WorldWideScience

Sample records for causing persistent headache

  1. Persistent trigeminal artery as a rare cause of ischaemic lesion and migraine-like headache.

    Science.gov (United States)

    Uhlig, S; Kurzepa, J; Czekajska-Chehab, E; Staśkiewicz, G; Polar, M K; Nastaj, M; Stochmal, E; Drop, A

    2015-01-01

    The persistent trigeminal artery (PTA) is a rare remnant of the embryonic intracranial circulatory system that forms a carotid-vertebrobasilar anastomosis. In most cases PTA does not have clear clinical implications. However, some authors report the association of PTA occurrence with vertigo, dizziness and nerve palsy, resulting in diplopia, strabismus or trigeminal neuralgia in patients. In rare cases it may also be related to posterior cerebral circulation strokes. This work reports the case of a female patient who presented with migraine-like headache and an ischaemic lesion in the left temporal lobe in association with PTA. PMID:25792408

  2. Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury.

    LENUS (Irish Health Repository)

    Aquilina, K

    2012-02-03

    Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.

  3. Causes of secondary headache (image)

    Science.gov (United States)

    Temporomandibular joint, or TMJ, dysfunction, can be a cause of secondary headache. Secondary headaches result from underlying disorders which produce pain as a symptom. The TMJ may become painful and dysfunctional as a result ...

  4. Translating Romans: some persistent headaches

    Directory of Open Access Journals (Sweden)

    A.B. du Toit

    2010-07-01

    Full Text Available Translating Romans: some persistent headaches Gone are the days when it was axiomatic that expertise in biblical languages automatically qualified one as a Bible translator. In 1949, Ronald Knox, who for nine years conscientiously struggled with translating the Bible for his generation, published a booklet under the title The trials of a translator. At that stage Bible translation as the subject of scientific study was still in its infancy. Since then, research into the intricacies of communicating the biblical message in an authentic but understandable manner, has made significant progress (cf. Roberts, 2009. However, the frustrations of Bible translators, first of all to really understand what the biblical authors wanted to convey to their original addressees, and then to commu-nicate that message to their own targeted readers in a meaningful way, have not disappeared. In fact, the challenge to meet the vary-ing requirements of the multiple kinds of translation that are present-ly in vogue, has only increased.

  5. Headache

    Science.gov (United States)

    ... of headache is tension headache. It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw. A tension headache : May be related to stress, depression, anxiety, a head injury, or holding your head ...

  6. Acetate Causes Alcohol Hangover Headache in Rats

    OpenAIRE

    Maxwell, Christina R.; Rebecca Jay Spangenberg; Hoek, Jan B.; Silberstein, Stephen D.; Oshinsky, Michael L.

    2010-01-01

    BACKGROUND: The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache. METHODS: We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats. RESULTS: Ethanol initially decreased sensitivity to mechanical stimuli on the face (ana...

  7. Acetate causes alcohol hangover headache in rats.

    Directory of Open Access Journals (Sweden)

    Christina R Maxwell

    Full Text Available BACKGROUND: The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache. METHODS: We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats. RESULTS: Ethanol initially decreased sensitivity to mechanical stimuli on the face (analgesia, followed 4 to 6 hours later by inflammatory pain. Inhibiting alcohol dehydrogenase extended the analgesia whereas inhibiting aldehyde dehydrogenase decreased analgesia. Neither treatment had nociceptive effects. Direct administration of acetate increased nociceptive behaviors suggesting that acetate, not acetaldehyde, accumulation results in hangover-like hypersensitivity in our model. Since adenosine accumulation is a result of acetate formation, we administered an adenosine antagonist that blocked hypersensitivity. DISCUSSION: Our study shows that acetate contributes to hangover headache. These findings provide insight into the mechanism of hangover headache and the mechanism of headache induction.

  8. Heat stress disorders and headache: a case of new daily persistent headache secondary to heat stroke

    OpenAIRE

    C. Di Lorenzo; Ambrosini, A; Coppola, G; Pierelli, F

    2009-01-01

    Headache is considered as a common symptom of heat stress disorders (HSD), but no forms of secondary headache from heat exposure are reported in the International Classification of Headache Disorders-2 Edition (ICHD-II). Heat-stroke (HS) is the HSD most severe condition, it may be divided into two forms: classic (due to a long period environmental heat exposure) and exertional (a severe condition caused by strenuous physical exercises in heat environmental conditions). Here we report the case...

  9. [Headache].

    Science.gov (United States)

    Godin, O

    1976-01-01

    Headache is an alarm symptom, whether there is an organic disease (lesional headache) or a perturbation of one of the various functions of the head (functional headache). Lesional headaches follow a sinusitis or an arthrosis, or accompany a "temporal arteritis of Horton". Functional headaches include several varieties. 1. Trigemellar neuralgia. 2. Vascular algia originating from the basal arteries, the large cerebral venous sinuses or the branches of the external carotid. Among these are: a) headaches due to a dilatation of the internal wall, causing "Horton headache", migrain-like psychosomatic migraine and hormonal migraines (premenstrual, menstrual, menopausal or linked to the use of contraceptive pills); b) headaches caused by an angiospasm of the arteriole, which is the case in exposure to the cold, in traumatic headaches (malfunction of temporomandibular articulation, dry alveolitis), in psychosomatic angiospastic algias and in ethmoidal artery algias previously described by the author in 1949 (Godin's disease). 3. Headaches due to psychic hypertension. 4. Postconcussional psychogenic headaches. 5. Neurotic headaches. The author gives a detailed description of the subjective symptoms in each case, including localisation, form, intensity, duration course and associated phenomenons. This facilitates greatly the differential diagnosis and the choice of complementary examinations. Necessary biological investigations should be performed (e.g. hormonal balance). One should however avoid to increase the number of complementary examinations which would only delay treatment and would expose patients to somatisation. Furthermore, in each case drug treatment, periarterial infiltration technics of the temporal, internal frontal, facial, mastoid and occipital arteries are described. The necessity of questioning the patient at length and to listen to him to enable him to verbalise conscious conflicts is emphasized. A serious medicopsychological examination and a relaxation

  10. Sinking Brain: Unusual Cause of Orthostatic Headache

    Directory of Open Access Journals (Sweden)

    Raina R

    2015-04-01

    Full Text Available We report a case presenting with an orthostatic headache. Brain magnetic resonance imaging (MRI revealed typical pachymeningeal enhancement. CT myelography revealed leakage at the thoracic level. Patient was successfully treated by lumbar epidural blood patch (EBP.

  11. Cluster headache

    Science.gov (United States)

    Histamine headache; Headache - histamine; Migrainous neuralgia; Headache - cluster; Horton's headache ... Doctors do not know exactly what causes cluster headaches. They ... (chemical in the body released during an allergic response) or ...

  12. Headaches

    Science.gov (United States)

    ... Physician November 15, 2007, http://www.aafp.org/afp/20071115/1518.html) The Patient with Daily Headaches ... Physician December 15, 2004, http://www.aafp.org/afp/20041215/2299.html) Written by familydoctor.org editorial ...

  13. Headache

    Science.gov (United States)

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 398. Ferri FF. Cluster headache. ... FF, ed. Ferri's Clinical Advisor 2016 . Philadelphia: PA Elsevier Mosby; 2016:347. Schoenen J, Sava SL. Tension- ...

  14. Headache.

    OpenAIRE

    Raskin, N H

    1994-01-01

    Headache-prone patients have many highly effective therapeutic options open to them. Used only at the time of headache, sumatriptan succinate by mouth or injection and dihydroergotamine nasal spray are novel choices now or soon to be available. The original migraine therapy, ergotamine, is highly effective in its rectal suppository formulation, when used at a subnauseating dosage. Valproate sodium is the latest addition to the many therapies available for long-term stabilization.

  15. Pro-inflammatory and vasoconstricting prostanoid PGF2α causes no headache in man

    DEFF Research Database (Denmark)

    Antonova, Maria; Wienecke, Troels; Olesen, Jes; Ashina, Messoud

    2011-01-01

    During two decades of migraine provocation studies with naturally occurring signalling molecules, vasodilators such as prostaglandin E(2), prostaglandin I(2) (prostacyclin) and prostaglandin D(2) were shown to be able to induce headache in man. To elucidate the role of inflammation and vasodilata...... vasodilatation in the generation of headache, we investigated whether the pro-inflammatory and vasoconstricting prostanoid prostaglandin F(2a) (PGF(2a)) would cause headache in a human model of headache....

  16. Pro-inflammatory and vasoconstricting prostanoid PGF2α causes no headache in man

    DEFF Research Database (Denmark)

    Antonova, Maria; Wienecke, Troels; Olesen, Jes; Ashina, Messoud

    2011-01-01

    During two decades of migraine provocation studies with naturally occurring signalling molecules, vasodilators such as prostaglandin E(2), prostaglandin I(2) (prostacyclin) and prostaglandin D(2) were shown to be able to induce headache in man. To elucidate the role of inflammation and vasodilata...... vasodilatation in the generation of headache, we investigated whether the pro-inflammatory and vasoconstricting prostanoid prostaglandin F(2α) (PGF(2α)) would cause headache in a human model of headache....

  17. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

  18. Headache Causes and Diagnosis in Adults (Beyond the Basics)

    Science.gov (United States)

    ... DW, Levine HL, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis ... Setzen M, Cady RK, et al. An otolaryngology, neurology, allergy, and primary care consensus on diagnosis and ...

  19. [Headache caused by pesticides--a review of the literature].

    Science.gov (United States)

    Titlić, Marina; Josipović-Jelić, Zeljka; Punda, Ante

    2008-05-01

    Headache makes one of the most common side effects of frequently pesticide application. This is to be taken care of in rural areas. Headaches have been reported with the use of ivermectin, ivermectin-diethylcarbamazine, organophosphates, and also with the fungicide maneb and copper sulfate, carbofuran, hexonal, dioxin, methomyl and its salts, as well as rare cases of poisoning with the fungicide combination of propineb and cymoxanil. Headache often occurs after long term work with pesticides and/or in laboratories. There are numerous symptoms accompanying headache in pesticide poisoning the most common being elevated body temperature, lassitude, dizziness, irritability, nausea, vomiting, epigastric pain, diarrhea, myalgia, pains in the arms and legs, sleepiness, pains in joints, irritation of eyes/face/skin, sweating. Much less common are respiratory disturbances, tachycardia, tachypnea and other cardiac distur bances, fall of blood pressure, gastrointestinal discomforts, constipation, poor appetite, significant decrease in leukocyte count, anemia, albuminuria, azotemia, fasciculations, miosis, blurred vision, memory disturbances and other neurologic disturbances, postural tremor, signs of cerebral function damage, bradykinesia, etc. PMID:18710090

  20. An unusual cause of headache in the medical tourist

    Directory of Open Access Journals (Sweden)

    Soaham Dilip Desai

    2014-01-01

    Full Text Available With booming medical tourism, Indian doctors are seeing a lot of patients from other countries for varied medical conditions. A citizen of Nairobi presented for treatment of his complaints consisting of severe episodic headache, with abdominal pain, spermatorrhea, decreased libido, constipation, and impotence. On detailed evaluation, he was found to have developed dependence to khat chewing; a social habit in his native country and his symptoms were attributed to effects of khat withdrawal. He improved after treatment with topiramate and escitalopram and lifestyle modification. Physicians need to be aware of various cultural habits of addiction in different parts of the world and their common presentations in view of globalization of health care.

  1. Vestibular schwannoma surgery and headache.

    Science.gov (United States)

    Levo, H; Blomstedt, G; Pyykkö, I

    2000-01-01

    The aim of the study was to evaluate aetiological factors for postoperative headache after vestibular schwannoma (VS) surgery with respect to asymmetric activation of vestibular reflexes. After surgery, 27 VS patients with persistent postoperative headache, 16 VS patients without headache and 9 healthy controls were examined. The vestibular, cervicocollic and cervicospinal reflexes were evaluated to study whether asymmetric activation of vestibular reflexes could cause headache. The effect of neck muscle and occipital nerve anaesthesia and the effect of sumatriptan on headache were also evaluated. The vestibular function of VS patients with headache did not differ from that of VS patients without headache, but was abnormal when compared to that of normal controls. The cervicospinal and cervicocollic reflexes did not differ in the patient groups. Injection of lidocaine around the operation scar gave pain relief to two patients, and one of them had occipital nerve entrapment. Infiltration of lidocaine deep in the neck muscles in the vicinity of the C2 root did not alleviate headache, but caused vertigo. Nine patients with musculogenic headache got pain relief from supportive neck collars, and two patients with cervicobrachial syndrome got pain relief from manual neck traction. The study shows that asymmetric activation of cervicocollic reflexes does not seem to be the reason for headache. Headache seems to be linked to neuropathic pain, allegedly caused by trigeminal irritation of the inner ear and the posterior fossa, which has recently been linked to vascular pain. PMID:10908966

  2. Nasal leech infestation causing persistent epistaxis

    OpenAIRE

    Sarathi, Kalra

    2011-01-01

    Foreign bodies in the nasal cavity are commonly encountered as a cause of epistaxis; however, nasal leech infestation as a cause of unilateral persistent epistaxis is very rare. Examination of nasal cavity revealed fleshy material in the left nostril, which was identified as leech. The leech was removed with the help of an artery forceps following irrigation of the left nostril with normal saline and adopting wait-and-watch policy. In developing countries, leech infestation as a cause of epis...

  3. Case Report of Post Concussion Syndrome with persistent Headache treated with Functional Neurology

    OpenAIRE

    Brad Ralston

    2015-01-01

    The following is a case report of a 17-year-old female with a history of postconcussion syndrome and a constant headache every day for four years. INTERVAL HISTORY: 17-year-old patient had a constant suboccipital headache that was both of the tension and migrainous variety, typically over the right orbital area at a consistent 6/10 on the analog pain scale. She had jaw pain, nausea, light sensitivity, depression. She had seen numerous specialists, was treated with injections, infusions,...

