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Kopfschmerz und Bluthochdruck

Mythos und Evidenz

Headache and hypertension

Myth and evidence

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Zusammenfassung

Die Beziehung zwischen Kopfschmerz und Bluthochdruck wird seit Jahrzehnten kontrovers diskutiert. Obwohl es nach aktueller Studienlage keine Evidenz für einen kausalen Zusammenhang zwischen Bluthochdruck und Kopfschmerz gibt, bleibt der Mythos „hypertensiver Kopfschmerz“ weit verbreitet.

Verschieden Gründe existieren, warum sich dieser Mythos so hartnäckig hält: Arterieller Hypertonus ist ein Epiphänomen von Schmerzen. Kopfschmerzen sind häufige Nebenwirkung von vielen antihypertensiven Medikamenten. Das klinische Syndrom der hypertensiven Enzephalopathie ist neben epileptischen Anfällen, Bewusstseinsstörung sowie fokalen neurologischen Ausfällen auch durch Kopfschmerzen charakterisiert. In diesem Artikel soll ein Überblick über die bestehende Literatur sowie mögliche pathologische Zusammenhänge zwischen Bluthochdruck, internistischen Erkrankungen und Kopfschmerzen gegeben werden. Insbesondere auf hypertensive Enzephalopathien und das posteriore reversible Enzephalopathiesyndrom (PRES) mit akuter Endothelschädigung soll vertieft eingegangen werden.

Summary

The relationship between headache and hypertension has been debated for many years. Although most studies have shown that chronic hypertension and headache are not associated, the myth of a hypertensive headache still exists. There are several reasons why the „hypertension headache“ misperception persists: Hypertension is an epiphenomenon of pain. Headache is a common side effect of some antihypertensive drugs. Headache is the most common presenting symptom of hypertensive encephalopathy, followed by seizures, focal neurological deficits and loss of consciousness. This review summarizes the existing literature and highlights the relationship between headache, hypertension and disease with a focus on hypertensive encephalopathy and posterior reversible encephalopathy syndrome with acute endothelial damage.

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Danksagungen

Die Autoren werden durch das Bundesministerium für Bildung und Forschung (Integriertes Forschungs- und Behandlungszentrum „Centrum für Schlaganfallforschnung Berlin“) unterstützt.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurologie, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    T. Liman & M. Endres

  2. Zentrum für diagnostische und interventionelle Radiologie und Nuklearmedizin , Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland

    E. Siebert

  3. Centrum für Schlaganfallforschung Berlin, Charité-Universitätsmedizin Berlin, Berlin, Deutschland

    T. Liman & M. Endres

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  1. T. Liman
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  2. E. Siebert
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Correspondence to T. Liman.

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Für die Arbeitsgemeinschaft Herz und Hirn der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Schlaganfallgesellschaft (DSG).

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Liman, T., Siebert, E. & Endres, M. Kopfschmerz und Bluthochdruck. Nervenarzt 81, 963–972 (2010). https://doi.org/10.1007/s00115-010-2996-6

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