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CEFALEA

CEFALEA

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Published by: api-3715153 on Oct 19, 2008
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03/18/2014

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CEFALEA
\u2022 PROYECTO ISS - ASCOFAME \u2022
GUIAS DE PRACTICA CLINICA
BASADAS EN LA EVIDENCIA
PROYECTOISS
-ASCOFAMECE
FALEA
ASOCIACION COLOMBIANA DE FACULTADES
DE MEDICINA- ASCOFAME -
Dr, Rodrigo Isaza Berm\u00fadez
Dr.Ed ga rCa rd ona
Dr. Jorg e CelisMej\u00eda
Dr. Ca rlosJa ime Yepes
Dr. Juan Jos\u00e9 XXIII Mej\u00eda
Volver P\u00e1gina Principal
11
AUTORES DE LA GUIA
COORDINACION Y ASESORIA
Dr, Rodrigo Isa za Berm\u00fadez
Neur\u00f3log o Cl\u00ednico
Universida d de Antioq uia
CoordinadorC\u00e1tedra de Neurolog\u00eda
Universida d Pontific ia Boliva riana
Ho sp ita lPa blo To b\u00f3 n Uribe, Medell\u00edn
Coordinador Gu\u00eda de Pr\u00e1ctica Cl\u00ednica
Dr.Ed ga rCa rd ona
Neur\u00f3log o Cl\u00ednico
Universida d de Antioq uia
Ho sp ita lPa blo To b\u00f3 n Uribe, Medell\u00edn
Dr. Jorge Celis Mej\u00eda
Ne ur\u00f3log o Ho sp ital Militar
Profesor de Neurolog \u00eda
Universida d Pontific ia Boliva riana
Cl\u00edica Ca rd iova sc ular Sa nta Ma r\u00eda, Medell\u00edn
Dr. Ca rlosJa ime Yepes
Neuroc irujano
Profesor de Neurolog \u00eda
Universida d Pontific ia Boliva riana
Instituto de SegurosSociales, Medell\u00edn
Dr. Juan Jo s\u00e9 XXIII Mej\u00eda
Pediatra
Hosp ita l Sa n Juan de Dios, Rioneg ro (Antioq uia)
Dr. Alva ro Ec heverri Bustamante
Decano Facultad de Medicina
Universida d Pontific ia Boliva riana
Deca no Coordina dor
Dra. Ma rtha Helena Beta nc ur
Vicedecana Acad\u00e9mica
Facultad de Medicina
Universida d Pontific ia Boliva riana
Coordinadora Gu\u00edas UPB

Dr. Jos\u00e9 Miguel L\u00e1 inezAndr\u00e9s
Profesor Asoc ia do de Neurolog\u00eda
Hosp ita l Genera l Universita ri

Valencia,Espa\u00f1a
Asesor Interna cional
12
INDICE
FORMULARIO DE AUTOEVALUACION DE LA GUIA DE

PRACTICA CLINICA - ISSASCOFAME............................................................. 14 1. INTRO DUCC ION........................................................................................ 15 2. EPIDEMIOLOGIA......................................................................................... 1 5 3. CLASIFICACION.......................................................................................... 15 4. EXAMEN CLINICO DELPACIENTE CO N CEFALEA..................................... 16 4.1. Signos de alarma..................................................................................... 16 4.1.1. Dentro de la historia cl\u00ednica................................................................. 16 4.1.2. Dentro de la evalua ci\u00f3n cl\u00ednic a del pa ciente....................................... 16 5. EVALUACION CLINICA DELPACIENTE CON CEFALEA.............................. 17 5.1. Frec uenc ia y va riac i\u00f3n de s\u00edntomas........................................................ 17 5.2. Loca liza ci\u00f3n deldolor............................................................................. 17 5.3. Otra sconsid erac iones............................................................................. 17 6. CEFALEASPRIMARIAS................................................................................. 17 6.1. Migra\u00f1a................................................................................................... 17 6.2. Ma nifestac ionescl\u00ednic as.......................................................................... 18 6.2.1. Aura...................................................................................................... 18 6.2.3. S\u00edntom as va ga les y sensitivo s............................................................... 18 6.2.4. S\u00edntom as mo tores................................................................................ 19 6.2.5. Otross\u00edntom as y signos que pued en presenta rse............................... 19 6.3. Tipo sde migra\u00f1a..................................................................................... 20 6.3.1. Migra\u00f1a con aura................................................................................. 20 6.3.2. Migra\u00f1a sin aura.................................................................................. 20 6.3.3. Migra\u00f1a ofta lmop l\u00e9jica........................................................................ 20 6.3.4. Migra\u00f1a ba silar..................................................................................... 20 6.3.5. Migra\u00f1a comp lica da............................................................................ 20 6.3.6. Otrosdes\u00f3rdenes que no cumplen los criterios de migra\u00f1a.............. 21 7. CRITERIOSDIAG NO STICO SDE LA CEFALEA............................................. 21 7.1. \u00bfC\u00f3mo usar la clasific ac i\u00f3n?.................................................................... 21 8. MANEJO AGUDO DE LA MIGRA\u00d1A EN URGENCIAS................................. 21 8.1. F\u00e1rmac osrecomendados........................................................................ 22 8.2. Uso de analg\u00e9sicospa ra el ma nejo de cefa lea en urgenc ia s.................. 22 8.2.1. Butorfanol............................................................................................. 22 8.2.2. Antiinflam atorios no esteroideos......................................................... 22 8.2.3. Ac id o ac etilsa lic\u00edlico............................................................................. 24 8.2.4. Analg\u00e9sicosop i\u00e1 ceos............................................................................ 24 8.3. Ma nejo de la cefa lea en sa lvas(c luster head ac he)................................. 24 9. CEFALEASSECUNDARIAS........................................................................... 24 9.1. Cefa lea de tipo tensiona l......................................................................... 24 9.2. Cefalea en crisisparox\u00edstica y hemicraneana parox\u00edstica cr\u00f3nica.......... 25 9.3. Cefa leasmixtas, no asoc ia da scon una lesi\u00f3n estruc tura l...................... 25 9.4. Cefalea asoc iada a trauma de cr\u00e1neo..................................................... 26 9.5. Cefalea asoc iada con alteracionesvasc ulares......................................... 26

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