  4. Can atlas spina bifida-occulta be a cause of cervicogenic headaches?

    Science.gov (United States)

    Adigo, Amégninou Mawuko Yao; Agoda-Kousséma, Lama Kegdigoma; Agbotsou, Ignéza Komi; Adambounou, Kokou; Bakpatina-Batako, Kpalma Duga; Djagnikpo, Oni; Adjénou, Komlanvi Victor

    2015-01-01

    Cervicogenic headaches are a nosologic entity recently recognized. In our common practice, we have noticed a relative frequency of the atlas spina-bifida occulta during the brain CT scan realized for headaches without cranio-encephalic causes or any other anomaly of the upper cervical region. The aim of this study was to determine a possible connection between cervicogenic headaches (CEH) and atlas spina-bifida occulta. A 2 years prospective and descriptive study in 20 black patients having an atlas spina-bifida occulta diagnosed with a brain CT scan. The mean age of the patients was 43.17 ± 18.35 years (extremes: 24 and 72 years). A light female predominance was noticed (sex-ratio = 1.5). The frequency of symptomatic spina-bifida was 1.72 % (17 cases). The mean age at onset was 31.84 years. The pain was sub-occipital in 14 cases, occipital in 8 cases, bilateral in 12 cases and unilateral in 5 cases. The mean duration of the attacks was 72 ± 24 h and the pain intensity was moderate (16 cases); mean and range were 3.6 and 3-6. The frequency of attacks varied between 1 per 7 months (n = 2) and 2 per week (n = 1) in those with non-daily headache. One attack per 5-7 weeks was the most commonly occurring attack frequency. The pain was reproduced by the pressure of the occipital region or upper cervical in 15 cases. The mean number of criteria was five and there was a strong positive correlation between criteria and CEH (χ (2) = 45.57; V = 0.62). The associated signs were photophobia and nausea in one case each. Indomethacin, Ergotamine and/or Sumatriptan were without any antalgic effect in 16 cases. Pain ceased after an anesthetic blockade of C2 (16 cases). The results show that atlas spina-bifida occulta is not involved in CEH pure form genesis. On a small sample, the atlas spina-bifida seems to be a cause of CEH associated with headache and disorders of the neck. PMID:26543740

  5. Other primary headaches

    Directory of Open Access Journals (Sweden)

    Anish Bahra

    2012-01-01

    Full Text Available The ′Other Primary Headaches′ include eight recognised benign headache disorders. Primary stabbing headache is a generally benign disorder which often co-exists with other primary headache disorders such as migraine and cluster headache. Primary cough headache is headache precipitated by valsalva; secondary cough has been reported particularly in association with posterior fossa pathology. Primary exertional headache can occur with sudden or gradual onset during, or immediately after, exercise. Similarly headache associated with sexual activity can occur with gradual evolution or sudden onset. Secondary headache is more likely with both exertional and sexual headache of sudden onset. Sudden onset headache, with maximum intensity reached within a minute, is termed thunderclap headache. A benign form of thunderclap headache exists. However, isolated primary and secondary thunderclap headache cannot be clinically differentiated. Therefore all headache of thunderclap onset should be investigated. The primary forms of the aforementioned paroxysmal headaches appear to be Indomethacin sensitive disorders. Hypnic headache is a rare disorder which is termed ′alarm clock headache′, exclusively waking patients from sleep. The disorder can be Indomethacin responsive, but can also respond to Lithium and caffeine. New daily persistent headache is a rare and often intractable headache which starts one day and persists daily thereafter for at least 3 months. The clinical syndrome more often has migrainous features or is otherwise has a chronic tension-type headache phenotype. Management is that of the clinical syndrome. Hemicrania continua straddles the disorders of migraine and the trigeminal autonomic cephalalgias and is not dealt with in this review.

  6. Cranial and Cervical Muscular Weakness in Mitochondrial Myopathy Is Associated With Resolution of Migraine Headaches: Further Evidence That Muscular Compression of Cranial and Peripheral Nerves Is a Cause of Headache in a Subset of Patients With Migraine

    OpenAIRE

    Miranda, Edward P.

    2015-01-01

    Objective: A significant subset of patients with migraine headaches has pain relief after neuroplasty/muscular decompression of select cranial and cervical nerves. In the majority of cases, compression occurs secondary to compression of the nerves by adjacent muscles. Previous studies have shown that both surgical decompression and chemical denervation (eg, botulinum toxin) provide relief of migraine headaches; however, controversy remains. If some migraine headaches are caused by muscular co...

  7. Sleep and primary headaches.

    Science.gov (United States)

    Aguggia, Marco; Cavallini, M; Divito, N; Ferrero, M; Lentini, A; Montano, V; Tinebra, M C; Saracco, M G; Valfrè, W

    2011-05-01

    The relationship between sleep and primary headaches has been known for over a century, particularly for headaches occurring during the night or early morning. Migraine, tension-tyre headache, and cluster headache may cause sleep fragmentation, insomnia, and hypersomnia, causing considerable social and economical costs and several familial problems. By contrast, sleep disorders may themselves trigger headache attacks. Finally, headaches and sleep disorders can also be symptoms of other underlying pathologies. Despite this background, there is still no clarity about the mechanism that links these two entities and their interdependence remains to be defined. Patients with primary headache should undergo a careful assessment of sleep habits. PMID:21533713

  8. Two family members with a syndrome of headache and rash caused by human parvovirus B19

    Directory of Open Access Journals (Sweden)

    Antonio Carlos M. Pereira

    2001-02-01

    Full Text Available Human parvovirus B19 infection can cause erythema infectiosum (EI and several other clinical presentations. Central nervous system (CNS involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 year old female with a 7-day history of headache, malaise, myalgias, joint pains, and rash was seen. Physical examination revealed a maculopapular rash on the patient's body, and arthritis of the hands. She completely recovered in 1 week. Two days before, her 6 year old son had been admitted to a clinic with a 1-day history of fever, headache, abdominal pain and vomiting. On admission, he was alert, and physical examination revealed neck stiffness, Kerning and Brudzinski signs, and a petechial rash on his trunk and extremities. Cerebrospinal fluid analysis was normal. He completely recovered in 5 days. Acute and convalescent sera of both patients were positive for specific IgM antibody to B19. Human parvovirus B19 should be considered in the differential diagnosis of aseptic meningitis, particularly during outbreaks of erythema infectiosum. The disease may mimic meningococcemia and bacterial meningitis.

  9. Causes and Associated Factors of Headaches among 5 to 15-year-old Children Referred to a Neurology Clinic in Kashan, Iran

    Directory of Open Access Journals (Sweden)

    Ahmad TALEBIAN

    2015-01-01

    Full Text Available How to Cite This Article: Talebian A, Soltani B, Haji Rezaei M. Causes and Associated Factors of Headaches among 5 to 15-year-old ChildrenReferred to a Neurology Clinic in Kashan, Iran. Iran J Child Neurol. 2015 Winter;9(1:71-75.AbstractObjectiveHeadaches are common neurologic problems for children and adolescents. They are divided into two types: primary and secondary. Primary headaches include migraines and tension-type as well as comprise the majority of headaches. We detect the causes of headaches and their associations with demographic variables among children and adolescents.Materials & MethodsThis cross-sectional study was performed on 5–15 year-old children with headaches from March 2010 to April 2012 who presented at a pediatric neurology clinic in Kashan, Iran. Diagnosis of headaches was done in accordance with the International Classification of Headache Disorders. Data regarding the type of headache, age, gender, pain severity, aura, family history, and sleep disorder were collected.ResultsOne hundred fourteen children (44 male and 70 female with headaches were enrolled in the study. The types of headaches were comprised as follows: 67 cases of migraines, 38 cases of tension-type headaches, 2 cases of cluster headaches, and 7 cases of secondary headaches. Pulsating headaches, family history of headaches, insomnia, and pain severity had higher prevalence in migrainous patients.ConclusionPhysicians should extend their information gathering about primary and secondary headaches. Sleep disturbances and a family history of headaches were the most important factors associated with migraine headaches.ReferencesCuvellier JC, Donnet A, Guegan-Massardier E, Nachit-Ouinekh F, Parain D, Vallee L. Treatment of primary headache in children: a multicenter hospital-based study in France. J Headache Pain 2009; 10: 447-53.Lateef TM, Merikangas KR, He J, Kalaydjian A, Khoromi S, Knight E, et al. Headache in a national sample of American children

  10. Does monosodium glutamate really cause headache? : a systematic review of human studies.

    Science.gov (United States)

    Obayashi, Yoko; Nagamura, Yoichi

    2016-12-01

    Although monosodium glutamate (MSG) is classified as a causative substance of headache in the International Classification of Headache Disorders 3rd edition (ICHD-III beta), there is no literature in which causal relationship between MSG and headache was comprehensively reviewed. We performed systematic review of human studies which include the incidence of headache after an oral administration of MSG. An analysis was made by separating the human studies with MSG administration with or without food, because of the significant difference of kinetics of glutamate between those conditions (Am J Clin Nutr 37:194-200, 1983; J Nutr 130:1002S-1004S, 2000) and there are some papers which report the difference of the manifestation of symptoms after MSG ingestion with or without food (Food Chem Toxicol 31:1019-1035, 1993; J Nutr 125:2891S-2906S, 1995). Of five papers including six studies with food, none showed a significant difference in the incidence of headache except for the female group in one study. Of five papers including seven studies without food, four studies showed a significant difference. Many of the studies involved administration of MSG in solution at high concentrations (>2 %). Since the distinctive MSG is readily identified at such concentrations, these studies were thought not to be properly blinded. Because of the absence of proper blinding, and the inconsistency of the findings, we conclude that further studies are required to evaluate whether or not a causal relationship exists between MSG ingestion and headache. PMID:27189588

  11. Migraine Headaches

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Migraine Headaches KidsHealth > For Teens > Migraine Headaches Print A ... help avoid them. What Makes a Headache a Migraine? Almost everyone gets headaches. You might feel pressure ...

  12. Secondary chronic cluster headache due to trigeminal nerve root compression.

    Science.gov (United States)

    Mjåset, Christer; Russell, M B; Russell, M Bjørn

    2010-12-01

    A 50-year-old woman had a gradual onset of chronic headache located in the right temporal region and a burning sensation in the root of the tongue which over a year evolved into chronic cluster headache with a milder chronic headache in-between the severe cluster headache attacks. A cerebral magnetic resonance imaging (MRI) showed vascular compression of the trigeminal nerve root on the pain side. Neurosurgery microvascular decompression relieved the patient's chronic cluster headache, the chronic intermittent headache and the burning tongue sensation. The effect was persistent at a 1 year follow-up. Patients with atypical symptoms of cluster headache should be examined with cerebral MRI angiography of arteries and veins to exclude symptomatic causes. PMID:20384588

  13. Headache during haemodialysis in a patient with shunt: a cause for concern?

    Science.gov (United States)

    O'Sullivan, Padraig; Sajjad, Jahangir; Abrar, Sahibzada; Marks, Charles

    2015-01-01

    A 20-year-old woman with a functioning ventriculoperitoneal (VP) shunt consistently reported unbearable vertex headaches and nausea during the last hour of her haemodialysis (HD) sessions. After one particularly severe episode, which was associated with vomiting, restlessness and blurred vision, her team suspected that she was developing dialysis disequilibrium syndrome. She improved fully on cessation of HD, requiring simple analgaesia only, and continued dialysis three times per week. Several more distressing episodes of nausea and headaches compelled us to give intravenous mannitol during HD, resulting in temporary improvement. Subsequently, shorter and more frequent dialysis sessions along with intravenous mannitol resulted in satisfactory clinical response. PMID:25819823

  14. Epidural blood patch for refractory low CSF pressure headache

    DEFF Research Database (Denmark)

    Madsen, Søren Aalbæk; Fomsgaard, Jonna Storm; Jensen, Rigmor

    2011-01-01

    Once believed an exceedingly rare disorder, recent evidence suggests that low cerebrospinal fluid (CSF) pressure headache has to be considered an important cause of new daily persistent headaches, particularly among young and middle-aged individuals. Treatment of low CSF pressure headache consists...... reduction in frequency. An increase in days with use of medication was found. Increased awareness of low CSF pressure headache is emphasized and a controlled larger randomized study is needed to confirm the results. However the present results, allows us to conclude that EBP in treatment-refractory low CSF...

  15. Retained knife blade: an unusual cause for headache following massive alcohol intake

    OpenAIRE

    Lesieur, O; Verrier, V; Lequeux, B.; Lempereur, M.; Picquenot, E

    2006-01-01

    Massive alcohol intake usually resolves in a banal headache. We report a case of a patient presenting with acute alcohol intoxication in which the ensuing “hangover” was due to a knife blade deeply retained in the brain parenchyma. This case underlines the unpredictability of retained foreign bodies without a high level of suspicion and a detailed description of the circumstances of admission.

  16. A Rare Cause of Persistent Nausea and Vomiting: Candida Duodenitis

    Directory of Open Access Journals (Sweden)

    Mustafa Yildirim

    2014-03-01

    Full Text Available Ižntestinal bowel lesions caused by Candida species are uncommon. These lesions may be  plaques or ulcers form. In this article, We presented endoscopic images  Candida duodenitis as a cause of persistent nausea, vomiting in a lung cancer patient treated with chemotherapy.  

  17. A Rare Cause of Persistent Nausea and Vomiting: Candida Duodenitis

    OpenAIRE

    Mustafa Yildirim

    2014-01-01

    Intestinal bowel lesions caused by Candida species are uncommon. These lesions may be  plaques or ulcers form. In this article, We presented endoscopic images  Candida duodenitis as a cause of persistent nausea, vomiting in a lung cancer patient treated with chemotherapy.  

  18. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus

    Directory of Open Access Journals (Sweden)

    Ananya Panda

    2013-01-01

    Full Text Available Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications.

  19. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus

    Science.gov (United States)

    Arora, Arundeep; Jana, Manisha

    2013-01-01

    Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. PMID:24459596

  20. Persistent primitive trigeminal artery: an unusual cause of vascular tinnitus.

    Science.gov (United States)

    Panda, Ananya; Arora, Arundeep; Jana, Manisha

    2013-01-01

    Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. PMID:24459596

  1. Persistent omphalomesenteric duct causing small bowel obstruction in an adult

    Institute of Scientific and Technical Information of China (English)

    Haridimos Markogiannakis; Dimitrios Theodorou; Konstantinos G Toutouzas; Panagiotis Drimousis; Sotirios Georgios Panoussopoulos; Stilianos Katsaragakis

    2007-01-01

    An extremely rare case of persistent omphalomesenteric duct causing small bowel obstruction is presented. A 20-year-old female patient without medical history presented with colicky abdominal pain, vomiting, absence of passage of gas and feces, and abdominal distension of 24 h duration. Physical examination and blood tests were normal. Abdominal X-ray showed small bowel obstruction.Computed tomography of the abdomen demonstrated dilated small bowel and a band originating from the umbilicus and continuing between the small bowel loops;an omphalomesenteric duct remnant was suspected. In exploratory laparotomy, persistent omphalomesenteric duct causing small bowel obstruction was identified and resected. The patient had an uneventful recovery and was discharged on the 5th postoperative day. Although persistent omphalomesenteric duct is an extremely infrequent cause of small bowel obstruction in adult patients, it should be taken into consideration in patients without any previous surgical history.

