OBJECTIVE: To summarize the evidence from Traditional Chinese Medicine(TCM) practice in the treatment of acute primary headache and provide clinical practice guidance. METHODS: The guidelines were developed in accordance with the World Health Organization guideline development manual. After the establishment of steering committee, panel and the registration and protocol formulation, the evidence on TCM for acute primary headache from published guidelines, clinical evidence, and expert experience and consensus were collected. The grading of recommendations assessment, development and evaluation method was used to grade the evidence and make the recommendations. RESULTS: Based on the available evidence, the guidelines recommended three TCM herbal decoctions, six Chinese patent medicines, and two kinds of external application of Chinese herbal medicines. Diagnostic recommendations based on the expert experience and consensus were also included in the guidelines. CONCLUSION: TCM diagnosis and treatment of decoction, Chinese patent medicine and external application for treating acute primary headache were recommended. We hope these guidelines will be helpful in standardize the TCM acute treatment of primary headache.

Objective To describe the clinical features of cerebral vein and sinus thrombosis (CVST), to evaluate the short-term prognosis of CVST and to determine the predictive factors for CVST. Methods In a single center observational study, consecutive patients who were diagnosed as having CVST were retrospectively investigated. Demographic data, symptoms and signs from onset to diagnosis, clinical and imaging features, location of the thrombus and therapy were collected. Patients were followed up on the day before discharge. Primary outcome as independence was assessed by modiifed Rankin Scale (mRS) score 2 at the end of follow-up. Univariate analysis and multivariate Logistic regression analysis were performed to predict the outcome. Receiver operating characteristic (ROC) curves were used to analyze the accuracy. The comparison of area under the curve (AUC) was calculated to test the superiority of the predicting model to the previous clinical score. Results From May 2000 to Jun 2010, we recruited 171 adult patients with CVST. Headache (91.8%) was the most common symptom, followed by seizure (36.5%) and disturbance of consciousness (33.3%). 50.2% (n=89) of the patients suffered from cerebral infarction, 31.6% (n=54) from cerebral hemorrhage. A straight sinus thrombosis was conifrmed in 45 (26.3%) patients in the cohort. Anticoagulation was initiated in 126 (73.7%) patients and thrombolysis was needed in 17 (10.0%) patients. At the end of follow-up, 137 patients (80.1%) were independent by mRS 2. Multivariate Logistic regression analysis showed independent factors were age ( 37, relative risk [RR] 3.25, 95%conifdence interval [CI] 1.29~8.17), sex (female, RR 4.06, 95%CI 1.43~11.5 ), conscious disturbance (RR 3.92, 95%CI 1.48~10.4), straight sinus thrombosis (RR 7.78, 95%CI 1.66~36.4) and coagulation (RR 0.13, 95%CI 0.05~0.35). The AUC of the predicting model in this study ( with the exception of anticoagulation ) and CVST score (range from 0 to 9) were 0.85 (95%CI 0.77~0.92, P<0.001) and 0.65 (95%CI 0.53~0.77, P<0.01) respectively. There was a signiifcant difference between the two models (P<0.01). Conclusion The prognosis of CVST is relatively good and a subgroup (19.9%) of CVST patients is at increased risk of bad outcome. The short-term outcome of CVST patients can be predicted well in our study and need to be evaluated prospectively.