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De plaats voor evidence based informatie ter ondersteuning van het spreekuur van de huisarts

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Hoofdpijn
De berekening van de kans op 6 aandoeningen wordt gemaakt op basis van resultaten uit 16 betrouwbare studies. Het algoritme extraheert deze gegevens uit de database en berekent nakansen aan de hand van voorkansen en positieve en negatieve likelihoodratio's. De uitkomst van de berekening is uiteraard een statistische inschatting en onderhevig aan diverse onzekerheden. Lees over de belangrijke statistische tekortkomingen.

Anamnese

Tranen tijdens hoofdpijn
Nausea
Fotofobie
Fonofobie
Kaakklem
Unilaterale pijn
Exacerbatie bij inspanning
Kloppende of bonzende pijn
Temporale pijn
Diplopie
Braken
Koorts
Myalgie
Hoofdpijn
Anorexie

Klinische tekens

Toename hoofdpijn bij bewegen hoofd
Teken van Brudzinski
Teken van Kenrig
Nekstijfheid

Aanvullend

Biopsie arteria temporalis
Echo doppler voor arteritis
Trombocytose
CRP > 100 mg/l
BSE > 100 mm/uur
Anemie

Voorkansen

Nakansen




Studies gebruikt in deze berekening

1.Smetana GW et al. The Diagnostic Value of Historical Features in Primary Headache SyndromesA Comprehensive Review. Arch Intern Med. 2000;160(18):2729-2737
2.Thomas KE et al. The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis. Clinical Infectious Diseases, Volume 35, Issue 1, 1 July 2002, Pages 46–52
3.Ala A et al. Accuracy of Neck stiffness, Kernig, Brudzinski, and Jolt Accentuation of Headache Signs in Early Detection of Meningitis. Emerg (Tehran). 2018; 6(1): e8
4.Mofidi M et al. Jolt accentuation and its value as a sign in diagnosis of meningitis in patients with fever and headache. Turk J Emerg Med. 2017 Mar; 17(1): 29–31
5.Uluduz D et al. Cranial autonomic features in migraine and migrainous features in cluster headache. Arch Neuropsychiatr 2016; 53
6.Pacheva IH et al. Diagnostic value of combinations of symptoms of migraine and tension-type headache included in the diagnostic criteria for children and adolescents in the international classification of headache disorders 2nd edition. Folia Medica 2013; 55(3&4): 46-55
7.Ryan D et al. Management of the Patient with Suspected Temporal Arteritis. Ophthalmology 2005;112:744–756
8.Battista NA et al. Is it giant cell arteritis? A retrospective audit on temporal artery biopsy for giant cell arteritis. Malta Medical School Gazette Volume 01 Issue 02 2017
9.Diamantopoulos AP et al. Diagnostic Value of Color Doppler Ultrasonography of Temporal Arteries and Large Vessels in Giant Cell Arteritis: A Consecutive Case Series. Arthritis Care & Research Vol. 66, No. 1, January 2014, pp 113–119
10.Hamilton W et al. Clinical features of primary brain tumours: a case–control study using electronic primary care records. Br J Gen Pract. 2007 Sep 1; 57(542): 695–699
11.Costello F et al. Thrombocytosis in giant cell arteritis: Diagnostic importance. Submitted for publication.
12.Sedlic M et al. Epidemiology of Primary Headaches Among 1,876 Adolescents: A Cross-Sectional Survey. Pain Medicine 2016; 17: 353–359
13.Kim BK et al. Prevalence and Impact of Migraine and Tension-Type Headache in Korea. J Clin Neurol. 2012 Sep; 8(3): 204–211
14.Stovner LJ et al. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain (2010) 11:289–299
15.Yates M et al. The prevalence of giant cell arteritis and polymyalgia rheumatica in a UK primary care population. BMC Musculoskelet Disord. 2016; 17: 285
16.Robles P et al. The worldwide incidence and prevalence of primary brain tumors: a systematic review and meta-analysis. Neuro Oncol. 2015 Jun; 17(6): 776–783