  2. Cluster headache after orbital exenteration.

    Science.gov (United States)

    Evers, S; Sörös, P; Brilla, R; Gerding, H; Husstedt, I W

    1997-10-01

    A 37-year-old man developed an ipsilateral headache which fulfilled the criteria for cluster headache after orbital extenteration because of a traumatic lesion of the bulb. The headache could be treated successfully by drugs usually applied in the therapy of cluster headache. Six similar cases of cluster headache after orbital exenteration could be identified in the literature suggesting that the eye itself is not necessarily part of the pathogenesis of cluster headache. We hypothesize that orbital exenteration can cause cluster headache by lesions of sympathetic structures. Possibly, these mechanisms are similar to those of sympathetic reflex dystrophy (Sudeck-Leriche syndrome) causing pain of the limbs. PMID:9350391

  3. Excessive Paranasal Sinuses and Mastoid Aeration as a Possible Cause of Chronic Headache

    OpenAIRE

    Panagiotis Kousoulis; Jiannis Hajiioannou; Vassiliki Florou; Dimitrios Kretzas; George Korres

    2013-01-01

    The objective of this case report is to present a patient with chronic headache who was diagnosed with excessive aeration of all paranasal sinuses and mastoid air cells using computed tomography imaging. The volume and linear measurements of all of the cavities revealed values greater than the greatest values reported in the literature. To date, this is the second reported case of excessive enlargement of all paranasal sinuses and the first which includes the enlargement of the mastoid air ce...

  4. Cluster Headache

    OpenAIRE

    Frederick G Freitag

    1985-01-01

    Learning Objectives: Review the current understanding of the pathophysiology of cluster headache Be able to recognize the clinical features of cluster headache Be able to develop a strategy for treatment of cluster headache Cluster headache is divided into multiple subtypes under the IHC classification criteria. The vast majority of patients present with episodic cluster headache (3.1.1). This will be the focus of the presentation. The syndrome is characterized by repeated at...

  5. Reversible Cerebral Vasoconstriction Syndrome Without Typical Thunderclap Headache.

    Science.gov (United States)

    Wolff, Valérie; Ducros, Anne

    2016-04-01

    Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe headache and diffuse segmental intracranial arterial constriction that resolve within three months. Stroke, which is the major complication of RCVS, can result in persistent neurological disability, and rarely causes death. Diagnosis of RCVS early in the clinical course might improve outcomes. Although recurrent thunderclap headache is the clinical hallmark of RCVS, the absence of such a pattern should not lead to discard the diagnosis. Our literature review shows that RCVS can also manifest as an unspecific headache, such as a single severe headache episode, a mild or a progressive headache. Moreover, a subset of patients with severe RCVS presents without any headache, but frequently with seizures, focal neurological deficits, confusion or coma, in the setting of stroke or posterior reversible encephalopathy syndrome. These patients may be aphasic or in comatose state, explaining their inability to give their own medical history. They may have forgotten the headache they had a few days before more dramatic symptoms, or may have a variant of the classical RCVS. By consequence, an RCVS should be suspected in patients with any unusual headache, whether thunderclap or not, and in patients with cryptogenic stroke or convexity subarachnoid hemorrhage, whether the patient also has headache or not. Diagnosis in such cases relies on the demonstration of reversible multifocal intracranial arterial stenosis and the exclusion of other causes. PMID:27016378

  6. Complete oculomotor palsy caused by persistent trigeminal artery.

    Science.gov (United States)

    Bosco, Domenico; Consoli, Domenico; Lanza, Pier Luigi; Plastino, Massimiliano; Nicoletti, Francesco; Ceccotti, Claudio

    2010-10-01

    Primitive trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebro-basilar system. PTA is a pathophysiology phenomenon which has been implicated as a rare cause of cranial nerve dysfunction. We report the case of a 40-year-old woman who developed a complete oculomotor nerve palsy caused by a persistent ecstatic trigeminal artery. Brain MRI and MRA studies documented a neurovascular conflict between the oculomotor nerve and a PTA. To the best of our knowledge there is no report about complete third cranial nerve palsy NC due to a PTA. A role of this rare vascular condition is discussed. PMID:20552240

  7. Ultrasonography Guided Excision of Isolated Cysticercosis of the Temporalis Muscle Causing Intractable Headache: A Rare Case Report.

    Science.gov (United States)

    Kumar, Vivek; Bhavana, Kranti; Kumar, Prem; Kumar, Subhash

    2016-09-01

    Cysticercosis cellulosae is a systemic parasitic infection caused by the larval stage of pork tapeworm, Taenia solium which involve humans as either a definitive or secondary hosts. The central nervous system is the most important primary site of involvement. Cases of cysticercosis presenting as an isolated muscle mass is an extremely rare entity and demands documentation. We report an extremely unusual case of isolated cysticercosis of the temporalis muscle causing intractable headache which presented a diagnostic challenge. The condition was surgically treated by ultrasonography guided excision of the cysticercosis swelling in the temporalis muscle. We also emphasize on the role of proper imaging modalities in the diagnosis and treatment of such unique cases. PMID:27508147

  8. Chronic hepatitis caused by persistent parvovirus B19 infection

    Directory of Open Access Journals (Sweden)

    Mogensen Trine H

    2010-08-01

    Full Text Available Abstract Background Human infection with parvovirus B19 may lead to a diverse spectrum of clinical manifestations, including benign erythema infectiosum in children, transient aplastic crisis in patients with haemolytic anaemia, and congenital hydrops foetalis. These different diseases represent direct consequences of the ability of parvovirus B19 to target the erythroid cell lineage. However, accumulating evidence suggests that this virus can also infect other cell types resulting in diverse clinical manifestations, of which the pathogenesis remains to be fully elucidated. This has prompted important questions regarding the tropism of the virus and its possible involvement in a broad range of infectious and autoimmune medical conditions. Case Presentation Here, we present an unusual case of persistent parvovirus B19 infection as a cause of chronic hepatitis. This patient had persistent parvovirus B19 viraemia over a period of more than four years and displayed signs of chronic hepatitis evidenced by fluctuating elevated levels of ALAT and a liver biopsy demonstrating chronic hepatitis. Other known causes of hepatitis and liver damage were excluded. In addition, the patient was evaluated for immunodeficiency, since she had lymphopenia both prior to and following clearance of parvovirus B19 infection. Conclusions In this case report, we describe the current knowledge on the natural history and pathogenesis of parvovirus B19 infection, and discuss the existing evidence of parvovirus B19 as a cause of acute and chronic hepatitis. We suggest that parvovirus B19 was the direct cause of this patient's chronic hepatitis, and that she had an idiopathic lymphopenia, which may have predisposed her to persistent infection, rather than bone marrow depression secondary to infection. In addition, we propose that her liver involvement may have represented a viral reservoir. Finally, we suggest that clinicians should be aware of parvovirus B19 as an unusual

  9. Familial occurrence in primary headaches

    OpenAIRE

    Russell, Michael Bjørn

    2001-01-01

    This paper reviews the literature of genetic epidemiology in primary headaches. Migraine without aura and migraine with aura are distinct disorders. Both are caused by a combination of genetic and environmental factors. Tension–type headache. The episodic form is most likely non–genetic, while the chronic form is caused by a combination of genetic and environmental factors. Cluster headache has previously not been thought to be genetic. However, first degree relatives of cluster headache suff...

  10. Evaluation of headache severity after aneurysmal subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Rachel Swope, PharmD, BCPS

    2014-12-01

    Conclusions: Headache after SAH is persistent and treatment refractory. There may be an association with development of vasospasm and worsening of headache. Novel treatment strategies to attenuate headache in this population are needed.

  11. Headaches. More than just sinusitis; Kopfschmerzen. Mehr als nur Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Knauth, Michael [Universitaetsklinikum Goettingen (Germany). Abt. Neuroradiologie

    2011-09-15

    Headaches are among the commonest somatic complaints seen in clinical practice. The International Headache Society differentiates about 190 types of headaches. This article focuses on the variety of secondary headaches with a radiologically identifiable cause. (orig.)

  12. Epidural blood patch for refractory low CSF pressure headache

    DEFF Research Database (Denmark)

    Madsen, Søren Aalbæk; Fomsgaard, Jonna Storm; Jensen, Rigmor

    2011-01-01

    of non-invasive/conservative measures and invasive measures with epidural blood patch providing the cornerstone of the invasive measures. In the present pilot study we therefore aimed to evaluate the treatment efficacy of epidural blood patch (EBP) in treatment-refractory low-pressure headache. Our......Once believed an exceedingly rare disorder, recent evidence suggests that low cerebrospinal fluid (CSF) pressure headache has to be considered an important cause of new daily persistent headaches, particularly among young and middle-aged individuals. Treatment of low CSF pressure headache consists...... reduction in frequency. An increase in days with use of medication was found. Increased awareness of low CSF pressure headache is emphasized and a controlled larger randomized study is needed to confirm the results. However the present results, allows us to conclude that EBP in treatment-refractory low CSF...

  13. Neurobiology in primary headaches

    DEFF Research Database (Denmark)

    Edvinsson, Lars; Uddman, Rolf

    2005-01-01

    ) receptors, causes the headache to subside and the levels of neuropeptides to normalise, in part through presynaptic inhibition of the cranial sensory nerves. These data suggest a central role for sensory and parasympathetic mechanisms in the pathophysiology of primary headaches. The positive clinical trial......Primary headaches such as migraine and cluster headache are neurovascular disorders. Migraine is a painful, incapacitating disease that affects a large portion of the adult population with a substantial economic burden on society. The disorder is characterised by recurrent unilateral headaches......, usually accompanied by nausea, vomiting, photophobia and/or phonophobia. A number of hypothesis have emerged to explain the specific causes of migraine. Current theories suggest that the initiation of a migraine attack involves a primary central nervous system (CNS) event. It has been suggested that a...

  14. Headaches in Children

    Science.gov (United States)

    ... while reading, may cause headaches. This is called convergence insufficiency, and symptoms include the doubling of images or ... the help of computer software, can help treat convergence insufficiency. Glasses are sometimes prescribed. Expensive in-office eye ...

  15. Sleep apnea headaches

    Directory of Open Access Journals (Sweden)

    Reza Boostani

    2016-12-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a common disorder characterized by recurrent apnea during sleep. Nocturnal laboratory-based polysomnography (PSG is the gold standard test for diagnosis of OSA. The sufferers may complain from daytime sleepiness, snoring or occasional headaches. Serious consequences such as cardiovascular complications, stroke or symptoms of depression may complicate the syndrome. Headache prevalence due to sleep apnea is estimated 1%-2% in general population and affects 2%-8% of middle age population. Morning headache is more common in the OSAS patients. OSAS patients present with various characteristics of morning headache. Treatment with continuous positive airway pressure usually reduces headache. The pathophysiologic background for a relation between obstructive sleep apnea and morning headache is multifactorial. Some theories have been proposed for OSAS-related headaches such as changing oxygen saturation during sleep, cerebral vasodilation and increased intracranial pressure due to cerebral vasodilation, sleep disruption and depression but the definite cause of headaches in OSAS patients is not yet clear.

  16. [Headache as the consequence of brain concussion and contusion in closed head injuries in children].

    Science.gov (United States)

    Lemka, M

    1999-01-01

    The most frequent type of head injury in children is closed head trauma with brain concussion or contusion, and headache is the dominant complaint of early and late postinjury period. Because of scant number of studies on the problem of occurrence, characteristics and persistence of posttraumatic headache this study was undertaken in a group of 100 children (29 girls and 71 boys), aged 3-14 years old, 90 after brain concussion and 10 after contusion. Children with a history of injuries, central nervous system infections, with headaches before injury and chronic diseases were excluded. In 9 cases linear skull fracture was present after injury. The material was examined within one week after trauma, and then after 3, 6, and 12 months. After 3 months EEG was performed and repeated after 6 and 12 months in children with persistent headache or those without headache but with abnormal EEG results in the first examination. According to the additional diagnostic examinations, I excluded other causes of headache, besides head injury. In my observation 83% of children had headache after brain concussion and contusion. The majority--56%--had acute posttraumatic headache, but 27% of children complained of chronic headache, mainly tension type headache. Only 3% had migraine. In 21% of all group of 100 children, I noticed the headache persisting during the whole year of my observation. The important risk factor for the occurrence of posttraumatic headache were the age of child at the moment injury and the period of unconsciousness. The electroencephalographic recording still remains the important additional examination of posttraumatic consequences. PMID:10719686

  17. Persistent organic dyspepsia of infrequent cause.Case presentation

    International Nuclear Information System (INIS)

    For the Rome III consensus criteria, the dyspepsia is defined as any pain or discomfort located in the central part of the superior abdomen and that it can be associated to a sensation of fullness, satiety precocious distension, burps, nauseas and vomits that can improve or to worsen with the foods, begun in the last 6 months and with present symptoms once a week in the 3 previous months. The dyspepsia this incorporated one for two big groups: the organic one and the functional one and it can be secondary to local or systemic alterations. Considered that between the 60 and 70% of the dyspeptic they are functional and that a 30 to 40% are of organic origin. The gastritis, ulcerates peptic either gastric or duodenal, the cancer and some medications, they are the frequently implied organic factors. The incidence of the dyspepsia for systemic alterations is not very well-known and its appearance is variable. We present a case that was derived to the gastroenterology service to present a dyspepsia related with Helycobacter pylori that persisted after the eradication of the infection, evidencing after the clinical study and paraclinic a symptomatic hypercalcaemia secondary to primary hyperparathyroidism (HPTP) like cause of their gastrointestinal square; and next the revision of the pathology will be made in mention and of its gastrointestinal component.

