauma has occurred, known sometimes to cause persistent CSF leakage (CSF fistula)
C. Headache has developed in temporal relation to the procedure or trauma
D. Not better accounted for by another ICHD-3 diagnosis.
≪旧≫
Diagnostic criteria:
A. Any headache fulfilling criterion C B. Both of the following:
1. a procedure has been performed, or trauma has occurred, known sometimes to cause persistent CSF leakage (CSF fistula) 2. low CSF pressure (<60 mm CSF) and/or evidence of low CSF pressure and/or of CSF leakage on MRI, myelography, CT myelography or radionuclide cisternography
C. Headache has developed in temporal relation to the procedure or trauma
D. Not better accounted for by another ICHD-3 diagnosis.
≪新≫ 第３版（ICHD-III）
7.2.3 Headache attributed to spontaneous intracranial hypotension
≪旧≫
7.2.3 Headache attributed to spontaneous intracranial hypotension
≪新≫ Previouslyusedterms:
Headacheattributedtospontaneous low CSF pressure or primary intracranial hypotension; low CSF-volume headache; hypoliquorrhoeic headache.
≪旧≫
Previously used terms:
Headache attributed to spontaneous low CSF pressure or primary intracranial hypotension; low CSF-volume headache; hypoliquorrhoeic headache.
≪新≫ Description:
Orthostatic headache caused by low cerebrospinal fluid (CSF) pressure of spontaneous origin. It is usually accompanied by neck stiffness and subjective hearing symptoms. It remits after normalization of CSF pressure.
≪旧≫
Description:
Orthostatic headache caused by low cerebrospinal fluid (CSF) pressure of spontaneous origin. It is usually accompanied by neck stiffness and subjective hearing symptoms. It remits after normalization of CSF pressure.
≪新≫ Diagnostic criteria:
A. Headache fulfilling criteria for 7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure, and criterion C below
B. Absence of a procedure or trauma known to be able to cause CSF leakage1
C. Headache has developed in temporal relation to occurrence of low CSF pressure or CSF leakage, or has led to its discovery2
D. Not better accounted for by another ICHD-3 diagnosis.
≪旧≫
Diagnostic criteria:
A. Any headache fulfilling criterion C B. Low CSF pressure (<60 mm CSF) and/or evidence of CSF leakage on imaging
C. Headache has developed in temporal relation to the low CSF pressure or CSF leakage, or has led to its discovery
D. Not better accounted for by another ICHD-3 diagnosis.
≪新≫ Notes:
1. 7.2.3 Headache attributed to spontaneous intracranial hypotension cannot be diagnosed in a patient who has had a dural puncture within the prior month.
（Notes 1.）（7.2.3 Headache attributed to spontaneous intracranial hypotension）・・（Diagnostic criteria:）・・（B. Absence of a procedure or trauma known to be able to cause CSF leakage1 ）
2. Dural puncture to measure CSF pressure directly is not necessary in patients with positive MRI signs of leakage such as dural enhancement with contrast.
（Notes 2.）（7.2.3 Headache attributed to spontaneous intracranial hypotension）・・（Diagnostic criteria:）・・（C. Headache has developed in temporal relation to occurrence of low CSF pressure or CSF leakage, or has led to its discovery2 ） 記載なし
≪新≫ Comments:
Spontaneous cerebrospinal fluid (CSF) leak has been associated with heritable connective tissue disorders. Patients with CSF leaks should be screened for connective tissue and vascular abnormalities.
While there is a clear postural component in most cases of 7.2.3 Headache attributed to spontaneous intracranial hypotension, it may not be as dramatic or immediate as in 7.2.1 Post-dural puncture headache.
Thus, 7.2.3 Headache attributed to spontaneous intracranial hypotension may occur immediately or within seconds of assuming an upright position and resolve quickly (within one minute) after lying horizontally, resembling 7.2.1 Post-dural puncture headache, or it may show delayed response to postural change, worsening after minutes or hours of being upright and improving, but not necessarily resolving, after minutes or hours of being horizontal.
The orthostatic nature of the headache at its onset should be sought when eliciting a history, as this feature may become much less obvious over time.
≪旧≫
Comments:
7.2.3 Headache attributed to spontaneous intracranial hypotension cannot be diagnosed in a patient who has had a dural puncture within the prior month.
The headache in patients with spontaneous CSF leaks or spontaneously low CSF pressure may resemble 7.2.1 Post-dural puncture headache, occurring immediately or within seconds of assuming an upright position and resolving quickly (within 1 minute) after lying horizontally.
Alternatively it may show delayed response to postural change, worsening after minutes or hours of being upright and improving, but not necessarily resolving, after minutes or hours of being horizontal.
Although there is a clear postural component in most cases of 7.2.3 Headache attributed to spontaneous intracranial hypotension, it may not be as dramatic or immediate as in 7.2.1 Post-dural puncture headache.
The orthostatic nature of the headache at its onset should be sought when eliciting a history, as this feature may become much less obvious over time.
Although autologous epidural blood patches (EBPs) are frequently effective in sealing CSF leaks, the response to a single EBP may not be permanent, and complete relief of symptoms may not be achieved until two or more EBPs have been performed. However, some degree of sustained improvement, beyond a few days, is generally expected. In some cases, sustained improvement cannot be achieved with EBPs and surgical intervention may be required.
≪新≫ In patients with typical orthostatic headache and no apparent cause, and after exclusion of postural orthostatic tachycardia syndrome (POTS), it is reasonable in clinical practice to provide autologous lumbar epidural blood patch (EBP). While EBPs are frequently effective in sealing CSF leaks, the response to a single EBP may not be permanent, and complete relief of symptoms may not be achieved until two or more EBPs have been performed. However, some degree of sustained improvement, beyond a few days, is generally expected. In some cases, sustained improvement cannot be achieved with targeted (to the site of the leak) and/or non-targeted lumbar EBPs, and surgical intervention may be required.
≪旧≫
In patients with typical orthostatic headache and no apparent cause, after exclusion of postural orthostatic tachycardia syndrome (POTS) it is reasonable in clinical practice to provide autologous lumbar EBP.
≪新≫ It is not clear that all patients with 7.2.3 Headache attributed to spontaneous intracranial hypotension have an active CSF leak, despite a compelling history or brain imaging signs compatible with CSF leakage.
The underlying disorder may be low CSF volume. A history of a trivial increase in intracranial pressure (e.g. on vigorous coughing) is sometimes elicited.
≪旧≫
It is not clear that all patients have an active CSF leak, despite a compelling history or brain imaging signs compatible with CSF leakage. Cisternography is an outdated test, now infrequently used; it is significantly less sensitive than other imaging modalities (MRI, CT or digital subtraction myelography). Dural puncture to measure CSF pressure directly is not necessary in patients with positive MRI signs such as dural enhancement with contrast.
The underlying disorder in 7.2.3 Headache attributed to spontaneous intracranial hypotension may be low CSF volume. A history of a trivial increase in intracranial pressure (e.g. on vigorous coughing) is sometimes elicited. Postural headache has been reported after coitus: such headache should be coded as 7.2.3 Headache attributed to spontaneous intracranial hypotension because it is most probably a result of CSF leakage.
≪新≫ Postural headache has been reported after coitus: such headache should be coded as 7.2.3 Headache attributed to spontaneous intracranial hypotension because it is most probably due to CSF leakage. ≪旧≫ Postural headache has been reported after coitus: such headache should be coded as 7.2.3 Headache attributed to spontaneous intracranial hypotension because it is most probably a result of CSF leakage.
|
脳脊髄液減少症
[ リスト ]
コメント（0）