  18. Persistent organic dyspepsia of infrequent cause. Case presentation

    International Nuclear Information System (INIS)

    For the Rome III consensus criteria, the dyspepsia is defined as any pain or discomfort located in the central part of the superior abdomen and that it can be associated to a sensation of fullness, satiety precocious distension, burps, nauseas and vomits that can improve or to worsen with the foods, begun in the last 6 months and with present symptoms once a week in the 3 previous months. The dyspepsia this incorporated one for two big groups: the organic one and the functional one and it can be secondary to local or systemic alterations. Considered that between the 60 and 70% of the dyspeptic they are functional and that a 30 to 40% are of organic origin. The gastritis, ulcerates peptic either gastric or duodenal, the cancer and some medications, they are the frequently implied organic factors. The incidence of the dyspepsia for systemic alterations is not very well-known and its appearance is variable. We present a case that was derived to the gastroenterology service to present a dyspepsia related with Helycobacter pylori that persisted after the eradication of the infection, evidencing after the clinical study and paraclinic a symptomatic hypercalcaemia secondary to primary hyperparathyroidism (HPTP) like cause of their gastrointestinal square; and next the revision of the pathology will be made in mention and of its gastrointestinal component.

  19. Tension headache

    Science.gov (United States)

    ... headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a ... and practice stress management . Some people find relaxation exercises or meditation helpful. Biofeedback may help you improve ...

  20. Idiopathic intracranial hypertension presenting as postpartum headache.

    Science.gov (United States)

    Mathew, Mariam; Salahuddin, Ayesha; Mathew, Namitha R; Nandhagopal, Ramachandiran

    2016-01-01

    Postpartum headache is described as headache and neck or shoulder pain during the first 6 weeks after delivery. Common causes of headache in the puerperium are migraine headache and tension headache; other causes include pre-eclampsia/eclampsia, post-dural puncture headache, cortical vein thrombosis, subarachnoid hemorrhage, posterior reversible leukoencephalopathy syndrome, brain tumor, cerebral ischemia, meningitis, and so forth. Idiopathic intracranial hypertension (IIH) is a rare cause of postpartum headache. It is usually associated with papilledema, headache, and elevated intracranial pressure without any focal neurologic abnormality in an otherwise healthy person. It is more commonly seen in obese women of reproductive age group, but rare during pregnancy and postpartum. We present a case of IIH who presented to us 18 days after cesarean section with severe headache and was successfully managed. PMID:26818168

  1. Headache characteristics and chronification of migraine and tension-type headache: A population-based study

    DEFF Research Database (Denmark)

    Ashina, Sait; Lyngberg, Ann; Jensen, Rigmor

    2010-01-01

    the relation of clinical characteristics of primary headaches to poor outcome: new-onset or persistent chronic headache (> or =180 days/year). Individuals who had migraine + / - TTH and those who had pure TTH were studied separately. Of 740 individuals who entered this study in 1989, 673 were eligible...... for follow-up in 2001, and a total of 549 individuals participated in the follow-up study. At baseline in 1989, no difference was found between episodic and chronic migraine headache ( + / - TTH). Duration of headache episodes >72 hours (p = .002) was associated with pure chronic TTH at baseline in...... pure TTH, unilateral headache, nausea and individual headache attack duration greater than 72 hours was associated with poor outcome. Pooled data univariate analysis revealed that nausea, daily use of acute headache medications, use of headache preventive medications and coexistent headaches were...

  2. Intercostal Neurinoma: A Rare Cause of Persistent Thoracic Pain

    OpenAIRE

    Meyer, Christian; Rodepeter, Fiona; Bartsch, Detlef; Kirschbaum, Andreas

    2014-01-01

    Persistent thoracic pain with no history of trauma demands diagnostic workup. In this case, the patient complained of right thoracic continuous belt-like pain, sometimes experienced as shooting pain, over several months. The symptoms were first treated conservatively with painkillers, which was rather ineffective. A magnetic resonance imaging scan of the thorax surprisingly showed an unclear piston-like enlargement near the seventh rib closely above the spinal canal. Video thoracoscopy was pe...

  3. Sinus Headache or Migraine

    Science.gov (United States)

    ... headaches . Home > "Sinus Headache" or Migraine Print Email "Sinus Headache" or Migraine ACHE Newsletter Sign up for ... newsletter by entering your e-mail address below. "Sinus Headache" or Migraine Susan Hutchinson, MD Key Points: ...

  4. Visual aura in ice cream headache

    OpenAIRE

    Álvaro, Luis-C.; Sádaba, Fernando; Cortina, Carlos

    2004-01-01

    We present a case of cold-induced visual symptoms in a 74-year-old woman with a history of migraine headaches. Migraine without aura was the starting symptom. It coexisted later with a typical pain of ice cream or cold stimulus headache that persisted after the migraine vanished. Finally the headache disappeared and the course was characterised by episodes of pure visual symptoms, always after swallowing cold material. The vasodynamic effects underlying migraine are invoked to understand this...

  5. The Geriatric Headache: A Unique Clinical Ailment

    OpenAIRE

    Donald F. Weaver; Purdy, R. Allan

    1986-01-01

    The “geriatric headache” may be a unique clinical ailment. A change in a chronic headache pattern or a new onset headache should raise suspicion immediately in an elderly patient. Temporal arteritis occurs almost exclusively in the elderly population. Because of its grave prognosis and ease of treatment, this condition should always be considered a possibility in the elderly patient with headache. A throbbing non-migranous headache may indicate an impending cerebrovascular event. Other causes...

  6. Methamphetamine Self-Administration Causes Persistent Striatal Dopaminergic Alterations and Mitigates the Deficits Caused by a Subsequent Methamphetamine Exposure

    OpenAIRE

    McFadden, Lisa M.; Hadlock, Greg C.; Allen, Scott C.; Vieira-Brock, Paula L.; Kristen A Stout; Ellis, Jonathan D; Hoonakker, Amanda J.; Andrenyak, David M.; Nielsen, Shannon M.; Wilkins, Diana G; Hanson, Glen R.; Fleckenstein, Annette E.

    2012-01-01

    Preclinical studies have demonstrated that repeated methamphetamine (METH) injections (referred to herein as a “binge” treatment) cause persistent dopaminergic deficits. A few studies have also examined the persistent neurochemical impact of METH self-administration in rats, but with variable results. These latter studies are important because: 1) they have relevance to the study of METH abuse; and 2) the effects of noncontingent METH treatment do not necessarily predict effects of contingent...

  7. Postdural Puncture Headache

    Directory of Open Access Journals (Sweden)

    Ahmed Ghaleb

    2010-01-01

    Full Text Available Postdural puncture headache (PDPH has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge needles, particularly of the pencil-point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle. A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24–48 h of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications of AEBP are rare.

  8. Childhood Headache Syndromes(Part I

    Directory of Open Access Journals (Sweden)

    Mohammad Ghofrani

    2010-06-01

    Full Text Available AbstractHeadache is one of the most common reason that children are referred to the Pediatric Neurology Services. It is said that ten percent of children aged 5 to 15 years have migraine. Subsequently, it is essential for clinician to have a through, comprehensive and systematic approach to the evaluation and management of the child or adolescent who complain of headache.This writing aims to explore the symptoms of headache, its epidemiology, classification, appropriate evaluation, differential diagnosis and management.Headaches are divided into primary and secondary categories. Migraine and tension type headaches are prototype of primary headaches without underlying pathology. On the other hand, the type of headache which stems from organic diseases such as: brain tumor, increased intracranial pressure, systemic disease, drug toxicity or Ear Nose and Throat problems are considered secondary. On the whole, the majority of children with primary headache have two patterns of headache. One is a chronic low-grade and the other is an intermittent disabling headache. The cause of the former is either caffeine or analgesic abuse, and the latter is predominantly migraine. Traditionally, if a child presents himself with chief complain of headache, care taker physician begins with history taking followed by thorough physical and neurological examinations. In the majority of the cases, this initial process leads to a diagnosis or indicate the need for further testing. Once the diagnosis is made, a management program can be put into place.Headaches, Child, Children, Migraine.

  9. CHILDHOOD HEADACHE SYNDROMES(PART II

    Directory of Open Access Journals (Sweden)

    Mohammad GHOFRANI

    2010-10-01

    Full Text Available ObjectiveHeadache is one of the most common reason that children are referred to the Pediatric Neurology Services. It is said that ten percent of children aged 5 to 15 years have migraine.Subsequently, it is essential for clinician to have a through, comprehensive and systematic approach to the evaluation and management of the child or adolescent who complains of headache.This writing aims to explore the symptoms of headache, its epidemiology, classification, appropriate evaluation, differential diagnosis and management.Headaches are divided into primary and secondary categories. Migraine and tension type headaches are prototype of primary headaches without underlying pathology. On the other hand, the type of headache which stems from organic diseases such as: brain tumor, increased intracranial pressure, systemic disease, drug toxicity, ear-nose and throat problems are considered secondary.On the whole, the majority of children with primary headache have two patterns of headache. One is a chronic low-grade and the other is an intermittent disabling headache. The cause of the former is either caffeine or analgesic abuse, and the latter is predominantly migraine.Traditionally, if a child presents himself with chief complain of headache, care taker physician begins with history taking followed by thorough physical and neurological examinations.In the majority of the cases, this initial process leads to a diagnosis or indicate the need for further testing.Once the diagnosis is made, a management program can be put into place.Keywords:Headaches, Child, Children, Migraine

  10. Tinnitus and Headache

    OpenAIRE

    Berthold Langguth; Verena Hund; Volker Busch; Jürgens, Tim P; Jose-Miguel Lainez; Michael Landgrebe; Martin Schecklmann

    2015-01-01

    Background. Tinnitus and headache are frequent disorders. Here, we aimed to investigate whether the occurrence of headache among tinnitus patients is purely coincidental or whether tinnitus and headache are pathophysiologically linked. We investigated a large sample of patients with tinnitus and headache to estimate prevalence rates of different headache forms, to determine the relationship between tinnitus laterality and headache laterality, and to explore the relationship between tinnitus a...

  11. Thrombosed persistent median artery causing carpal tunnel syndrome associated with bifurcated median nerve: A case report

    International Nuclear Information System (INIS)

    Background: Carpal tunnel syndrome is a sporadically occurring abnormality due to compression of median nerve. It is exceedingly rare for it to be caused by thrombosis of persistent median artery. Case Report: A forty two year old female was referred for ultrasound examination due to ongoing wrist pain, not relived by pain killers and mild paraesthesia on the radial side of the hand. High resolution ultrasound and Doppler revealed a thrombosed persistent median artery and associated bifurcated median nerve. The thrombus resolved on treatment with anticoagulants. Conclusions: Ultrasound examination of the wrist when done for patients with carpal tunnel syndrome should preferably include looking for persistent median artery and its patency. (authors)

  12. CHILDHOOD HEADACHE SYNDROMES(PART II

    Directory of Open Access Journals (Sweden)

    Mohammad GHOFRANI

    2010-09-01

    Full Text Available ObjectiveHeadache is one of the most common reason that children are referred to the Pediatric Neurology Services. It is said that ten percent of children aged 5 to 15 years have migraine.Subsequently, it is essential for clinician to have a through, comprehensive and systematic approach to the evaluation and management of the child or adolescent who complains of headache.This writing aims to explore the symptoms of headache, its epidemiology, classification, appropriate evaluation, differential diagnosis and management.Headaches are divided into primary and secondary categories. Migraine and tension type headaches are prototype of primary headaches without underlying pathology. On the other hand, the type of headache which stems from organic diseases such as: brain tumor, increased intracranial pressure, systemic disease, drug toxicity, ear-nose and throat problems are considered secondary.On the whole, the majority of children with primary headache have two patterns of headache. One is a chronic low-grade and the other is an intermittent disabling headache. The cause of the former is either caffeine or analgesic abuse, and the latter is predominantly migraine.Traditionally, if a child presents himself with chief complain of headache, care taker physician begins with history taking followed by thorough physical and neurological examinations.In the majority of the cases, this initial process leads to a diagnosis or indicate the need for further testing.Once the diagnosis is made, a management program can be put into place.

  13. Headaches and exercise.

    Science.gov (United States)

    McCrory, P

    2000-09-01

    Exercise-related headache is one of the most common medical problems affecting the modern-day athlete. Despite the high prevalence of headache in community populations, the epidemiology of sports-related headache is unclear. In certain collision sports, up to 50% of athletes report regular headaches as a consequence of their athletic participation. The classification of the different types of sport-related headache by the International Headache Society (IHS) and in previously published articles does not adequately encompass the clinical problem faced by team physicians. Confusion exists where terms such as 'effort headache' and 'exertional headache' may be used to describe similar entities. In this review, the specific headache entities discussed include benign exertional headache, effort headache, acute post-traumatic headache and cervicogenic headache. For the sports physician, an understanding of the variety of specific headache syndromes that occur with particular sports is necessary for everyday clinical practice. This article reviews the common exercise-related headache syndromes and attempts to provide a framework for their overall management. Team physicians also need to be cognisant that many of the standard preparations used to treat headaches may be banned drugs under International Olympic Committee (IOC) rules. PMID:10999425

  14. Are headache and temporomandibular disorders related? A blinded study

    DEFF Research Database (Denmark)

    Ballegaard, V.; Thede-Schmidt-Hansen, P.; Svensson, P.;

    2008-01-01

    To investigate overlaps between headache and temporomandibular disorders (TMD) in a clinical headache population and to describe the prevalence of TMD in headache patients, 99 patients referred to a specialized headache centre were diagnosed according to Research Diagnostic Criteria for TMD (RDC/TMD......) and classified in headache groups according to the International Classification of Headache Disorders, second edition for headache diagnoses in a blinded design. The prevalence of TMD in the headache population was 56.1%. Psychosocial dysfunction caused by TMD pain was observed in 40.4%. No significant...... differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence...

  15. Analyzing the causes for the persistence of chironomids in flood plain lake sediments

    NARCIS (Netherlands)

    Haas, de E.M.; Haaren, van R.; Koelmans, A.A.; Kraak, M.H.S.; Admiraal, W.

    2005-01-01

    The aim of the present study was to analyse the causes for the absence and persistence of chironomids in sediments with a complex pollution history. Observations on the benthic community composition in floodplain lake sediments of the River Rhine, differing in contaminant level and food quality, wer

  16. Characteristics of Escherichia coli causing persistence or relapse of urinary tract infections

    DEFF Research Database (Denmark)

    Ejrnæs, Karen; Stegger, Marc; Reisner, Andreas;

    2011-01-01

    pivmecillinam and aimed to identify associations between the presence of 29 virulence factor genes (VFGs), phylogenetic groups and biofilm formation and the course of infection during follow-up visits at 8-10 and 35-49 days post-inclusion, respectively. E. coli causing persistence or relapse were more often of...

  17. Cluster headache associated with acute maxillary sinusitis.

    OpenAIRE

    Edvardsson, Bengt

    2013-01-01

    Background Cluster headache is a primary headache by definition not caused by any known underlying structural pathology. However, symptomatic cases have been described, for example tumours, particularly pituitary adenomas, malformations, and infections/inflammations. The evaluation of cluster headache is an issue unresolved. Case description I present a case of a 24-year-old patient who presented with a 4-week history of side-locked attacks of pain located in the left orbit. He satisfied the ...

  18. Chronic Daily Headaches : Clinical Profile In Indian Patients

    Directory of Open Access Journals (Sweden)

    Chakravarty A

    2002-01-01

    Full Text Available Chronic daily headache (CDH still remains a relatively unexplored entity in our country. Misconceptions are common, unnecessary investigations are done often and inappropriate therapy is prescribed. Analgesic overuse in seldom recognized. The present report is a detailed analysis of CDH in an Indian setting. CDH has been defined as headaches occurring more than 15 days per month for more than 3 months (secondary causes excluded. Over two years (1998-99 876 cases (51.2% of all primary headaches were seen. More than one year follow up data ware available in 232 subjects (m-52; F-180. The distribution of these cases were as follows: a Chronic tension type headache (CTH : 24(10.3%; (b transformed migraine (TM : 166(17.6%; (c migraine-CTH-from episodic tension headache : 12 (5.2%; (d new persistent CDH : 3 (1.3%; and (e chronic post-traumatic headache : 27 (11.6%. There were 166 cases of TM (M:F-1:4.7; age 26-58 yrs.. History of past episodic migraine was present in all. Transformation had been gradual (89.2% or acute (10.8%. Possible factors in transformation included - psychological stress (43.8%, analgesic overuse (20.9%, ergot overuse (4.2%. Hormone replacement therapy seemed to be implicated in 3 female subjects. Analgesic overuse was limited between intake of 600-2400 mg of aspirin equivalent per day (mean 735 mg. Ergot overuse varied between 1-3 mg/day of ergotamine for 3 or more days per week. With medical therapy approximately 70% TM and 40% CTH patients noted significant improvement. About 80% of these relapsed on therapy withdrawal. CDH in India is not uncommon. Analgesic/ergot overuse needs to be recognized early. The average dose of analgesic implicated in CDH seems much less compared to that reported from the West.

  19. Headache and school absence.

    OpenAIRE

    Collin, C; Hockaday, J M; Waters, W E

    1985-01-01

    The amount of time missed from school in two small town school populations was estimated by measuring absence from school and attendance at sickbay, and stated causes were analysed. School absence related to headache (expressed as percentage of pupil days missed out of possible pupil days, during two 12 week periods) in children aged 5 to 14 years, was 0.05%. This represented approximately 1% of all school absence, and was recorded (usually only once) in 3.7% of children. The duration of abse...

  20. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  1. American Headache Society

    Science.gov (United States)

    ... Us American Migraine Foundation Login THE AMERICAN Headache Society is a professional society of health care providers dedicated to the study ... MIGRAINE MOMENT” FILM CONTEST WINNERS The American Headache Society and American Migraine Foundation, the AHS’s charitable division, ...

  2. Team players against headache

    DEFF Research Database (Denmark)

    Gaul, Charly; Visscher, Corine M; Bhola, Rhia;

    2011-01-01

    Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform...

  3. Allergies and Headache

    Science.gov (United States)

    ... to be controversial. Many patients with migraine headache attribute their reactions to certain foods as being an ... in Headache Medicine. Benefits include a recognition of skills and the possibility of referrals. Healthcare professionals: Learn ...

  4. Headache Sufferers' Diet

    Science.gov (United States)

    ... Headache Disorders New Perspectives on Caffeine and Headache War Veterans Health Resource Initiative Brochures Contact SUPPORT NHF ... oz. (regular and sugar-free): 0 – 50 mg. (Colas, unless marked caffeine free, and Mountain Dew are ~ ...

  5. Team players against headache

    DEFF Research Database (Denmark)

    Gaul, Charly; Visscher, Corine M; Bhola, Rhia;

    2011-01-01

    Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform f...

  6. Headache Hygiene -- What Is It?

    Science.gov (United States)

    ... Headache Hygiene - What is it? Print Email Headache Hygiene - What is it? ACHE Newsletter Sign up for ... by entering your e-mail address below. Headache Hygiene - What is it? Headache hygiene is the practice ...

  7. Methacholine induced headache.

    Science.gov (United States)

    Carratala, C; Gea, J G; Aguar, M C; Grau, S; Espadaler-Medina, J M; Broquetas, J M

    1995-03-01

    A lung function technician developed episodes of headache, probably related to the use of methacholine. The headache disappeared with breathing 100% oxygen. Cholinergic agents are known to induce headaches but the mechanism remains unclear. Vascular factors could be implicated. PMID:7660351

  8. Headache characteristics during the development of tolerance to nitrates

    DEFF Research Database (Denmark)

    Christiansen, I; Iversen, Helle Klingenberg; Olesen, J

    2000-01-01

    tolerance to headache could lead to insight into vascular headache mechanisms in general. The specific aim of the present study was therefore to characterize the headache and accompanying symptoms during continuous nitrate administration until a state of tolerance to headache had developed. 5-isosorbide......-ISMN induced dilatation of the superficial temporal artery was observed. In contrast, tolerance in the middle cerebral artery already appeared after 24 h, which was earlier than the development of tolerance to headache. If vasodilatation is the cause of headache the results point to extracerebral...

  9. Childhood Headache Syndromes(Part I

    Directory of Open Access Journals (Sweden)

    Mohammad GHOFRANI

    2010-07-01

    Full Text Available Headache is one of the most common reason that children are referred to the Pediatric Neurology Services. It is said that ten percent of children aged 5 to 15 years have migraine. Subsequently, it is essential for clinician to have a through, comprehensive and systematic approach to the evaluation and management of the child or adolescent who complain of headache.This writing aims to explore the symptoms of headache, its epidemiology, classification, appropriate evaluation, differential diagnosis and management.Headaches are divided into primary and secondary categories. Migraine and tension type headaches are prototype of primary headaches without underlying pathology. On the other hand, the type of headache which stems from organic diseases such as: brain tumor, increased intracranial pressure, systemic disease, drug toxicity or Ear Nose  and Throat problems are considered secondary. On the whole, the majority of children with primary headache have two patterns of headache. One is a chronic low-grade and the other is an intermittent disabling headache. The cause of the former is either caffeine or analgesic abuse, and the latter is predominantly migraine. Traditionally, if a child presents himself with chief complain of headache, care taker physician begins with history taking followed by thorough physical and neurological examinations. In the majority of the cases, this initial process leads to a diagnosis or indicate the need for further testing. Once the diagnosis is made, a management program can be put into place.Key words: Headaches, Child,  Children, Migraine. 

  10. [Headache. Current status of research and treatment].

    Science.gov (United States)

    Straube, A; Gaul, C

    2015-10-01

    The starting point for German headache research and clinical education was the engagement of D. Soyka in the 1970s, which enabled the foundation of the German Headache Society (DMKG) on 28 June 1979 and, some years later, the founding congress of the International Headache Society (IHS) in Munich 1982. As a result of these activities, in 1988 the first international classification of headache disorders was published. This classification was one of the major milestones in the development of basic as well as clinical headache research. In the following years, epidemiological studies all over the world showed a 1-year prevalence for headache of approximately 60%, making headaches one of the most frequent medical complaints. Basic research showed an involvement of serotonergic mechanisms in migraine pain and triptans were one of the first drugs designed to influence these mechanisms. Functional brain imaging studies in migraine patients further showed a cyclic modulation of the activity of brainstem areas independent of the current pain state. Various research groups were involved in the clarification of the role of calcitonin gene-related peptide (CGRP) in migraine and cluster headache. A specific development in the German headache scene is the establishment of integrated headache centers and reflects the primarily multimodal treatment approach in Germany which contrasts with the settings in other countries. These successful developments are increasingly being undermined by the fact that the low financial support of headache research, for example, by the German science council is causing a decreasing interest in headache research, with the consequence that the clinical education of students as well as young medical doctors shows increasing deficits. The consequence for the future will be a deficit in the clinical care of the population. PMID:26264901

  11. Hijab (headscarf) headache.

    Science.gov (United States)

    Ansari, Huma N; Solomon, Glen D

    2015-03-01

    Hijab (headscarf) headache is well known among wearers and is a common topic of discussion. It has never previously been reported in the medical literature. Five women described bilateral headache either prompted by or worsened by donning the hijab, or headscarf. The headache always resolved soon after removal of the headscarf. Hijab headache may also be alleviated by minimal modifications in style while allowing women to maintain their moral conviction. It likely represents an extracranial etiology of headache, and recognition may prevent unnecessary evaluation and suffering in hijab wearers. PMID:25711501

  12. Post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Ghaleb A

    2012-01-01

    Full Text Available Ahmed Ghaleb1, Arjang Khorasani2, Devanand Mangar31Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, 2Anesthesiology Residency Program, Advocate Illinois Masonic Medical Center, Chicago, IL, 3Florida Gulf to Bay Anesthesiology, Tampa General Hospital, Tampa, FL, USAAbstract: Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle. A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24–48 hours of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP are rare.Keywords: post-dural puncture headache, gauge, needles, cause, risk, incidence

  13. Thrombosis of the persistent median artery as a cause of carpal tunnel syndrome - case study.

    Science.gov (United States)

    Rzepecka-Wejs, Ludomira; Multan, Aleksandra; Konarzewska, Aleksandra

    2012-12-01

    Carpal tunnel syndrome is the most frequent neuropathy of the upper extremity, that mainly occurs in manual workers and individuals, whose wrist is overloaded by performing repetitive precise tasks. In the past it was common among of typists, seamstresses and mechanics, but nowadays it is often caused by long hours of computer keyboard use. The patient usually complains of pain, hypersensitivity and paresthesia of his hand and fingers in the median nerve distribution. The symptoms often increase at night. In further course of the disease atrophy of thenar muscles is observed. In the past the diagnosis was usually confirmed in nerve conduction studies. Nowadays a magnetic resonance scan or an ultrasound scan can be used to differentiate the cause of the symptoms. The carpal tunnel syndrome is usually caused by compression of the median nerve passing under the flexor retinaculum due to the presence of structures reducing carpal tunnel area, such as an effusion in the flexor tendons sheaths (due to overload or in the course of rheumatoid diseases), bony anomalies, muscle and tendon variants, ganglion cysts or tumors. In some cases diseases of upper extremity vessels including abnormalities of the persistent median artery may also result in carpal tunnel syndrome. We present a case of symptomatic carpal tunnel syndrome caused by thrombosis of the persistent median artery which was diagnosed in ultrasound examination. The ultrasound scan enabled for differential diagnosis and resulted in an immediate referral to clinician, who recommended instant commencement on anticoagulant treatment. The follow-up observation revealed nearly complete remission of clinical symptoms and partial recanalization of the persistent median artery. PMID:26676173

  14. American Headache Society, Committee on Headache Education

    Science.gov (United States)

    ... 20 Miles 50 Miles 100 Miles Specialty: Anesthesiology Dentistry/TMJ/Oral Surgery Headache Medicine Neurology Nurse Practitioner/ ... by entering your e-mail address below. Featured News View All News Post-Traumatic Stress Disorder & Migraine # ...

  15. Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau

    DEFF Research Database (Denmark)

    Mølbak, K; Aaby, P; Ingholt, L;

    1992-01-01

    An investigation of child mortality in a semi-urban community, Bandim II, in the capital of Guinea Bissau was carried out from April 1987 to March 1990. 153 deaths were recorded among 1426 live-born children who were followed for 2753 child-years. The under-five mortality risk was 215 per 1000...... children (95% confidence interval [CI] 176-264), infant mortality 94 per 1000 (95% CI 73-115), and perinatal mortality 52 per 1000 (95% CI 41-63). By prospective registration of morbidity, post-mortem interviews, and examination of available hospital records, a presumptive cause of death was established in...... 86% of the deaths. Persistent and acute diarrhoea were the most frequent causes of death, accounting for 43 and 31 deaths per 1000 children, respectively. Fever deaths (possibly malaria), neonatal deaths, acute respiratory infections, and measles were other frequent causes. The access to health...

  16. Familial aggregation of cluster headache

    OpenAIRE

    Simao Cruz; Carolina Lemos; Jose Maria Pereira Monteiro

    2013-01-01

    Several studies suggest a strong familial aggregation for cluster headache (CH), but so far none of them have included subjects with probable cluster headache (PCH) in accordance with the International Classification of Headache Disorders. Objective To identify cases of probable cluster headache and to assess the familial aggregation of cluster headache by including these subjects. Method Thirty-six patients attending a headache consultation and diagnosed with trigeminal autonomic headache...

  17. Headache secondary to sleep-related bruxism: A case with polysomnographic findings

    OpenAIRE

    Sourav Das; Ravi Gupta; Mohan Dhyani; Deepak Goel

    2015-01-01

    Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related b...

  18. Neuromodulation of chronic headaches

    DEFF Research Database (Denmark)

    Martelletti, Paolo; Jensen, Rigmor H; Antal, Andrea;

    2013-01-01

    The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even...... medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases.Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain...... proper RCT-based evidence is limited. The European Headache Federation herewith provides a consensus statement on the clinical use of neuromodulation in headache, based on theoretical background, clinical data, and side effect of each method. This international consensus further gives recommendations for...

  19. Cluster headache with aura

    OpenAIRE

    Martínez-Fernández, Eva; Alberca, Roman; Mir, Pablo; Franco, Emilio; Montes, Enrique; Lozano, Pilar

    2002-01-01

    The objective of our study is to report the frequency and characteristics of cluster headache with aura among the population of patients with cluster headache treated in our outpatient neurology clinic. 254 patients were submitted to semi-structured interviews to identify the presence of symptoms similar to the migraine aura. 5 patients who suffered from a cluster headache with aura filled a diary with the characteristics of the pain attacks and the aura. All the patients with either episodic...

  20. Experimental headache in humans

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg

    1995-01-01

    The need for valid human experimental models of headache is obvious. Several compounds have been proposed as headache-inducing agents, but only the nitroglycerin (NTG) model has been validated. In healthy subjects, intravenous infusions of the nitric oxide (NO) donor NTG induce a dose-dependent h......The need for valid human experimental models of headache is obvious. Several compounds have been proposed as headache-inducing agents, but only the nitroglycerin (NTG) model has been validated. In healthy subjects, intravenous infusions of the nitric oxide (NO) donor NTG induce a dose...

  1. Medication Overuse Headache

    DEFF Research Database (Denmark)

    Munksgaard, Signe B; Jensen, Rigmor H

    2014-01-01

    BACKGROUND: Medication overuse headache (MOH) affects between 1% and 2% of the general population but is present in up to 50% of patients seen in headache centers. There are currently no internationally accepted guidelines for treatment of MOH. METHODS: A review of the current literature on MOH...... treatment and pathophysiology. RESULTS: We conclude that headache frequency can be reduced to episodic headache in more than 50% of the patients by simple detoxification and information. Approximately half the patients will not have need for prophylactic medication after withdrawal. Pain perception is...

  2. Gum-Chewing and Headache: An Underestimated Trigger of Headache Pain in Migraineurs?

    Science.gov (United States)

    Lippi, Giuseppe; Cervellin, Gianfranco; Mattiuzzi, Camilla

    2015-01-01

    Tension-type headache and migraine are currently considered the second and third most frequent human diseases. Since a variety of conditions that involve the temporomandibular joint and chewing muscles are frequent causes of orofacial pain, the aim of this article was to review current published evidence about the potential relationship between gum-chewing and headache. A systematic electronic search performed on Medline, Scopus and Web of Science using the keywords "headache" or "migraine" and "chewing" allowed to finally identify 1 cross-sectional, 1 observational and 3 randomized studies, along with 3 case reports about the potential association between gum-chewing and headache. Despite the limited evidence, it seems reasonable to suggest that headache attacks may be triggered by gum-chewing in migraineurs and in patients with tension-type headache. Opposite results were obtained in non-migraineurs, since in none of these studies an increased prevalence of headache pain was reported after gum-chewing. Although larger randomized studies will be necessary to definitely establish the relationship between gum-chewing and headache across different populations, it seems cautionary to suggest that subjects with migraine or tension-type headache should avoid or limit gum-chewing in their lifestyle. PMID:25714969

  3. Developmental Deltamethrin Exposure Causes Persistent Changes in Dopaminergic Gene Expression, Neurochemistry, and Locomotor Activity in Zebrafish.

    Science.gov (United States)

    Kung, Tiffany S; Richardson, Jason R; Cooper, Keith R; White, Lori A

    2015-08-01

    Pyrethroids are commonly used insecticides that are considered to pose little risk to human health. However, there is an increasing concern that children are more susceptible to the adverse effects of pesticides. We used the zebrafish model to test the hypothesis that developmental exposure to low doses of the pyrethroid deltamethrin results in persistent alterations in dopaminergic gene expression, neurochemistry, and locomotor activity. Zebrafish embryos were treated with deltamethrin (0.25-0.50 μg/l), at concentrations below the LOAEL, during the embryonic period [3-72 h postfertilization (hpf)], after which transferred to fresh water until the larval stage (2-weeks postfertilization). Deltamethrin exposure resulted in decreased transcript levels of the D1 dopamine (DA) receptor (drd1) and increased levels of tyrosine hydroxylase at 72 hpf. The reduction in drd1 transcripts persisted to the larval stage and was associated with decreased D2 dopamine receptor transcripts. Larval fish, exposed developmentally to deltamethrin, had increased levels of homovanillic acid, a DA metabolite. Since the DA system is involved in locomotor activity, we measured the swim activity of larval fish following a transition to darkness. Developmental exposure to deltamethrin significantly increased larval swim activity which was attenuated by concomitant knockdown of the DA transporter. Acute exposure to methylphenidate, a DA transporter inhibitor, increased swim activity in control larva, while reducing swim activity in larva developmentally exposed to deltamethrin. Developmental exposure to deltamethrin causes locomotor deficits in larval zebrafish, which is likely mediated by dopaminergic dysfunction. This highlights the need to understand the persistent effects of low-dose neurotoxicant exposure during development. PMID:25912032

  4. Lupus Headaches in 55 Childhood-Onsets SLE

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Moradinejad

    2007-05-01

    Full Text Available Objective: Although headache is a common complaint among patients with lupus, no universally accepted explanation was available until the International Headaches Society adopted Lupus headache as a Nomenclature in its classification recently. Few studies indicate that lupus patients with positive anti-nuclear antibody (ANA and positive antiphospholipid antibodies (aPL experience more frequent headaches. The aim of this study was to determine the correlation between headache frequencies and ANA, anti-double strand DNA (anti-ds-DNA and aPL positivity. Material & Methods: In this prospective multicenter study were enrolled 55 children, 45 girls and 10 boys (F/M ratio:4.5, aged 3-16 years (mean 11.5 years, with neuropsychiatric lupus complaining of headache, that where followed-up for 5 years.. Whether lupus headache is a sign of progressive nature of the disease and how it should be treated is not clear yet. Those with active disease, hypertension, or tension headache were not included in this study. Findings: We studied 55 children with definite lupus. Twenty three (43% of our patients developed new or significantly worse, persistent headaches that sometimes were similar to migraine in the early course of their disease. However their headaches were not accompanied with disease flare up and the headaches were not found to be related to hypertension or use of other medications either. Accordingly, we came to a diagnosis of lupus headache for these patients. Among them 19/55 cases (35% had a positive aPL and 53/55 cases (96% had a positive ANA. Conclusion: Lupus headaches are most likely multifactorial, and probably only a small proportion of them truly represent active lupus. The above data highlights probable correlation between aPL, ANA, an anti-ds-DNA and lupus headache. However, more research is required to find better treatments and to establish a definitive correlation among them.

  5. Management of cluster headache.

    Science.gov (United States)

    Tfelt-Hansen, Peer C; Jensen, Rigmor H

    2012-07-01

    The prevalence of cluster headache is 0.1% and cluster headache is often not diagnosed or misdiagnosed as migraine or sinusitis. In cluster headache there is often a considerable diagnostic delay - an average of 7 years in a population-based survey. Cluster headache is characterized by very severe or severe orbital or periorbital pain with a duration of 15-180 minutes. The cluster headache attacks are accompanied by characteristic associated unilateral symptoms such as tearing, nasal congestion and/or rhinorrhoea, eyelid oedema, miosis and/or ptosis. In addition, there is a sense of restlessness and agitation. Patients may have up to eight attacks per day. Episodic cluster headache (ECH) occurs in clusters of weeks to months duration, whereas chronic cluster headache (CCH) attacks occur for more than 1 year without remissions. Management of cluster headache is divided into acute attack treatment and prophylactic treatment. In ECH and CCH the attacks can be treated with oxygen (12 L/min) or subcutaneous sumatriptan 6 mg. For both oxygen and sumatriptan there are two randomized, placebo-controlled trials demonstrating efficacy. In both ECH and CCH, verapamil is the prophylactic drug of choice. Verapamil 360 mg/day was found to be superior to placebo in one clinical trial. In clinical practice, daily doses of 480-720 mg are mostly used. Thus, the dose of verapamil used in cluster headache treatment may be double the dose used in cardiology, and with the higher doses the PR interval should be checked with an ECG. At the start of a cluster, transitional preventive treatment such as corticosteroids or greater occipital nerve blockade can be given. In CCH and in long-standing clusters of ECH, lithium, methysergide, topiramate, valproic acid and ergotamine tartrate can be used as add-on prophylactic treatment. In drug-resistant CCH, neuromodulation with either occipital nerve stimulation or deep brain stimulation of the hypothalamus is an alternative treatment strategy

  6. Allergy, Rhinitis and Migraine Headache

    Science.gov (United States)

    ... Home > Allergy, Rhinitis, and Migraine Headache Print Email Allergy, Rhinitis, and Migraine Headache ACHE Newsletter Sign up ... newsletter by entering your e-mail address below. Allergy, Rhinitis, and Migraine Headache Vincent Martin, MD Key ...

  7. Headache Hygiene -- What Is It?

    Science.gov (United States)

    ... on Instagram DONATE TODAY Headache Hygiene – What is It? Abuse, Maltreatment, and PTSD and Their Relationship to ... If My Head Hurts? Headache Hygiene – What is It? Migraine’s House of Headaches ..and Visiting the Neighbors ...

  8. Familial aggregation of cluster headache

    OpenAIRE

    Cruz, S; Lemos, C; Monteiro, JM

    2013-01-01

    Several studies suggest a strong familial aggregation for cluster headache (CH), but so far none of them have included subjects with probable cluster headache (PCH) in accordance with the International Classification of Headache Disorders. OBJECTIVE: To identify cases of probable cluster headache and to assess the familial aggregation of cluster headache by including these subjects. METHOD: Thirty-six patients attending a headache consultation and diagnosed with trigeminal autonom...

  9. Headache And Hormones

    Directory of Open Access Journals (Sweden)

    Shukla Rakesh

    2002-01-01

    Full Text Available There are many reasons to suggest a link between headache and hormones. Migraine is three times common in women as compared to men after puberty, cyclic as well as non-cyclic fluctuations in sex hormone levels during the entire reproductive life span of a women are associated with changes in frequency or severity of migraine attack, abnormalities in the hypothalamus and pineal gland have been observed in cluster headache, oestrogens are useful in the treatment of menstrual migraine and the use of melatonin has been reported in various types of primary headaches. Headache associated with various endocrinological disorders may help us in a better understanding of the nociceptive mechanisms involved in headache disorders. Prospective studies using headache diaries to record the attacks of headache and menstrual cycle have clarified some of the myths associated with menstrual migraine. Although no change in the absolute levels of sex hormones have been reported, oestrogen withdrawal is the most likely trigger of the attacks. Prostaglandins, melatonin, opioid and serotonergic mechanisms may also have a role in the pathogenesis of menstrual migraine. Guidelines have been published by the IHS recently regarding the use of oral contraceptives by women with migraine and the risk of ischaemic strokes in migraineurs on hormone replacement therapy. The present review includes menstrual migraine, pregnancy and migraine, oral contraceptives and migraine, menopause and migraine as well as the hormonal changes in chronic migraine.

  10. Pathophysiology of primary headaches

    DEFF Research Database (Denmark)

    Edvinsson, L

    2001-01-01

    The cerebral circulation is innervated by sympathetic, parasympathetic, and sensory nerves, which store a considerable number of neurotransmitters. The role of these has been evaluated in primary headaches. A clear association between head pain and the release of calcitonin gene-related peptide w...... normalized. These data show the involvement of sensory and parasympathetic mechanisms in the pathophysiology of primary headaches.......The cerebral circulation is innervated by sympathetic, parasympathetic, and sensory nerves, which store a considerable number of neurotransmitters. The role of these has been evaluated in primary headaches. A clear association between head pain and the release of calcitonin gene-related peptide was...

  11. Headache secondary to sleep-related bruxism: A case with polysomnographic findings

    Directory of Open Access Journals (Sweden)

    Sourav Das

    2015-01-01

    Full Text Available Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related bruxism can cause headache that is worse in the morning. It is associated with poor quality sleep.

  12. Looking at "thunderclap headache" differently? Circa 2016.

    Science.gov (United States)

    Ravishankar, K

    2016-01-01

    The term "thunderclap headache" (TCH) was first coined in 1986 by Day and Raskin to describe headache that was the presenting feature of an underlying unruptured cerebral aneurysm. The term is now well established to describe the abrupt onset headache seen with many other conditions and is also now included in The International Classification of Headache Disorders 3(rd) edition beta version rubric 4.4. An essential to label an acute headache as "TCH" and differentiate it from other "sudden onset, severe headaches" is the arbitrary time frame of 1 min from onset to peak intensity for "TCH." What happens in practice, however, is that even those "sudden onset, severe headaches" that do not strictly fulfill the definition criteria are also labeled as "TCH" and investigated with the same speed and in the same sequence and managed based on the underlying cause. This article begins by questioning the validity and usefulness of this "one minute" arbitrary time frame to define "TCH," particularly since this time frame is very difficult to assess in practice and is usually done on a presumptive subjective basis. The article concludes with suggestions for modification of the current investigation protocol for this emergency headache scenario. This proposal for "a change in practice methodology" is essentially based on (1) the fact that in the last two decades, we now have evidence for many more entities other than just subarachnoid hemorrhage that can present as "TCH" or "sudden onset, severe headache" and (2) the evidence from literature which shows that advances in imaging technology using higher magnet strength, better contrast, and newer acquisition sequences will result in a better diagnostic yield. It is therefore time now, in our opinion, to discard current theoretical time frames, use self-explanatory terminologies with practical implications, and move from "lumbar puncture (LP) first" to "LP last!" PMID:27570377

  13. Giant, thrombosed, sellar-suprasellar internal carotid artery aneurysm with persistent, primitive trigeminal artery causing hypopituitarism.

    Science.gov (United States)

    Tungaria, Arun; Kumar, Vijendra; Garg, Pallav; Jaiswal, Awadhesh K; Behari, Sanjay

    2011-05-01

    A rare case of a giant, thrombosed, sellar-suprasellar paraclinoid internal carotid artery (ICA) aneurysm with persistent primitive trigeminal artery (PPTA) causing hypopituitarism that manifested as hypogonadism, hypothyroidism, and hypocortisolism is reported. There were no visual/neurological deficits, diabetes insipidus, or episodes of subarachnoid hemorrhage. The alteration in the flow dynamics of the circle of Willis due to the presence of PPTA may have been responsible for both the genesis of the giant aneurysm as well as for the induction of thrombogenesis within its lumen. As the digital subtraction angiogram showed complete thrombosis within the aneurysm and hormonal replacement therapy was effective in ensuring complete normalization of symptoms, the patient was unwilling to undergo surgical clipping of the aneurysm and removal of the suprasellar clot in an attempt to restore pituitary functions. Hypopituitarism recurred when the patient stopped her hormonal supplementation therapy after 7 years, and she again became symptom-free on restarting the therapy. To the best of the authors' knowledge, this represents the first reported case in the literature of hypopituitarism consequent to a giant, thrombosed, sellar-suprasellar ICA aneurysm with an associated PPTA on the side of the aneurysm. PMID:21234615

  14. Clozapine-responsive cluster headache

    OpenAIRE

    Datta Soumitra; Kumar Sudhir

    2006-01-01

    Headaches are commonly associated with various psychiatric disorders. The comorbidity of migraine and psychiatric disorders has been well documented. Here we present a case of schizophrenia with comorbid headache treated with clozapine. The patient′s headache fulfilled the diagnostic criteria for cluster headache (CH). To our knowledge this is the first report of CH responding to clozapine therapy. The relationship of headache and psychiatric disorders is a matter of debate and there h...

  15. Breast reconstruction with an expander prosthesis following mastectomy does not cause additional persistent pain

    DEFF Research Database (Denmark)

    Klit, Anders; Mejdahl, Mathias Kvist; Gärtner, Rune;

    2013-01-01

    Few studies have examined the prevalence of persistent pain after breast reconstruction with an implant after tissue expansion in comparison to mastectomy without breast reconstruction. Our primary objective was to evaluate the prevalence of persistent pain after breast reconstruction with a subp...

  16. The Prevalence of Headache Among Athletic University Students

    OpenAIRE

    Jahani, Pegah; Salesi, Mohsen; Marzban, Maral; Abdollahifard, Gholamreza

    2016-01-01

    Background: Headache is certainly one of the most common medical complaints of general population and one of the important causes of consumption of drugs. Despite its high overall prevalence, the epidemiology of exertional headache is not clear enough. Objectives: To determine the prevalence of headache in athletic and non-athletic university students and also estimating its variation between different sports fields including concussion prone sports. Materials and Methods: This cross-sectiona...

  17. Sleep in cluster headache

    DEFF Research Database (Denmark)

    Barloese, M C J; Jennum, P J; Lund, N T;

    2015-01-01

    BACKGROUND AND PURPOSE: Cluster headache (CH) is a primary headache disorder characterized by severe attacks of unilateral pain following a chronobiological pattern. There is a close connection with sleep as most attacks occur during sleep. Hypothalamic involvement and a particular association with...... rapid eye movement (REM) sleep have been suggested. Sleep in a large, well-characterized population of CH patients was investigated. METHODS: Polysomnography (PSG) was performed on two nights in 40 CH patients during active bout and one night in 25 age, sex and body mass index matched controls in...... hospital. Macrostructure and other features of sleep were analyzed and related to phenotype. Clinical headache characterization was obtained by semi-structured interview. RESULTS: Ninety-nine nights of PSG were analyzed. Findings included a reduced percentage of REM sleep (17.3% vs. 23.0%, P = 0...

  18. Characteristics of Escherichia coli causing persistence or relapse of urinary tract infections: phylogenetic groups, virulence factors and biofilm formation.

    Science.gov (United States)

    Ejrnæs, Karen; Stegger, Marc; Reisner, Andreas; Ferry, Sven; Monsen, Tor; Holm, Stig E; Lundgren, Bettina; Frimodt-Møller, Niels

    2011-01-01

    Recurrent urinary tract infections (RUTIs) pose a major problem but little is known about characteristics of Escherichia coli associated with RUTI. This study includes E. coli from 155 women with community-acquired lower urinary tract infections (UTIs) randomized to one of three dosing regiments of pivmecillinam and aimed to identify associations between the presence of 29 virulence factor genes (VFGs), phylogenetic groups and biofilm formation and the course of infection during follow-up visits at 8-10 and 35-49 days post-inclusion, respectively. E. coli causing persistence or relapse were more often of phylogenetic group B2 and had a significantly higher aggregate VFG score than E. coli that were not detectable at follow-up. Specifically, these E. coli causing persistence or relapse were characterized by a higher prevalence of hemolysis and 12 VFGs (sfa/focDE, papAH, agn43, chuA, fyuA, iroN, kpsM II, kpsM II K2, cnf1, hlyD, malX and usp). KpsM II K2 and agn43a(CFT073) were independently associated with persistence or relapse. No specific combination of presence/absence of VFGs could serve as a marker to predict RUTI. Stratifying for VFGs, seven days of pivmecillinam treatment reduced the prevalence of persistence or relapse of UTI compared with three days. In vitro biofilm formation was not higher among E. coli causing persistence or relapse. The presence of agn43a(CFT073) or agn43b(CFT073) was associated with biofilm forming capacity. In conclusion, our results show potential targets for prevention and treatment of persistence/relapse of UTI and potential markers for selecting treatment lengths and warrant studies of these and new VFGs. PMID:22030858

  19. Temporomandibular Disorders and Headache.

    Science.gov (United States)

    Graff-Radford, Steven B; Abbott, Jeremy J

    2016-08-01

    Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship. PMID:27475510

  20. Persistence of secondary restless legs syndrome in a phantom limb caused by end-stage renal disease.

    Science.gov (United States)

    Nishida, Shingo; Hitsumoto, Akiko; Namba, Kazuyoshi; Usui, Akira; Inoue, Yuichi

    2013-01-01

    Our patient had secondary restless legs syndrome (RLS) in the left lower limb caused by end-stage renal disease (ESRD). Severe RLS symptoms persisted even after amputation of the affected limb. Considering that oral administration of a dopamine receptor agonist was effective in treating the RLS in the phantom limb in this case, dysfunction of the central dopaminergic system was thought to be involved in the phantom limb-RLS mechanism. The persistence of RLS symptoms even after amputation of the affected limb suggests that the area responsible for ESRD-related RLS symptoms exists at the spinal level or in the higher central nervous system. PMID:23545682

  1. The headache-inducing effect of cilostazol in human volunteers

    DEFF Research Database (Denmark)

    Birk, S; Kruuse, Christina; Petersen, K.A.; Tfelt-Hansen, P; Olesen, J.

    2006-01-01

    migraine patients, but CGRP receptor activation causes an increase in cyclic adenosine monophosphate (cAMP). In order to investigate the role of cAMP in vascular headache pathogenesis, we studied the effect of cilostazol, an inhibitor of cAMP degradation, in our human experimental headache model. Twelve...... healthy volunteers were included in a double-blind, randomized, crossover study. Placebo or cilostazol (200 mg p.o.) was administered on two separate study days. Headache was scored on a verbal rating scale (0-10) and mechanical pain thresholds were measured with von Frey hairs. The median peak headache...

  2. Headache in children

    DEFF Research Database (Denmark)

    Soee, Ann Britt L; Skov, Liselotte; Thomsen, Lise L.;

    2013-01-01

    after six and 12 months. Pharmacological and non-pharmacological treatments were offered by a team of specialists (physicians, headache nurses, a physiotherapist and a psychologist). Patients: The subjects comprised 169 children (mean age 11.7 (range 4-17), 91 females, 78 males), 39% of whom suffered...

  3. An Enduring Headache

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Lingering inflation has become the biggest headache for ordinary Chinese people. The CPI growth,a broad measure of inflation,has been hovering around 5 percent since last November,and it even hit a 32-monthhigh of 5.4 percent in March.

  4. Refractory chronic cluster headache

    DEFF Research Database (Denmark)

    Mitsikostas, Dimos D; Edvinsson, Lars; Jensen, Rigmor H;

    2014-01-01

    five years. Eighty-five investigators reached by email. Proposed criteria were in the format of the International Classification of Headache Disorders III-beta (description, criteria, notes, comments and references). Following this evaluation eight drafts were prepared before the final. Twenty-four (28...

  5. Neurostimulation for Primary Headache Disorders

    OpenAIRE

    Schwedt, Todd J.

    2009-01-01

    Neurostimulation has emerged as a potential treatment option for patients with chronic, disabling, intractable primary headache disorders. Although safety and efficacy data are limited in quantity, there is accumulating experience with the use of peripheral nerve stimulation for the treatment of intractable occipital neuralgia, cluster headache, migraine, and less common headache disorders. Deep brain stimulation has been used to treat intractable chronic cluster headache and short-lasting un...

  6. Cocaine-related vascular headaches.

    OpenAIRE

    Dhuna, A; Pascual-Leone, A; Belgrade, M

    1991-01-01

    The records of 21 patients admitted to hospital from January 1985 to December 1988 for acute headache associated with cocaine intoxication were reviewed. Fifteen patients were identified who experienced headaches with migrainous features in the absence of neurological or systemic complications. None of them had a history of cocaine-unrelated headaches or a family history of migraine, and all had a favourable outcome. Three possible mechanisms of cocaine-related vascular headaches are discusse...

  7. Anxiety in Children with Headaches

    OpenAIRE

    Anita Vulić-Prtorić; Slavka Galić; Renata Coha; Marina Grubić; Josip Lopižić; Patricija Padelin

    2007-01-01

    The aim of this study was to examine the different aspects of anxiety symptoms: separation anxiety, social anxiety, test anxiety, obsessive-compulsive symptoms, worry, anxiety sensitivity, somatic symptoms in four groups of subjects: 1) children with headaches in pediatric care, 2) nonclinical headachers, 3) subjects with anxiety disorders, and 4) healthy controls. The sample consisted of 187 schoolchildren: 43 patients with headaches as a primary complaint, 59 headachers recruited from th...

  8. Characterization of a mouse model of headache.

    Science.gov (United States)

    Huang, Dongyue; Ren, Lynn; Qiu, Chang-Shen; Liu, Ping; Peterson, Jonathan; Yanagawa, Yuchio; Cao, Yu-Qing

    2016-08-01

    Migraine and other primary headache disorders affect a large population and cause debilitating pain. Establishing animal models that display behavioral correlates of long-lasting and ongoing headache, the most common and disabling symptom of migraine, is vital for the elucidation of disease mechanisms and identification of drug targets. We have developed a mouse model of headache, using dural application of capsaicin along with a mixture of inflammatory mediators (IScap) to simulate the induction of a headache episode. This elicited intermittent head-directed wiping and scratching as well as the phosphorylation of c-Jun N-terminal kinase in trigeminal ganglion neurons. Interestingly, dural application of IScap preferentially induced FOS protein expression in the excitatory but not inhibitory cervical/medullary dorsal horn neurons. The duration of IScap-induced behavior and the number of FOS-positive neurons correlated positively in individual mice; both were reduced to the control level by the pretreatment of antimigraine drug sumatriptan. Dural application of CGRP(8-37), the calcitonin gene-related peptide (CGRP) receptor antagonist, also effectively blocked IScap-induced behavior, which suggests that the release of endogenous CGRP in the dura is necessary for IScap-induced nociception. These data suggest that dural IScap-induced nocifensive behavior in mice may be mechanistically related to the ongoing headache in humans. In addition, dural application of IScap increased resting time in female mice. Taken together, we present the first detailed study using dural application of IScap in mice. This headache model can be applied to genetically modified mice to facilitate research on the mechanisms and therapeutic targets for migraine headache. PMID:27058678

  9. A rare cause of hyperprolactinemia: persistent trigeminal artery with stalk-section effect

    Energy Technology Data Exchange (ETDEWEB)

    Ekinci, G.; Baltacioglu, F.; Cimsit, C.; Akpinar, I.; Erzen, C. [Dept. of Radiology, Marmara University, Altunizade Istanbul (Turkey); Kilic, T.; Pamir, N. [Dept. of Neurosurgery, Faculty of Medicine, Marmara University, Altunizade Istanbul (Turkey)

    2001-04-01

    The primitive trigeminal, otic, hypoglossal, and proatlantal intersegmental arteries are fetal anastomoses between the carotid and vertebrobasilar systems. Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the vertebrobasilar and carotid systems in adults. We report a case of PTA compressing the left side of the pituitary gland and stalk, in a patient with elevated blood prolactin level. (orig.)

  10. A rare cause of hyperprolactinemia: persistent trigeminal artery with stalk-section effect

    International Nuclear Information System (INIS)

    The primitive trigeminal, otic, hypoglossal, and proatlantal intersegmental arteries are fetal anastomoses between the carotid and vertebrobasilar systems. Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the vertebrobasilar and carotid systems in adults. We report a case of PTA compressing the left side of the pituitary gland and stalk, in a patient with elevated blood prolactin level. (orig.)

  11. INFRARED DIODE LASER RETINAL TREATMENT FOR CHRONIC HEADACHE

    Directory of Open Access Journals (Sweden)

    Subba Rao

    2013-12-01

    Full Text Available ABSTRACT: Nearly 60 to 70 crores of people all over the world are suffering from various types of chronic headache. This is one of the commonest medical problems. To get relief from headache various medical treatments are used with little success. The aim of our study is to give permanent treatment to chronic headache patients by using infrared diode laser selective retinal photocoagulati on. NIDEK infrared diode laser with NIDEK SL40 slit - lamp and NIDEK digital fundus camera for retinal evaluation, MAINSTER 135D lens for laser beam focusing and retinal examination and TOPCON non - contact tonometer for intra ocular pressure measurements are used. Diode laser is chosen because of its deep penetration into all the layers of retina and choroid. 500 cases of chronic headache were studied. Laser photocoagulation was given in selective areas of retina in 2 to 3 sessions with 15 days interval. 10 to 60 years age group were studied. 90% of patients who got laser treatment are relieved from their headache in severity and in frequency. 80% of patients needed 2 sittings and 20% of patients needed 3 sittings. 70% of patients got relief from headache by fi rst sitting itself. 50% of patients are not only relieved from their headaches but also noticed visual clarity improvement. Retinal ischaemia is one of the main cause for ocular pain and headache. Laser treatment will improve circulation by reducing ischae mia thereby relieves ocular pain and headache

  12. Tension‑Type Headache - Psychiatric Perspective

    Directory of Open Access Journals (Sweden)

    João Campos Mendes

    2013-11-01

    Full Text Available Introduction: The tension‑type headaches (Ctt are the most frequent headaches in the general population and those with higher socio‑economic impact, given the high degree of disability they cause. Objective: The authors propose to conduct a review of the available literature on the subject, from a psychiatric perspective. Discussion: Several studies have identified a higher prevalence of psychiatric disorders, personality traits and ineffective coping mechanisms in patients with Ctt, so it is essential to understand this relationship and the impact of these psychopathological factors on this kind of headaches. Conclusion: Their clinical and therapeutic approach is hampered by these and other factors and multiple strategies of pharmacological and psycho‑behavioral treatment have been used on them, however, scientific evidence is still scarce.

  13. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Olesen, Jes; Osipova, Vera V;

    2013-01-01

    disability are well in excess of the global and European averages, is no exception, while arcane diagnoses and treatment preferences are an aggravating factor. Urgent remedial action, with political support, is called for. METHODS: Yekaterinburg, in Sverdlovsk Oblast, is the chosen centre for a...... demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation...... context of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache...

  14. Carotid-cavernous fistula caused by rupture of persistent primitive trigeminal artery trunk aneurysm--case report.

    Science.gov (United States)

    Yoshida, Masahiro; Ezura, Masayuki; Mino, Masaki

    2011-01-01

    A 60-year-old female presented with a carotid-cavernous fistula (CCF) manifesting as left abducens nerve palsy. Left internal carotid digital subtraction angiography showed a persistent primitive trigeminal artery (PPTA) near the CCF. Super-selective angiography showed direct shunt flow between the PPTA trunk aneurysm and the left cavernous sinus. The aneurysm was successfully occluded with detachable coils. The CCF disappeared and the PPTA was preserved. The abducens nerve paralysis had disappeared 6 months later. CCF caused by a PPTA trunk aneurysm is extremely rare. We speculate that the PPTA trunk aneurysm formed and then ruptured due to hemodynamic stress caused by hypoplasia of the basilar artery. PMID:21785245

  15. Headache currents commentary.

    Science.gov (United States)

    Peatfield, Richard

    2012-04-01

    What Happens to the Old Headache Medicines? Rapoport AM, MD. Old headache medicines never die; they either fade away or come back in disguise. The disguise is often a new route of administration, which may work better, faster, more completely, with fewer adverse events, and/or have certain other advantages. The clinical aspects of 3 of the oldest headache medicines (ergotamine tartrate, dihydroergotamine, and methysergide) will be discussed here. Sumatriptan will then be discussed as the prototype of the newest category of acute care therapy (triptans) for migraine. It will be compared with the older medications, and the new forms being developed will be briefly discussed. Diclofenac potassium for oral solution will be mentioned as the newest drug approved for migraine by the Food and Drug Administration and a possible alternative to triptans in patients with frequent headaches or those with contraindications to vasoconstrictors. Dihydroergotamine, Ergotamine, Methysergide and Sumatriptan - Basic Science in Relation to Migraine Treatment. Dahlöf C, Maassen Van Den Brink A. The 5-hydroxytryptamine (5-HT) receptor family mediates the effects of several drugs highly effective in migraine primarily by activating 5-HT(1B) , 5-HT(1D) , and 5-HT(1F) receptors. Ergotamine, dihydroergotamine and methysergide, as well as the "triptan" sumatriptan, are all agonists for these receptors. The receptor profile and degree of selectivity of these 4 drugs differ, which is reflected by their side effects that limit their use in the acute and prophylactic treatment of migraine. The acute antimigraine efficacy of these remedies is very much dependent on the formulation used where, in general, parenteral formulations are more effective in relieving the symptoms of a migraine attack. PMID:22414189

  16. Excessive nickel release from mobile phones--a persistent cause of nickel allergy and dermatitis

    DEFF Research Database (Denmark)

    Jensen, Peter; Johansen, Jeanne D; Zachariae, Claus; Menné, Torkil; Thyssen, Jacob P

    2011-01-01

    Despite the political intention to limit nickel allergy and dermatitis in Europeans, nickel allergy remains frequent. There are several explanations for the persistence of nickel allergy and dermatitis, including the increasing use of mobile phones. Before regulation of nickel release from mobile...... phones, we showed that eight (19.5%) of 41 mobile phones marketed in Denmark between 2003 and 2007 released nickel in concentrations that may result in nickel allergy and dermatitis. In 2009, the EU Nickel Directive was revised to include nickel-releasing mobile phones....

  17. The evolution of headache from childhood to adulthood: a review of the literature

    OpenAIRE

    Antonaci, F; C. Voiticovschi-Iosob; A.L. Di Stefano; Galli, F.; A. Ozge; Balottin, U

    2014-01-01

    Headache is one of the most common disorders in childhood, with an estimated 75% of children reporting significant headache by the age of 15 years. Pediatric migraine is the most frequent recurrent headache disorder, occurring in up to 28% of older teenagers. Headaches rank third among the illness-related causes of school absenteeism and result in substantial psychosocial impairment among pediatric patients. The aim of this study was to clarify the evolution of the clinical features of primar...

  18. Experiences and perceptions of people with headache: a qualitative study

    Directory of Open Access Journals (Sweden)

    Elliott Alison M

    2006-05-01

    Full Text Available Abstract Background Few qualitative studies of headache have been conducted and as a result we have little in-depth understanding of the experiences and perceptions of people with headache. The aim of this paper was to explore the perceptions and experiences of individuals with headache and their experiences of associated healthcare and treatment. Methods A qualitative study of individuals with headache, sampled from a population-based study of chronic pain was conducted in the North-East of Scotland, UK. Seventeen semi-structured interviews were conducted with adults aged 65 or less. Interviews were analysed using the Framework approach utilising thematic analysis. Results Almost every participant reported that they were unable to function fully as a result of the nature and unpredictability of their headaches and this had caused disruption to their work, family life and social activities. Many also reported a negative impact on mood including feeling depressed, aggressive or embarrassed. Most participants had formed their own ideas about different aspects of their headache and several had searched for, or were seeking, increased understanding of their headache from a variety of sources. Many participants reported that their headaches caused them constant worry and anguish, and they were concerned that there was a serious underlying cause. A variety of methods were being used to manage headaches including conventional medication, complementary therapies and self-developed management techniques. Problems associated with all of these management strategies emerged. Conclusion Headache has wide-ranging adverse effects on individuals and is often accompanied by considerable worry. The development of new interventions or educational strategies aimed at reducing the burden of the disorder and associated anxiety are needed.

  19. Neurostimulation in cluster headache

    DEFF Research Database (Denmark)

    Pedersen, Jeppe L; Barloese, Mads; Jensen, Rigmor H

    2013-01-01

    PURPOSE OF REVIEW: Neurostimulation has emerged as a viable treatment for intractable chronic cluster headache. Several therapeutic strategies are being investigated including stimulation of the hypothalamus, occipital nerves and sphenopalatine ganglion. The aim of this review is to provide an...... prophylactic effect to occur, suggesting brain plasticity as a possible mechanism, and only stimulation of the sphenopalatine ganglion has demonstrated an acute, abortive effect. Predictors of effect for all modes of neurostimulation still need to be identified and in the future, the least invasive and most...

  20. Neurostimulation for chronic cluster headache

    OpenAIRE

    Wolter, Tilman; Kaube, Holger

    2012-01-01

    Neurostimulation techniques for the treatment of primary headache syndromes, particularly of chronic cluster headache, have received much interest in recent years. Occipital nerve stimulation (ONS) has yielded favourable clinical results and, despite the limited numbers of published cases, is becoming a routine treatment for refractory chronic cluster headache in specialized centres. Meanwhile, other promising techniques such as spinal cord stimulation (SCS) or sphenopalate ganglion stimulati...

  1. Cluster headache and intracranial aneurysm

    OpenAIRE

    Valença, Marcelo Moraes; Andrade-Valença, Luciana P. A.; Martins, Carolina; de Aragão, Maria Fátima Vasco; Batista, Laécio Leitão; Peres, Mario Fernando Prieto; da Silva, Wilson Farias

    2007-01-01

    In the present study we describe the cases of two patients with cluster-like headache related to intracranial carotid artery aneurysm. One of these patients responded to verapamil prescription with headache resolution. In both cases the surgical clipping of the aneurysm resolved the cluster pain. These findings strongly suggest a pathophysiological link between the two conditions. The authors discuss the potential pathophysiological mechanisms underlying cluster-like headache due to intracran...

  2. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study

    Institute of Scientific and Technical Information of China (English)

    Cui-Bai Wei; Jian-Ping Jia; Fen Wang; Ai-Hong Zhou; Xiu-Mei Zuo; Chang-Biao Chu

    2016-01-01

    Background:Many studies have reported that depression and anxiety have bidirectional relationship with headache.However,few researches investigated the roles of depression or anxiety in patients with headache.We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals.Additional risk factors for depression and anxiety were also analyzed.Methods:A cross-sectional study was conducted at 11 general neurological clinics.All consecutive patients with a chief complaint of headache were enrolled.Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview,and those for headache were made according to the International Classification of Headache Disorders,2nd Edition.The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity.Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety.Results:A total of 749 outpatients with headache were included.Among them,148 (19.7%) were diagnosed with depression and 103 (13.7%) with anxiety.Further analysis showed that 114 (15.2%) patients complaining headache due to somatic symptoms of psychiatric disorders and 82 (10.9%) had a depression or anxiety comorbidity with headache.Most patients with depression or anxiety manifested mild to moderate headaches.Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety.Conclusion:Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.

  3. Autonomic dysregulation in headache patients.

    Science.gov (United States)

    Gass, Jason J; Glaros, Alan G

    2013-12-01

    To analyze autonomic nervous system activity in headache subjects, measurements of heart rate variability (HRV), skin temperature, skin conductance, and respiration were compared to a matched control group. HRV data were recorded in time and frequency domains. Subjects also completed self-report questionnaires assessing psychological distress, fatigue, and sleep dysfunction. Twenty-one headache and nineteen control subjects participated. In the time domain, the number of consecutive R-to-R intervals that varied by more than 50 ms and the standard deviation of the normalized R-to-R intervals, both indices of parasympathetic nervous system activity, were significantly lower in the headache group than the control group. Groups did not differ statistically on HRV measures in the frequency domain. Self-report measures showed significantly increased somatization, hostility, anxiety, symptom distress, fatigue, and sleep problems in the headache group. The results suggest headache subjects have increased sympathetic nervous system activity and decreased parasympathetic activity compared to non-headache control subjects. Headaches subjects also showed greater emotional distress, fatigue, and sleep problems. The results indicate an association between headaches and cardiovascular functioning suggestive of sympathetic nervous system activation in this sample of mixed migraine and tension-type headache sufferers. PMID:23912525

  4. Persistence of Gliocephalotrichum spp. causing fruit rot of rambutan (Nephelium lappaceum L.) in Puerto Rico

    Science.gov (United States)

    Worldwide, fruit rot of rambutan is an important problem that limits the storage, marketing and long-distance transportation of the fruit. A complex of pathogens has been reported to cause fruit rot of rambutan and significant post-harvest economic losses. During 2009 and 2011 rambutan fruit rot was...

  5. Thrombosis of the persistent median artery as a cause of carpal tunnel syndrome – case study

    OpenAIRE

    Rzepecka-Wejs, Ludomira; Multan, Aleksandra; Konarzewska, Aleksandra

    2012-01-01

    Carpal tunnel syndrome is the most frequent neuropathy of the upper extremity, that mainly occurs in manual workers and individuals, whose wrist is overloaded by performing repetitive precise tasks. In the past it was common among of typists, seamstresses and mechanics, but nowadays it is often caused by long hours of computer keyboard use. The patient usually complains of pain, hypersensitivity and paresthesia of his hand and fingers in the median nerve distribution. The symptoms often incre...

  6. Headache in Systemic Lupus Erythematosus

    DEFF Research Database (Denmark)

    Hanly, John G; Urowitz, Murray B; O'Keeffe, Aidan G;

    2013-01-01

    To examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE).......To examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE)....

  7. Adolescents' medicine use for headache

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Andersen, Anette; Fotiou, Anastasios;

    2015-01-01

    BACKGROUND: This study reports secular trends in medicine use for headache among adolescents in 20 countries from 1986 to 2010. METHODS: The international Health Behaviour in School-aged Children (HBSC) survey includes self-reported data about medicine use for headaches among nationally...... representative samples of 11-, 13- and 15-year-olds. We included 20 countries with data from at least three data collection waves, with a total of 380 129 participants. RESULTS: The prevalence of medicine use for headaches varied from 16.5% among Hungarian boys in 1994 to 62.9% among girls in Wales in 1998....... The prevalence was higher among girls than boys in every country and data collection year. The prevalence of medicine use for headaches increased in 12 of 20 countries, most notably in the Czech Republic, Poland, Russia, Sweden and Wales. CONCLUSION: The prevalence of medicine use for headaches among adolescents...

  8. Cytomegalovirus pneumonia as cause of persistently wheezing in an infant with cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Ömer Cevit

    2011-06-01

    Full Text Available Cystic fibrosis, presenting in childhood, is a hereditary disease that proceeds with the dysfunction of all exocrine glands. Two months infant who was born premature admitted with respiratory distress. The infant’s oxygen saturation was 80% and white sphere was 23.000/mm3. Clor levels were found as 88 mEq/l and 103 mEq/l by sweat chloride test. Cystic fibrosis was diagnosed. The patient not responded to treatment and was positive CMV-DNA was detected. The patient responded well to ganciclovir treatment. When a case with cystic fibrosis does not respond to treatment, another underlying causes should be considered. J Clin Exp Invest 2011;2(2:235-7

  9. Headaches as Somatoform Disorders in Children and Adolescents

    OpenAIRE

    Anna Kostorz; Ilona Kopyta; Barbara Szwed-Białożyt; Ewa Widera-Emich; Beata Kazek

    2012-01-01

    Somatoform disorders are often the main cause for seeking professional advice and performing a number of specialist checks. The aim of the study was to determine the frequency of somatoform disorders in the form of headaches in children and adolescents neurologically diagnosed and the risk factors thereof. Analysis of the biological and situational risk factors were established. Somatoform disorders were diagnosed in 27 out of 276 children with headaches. We concluded that in the differential...

  10. Post-cholecystectomy symptoms were caused by persistence of a functional gastrointestinal disorder

    Institute of Scientific and Technical Information of China (English)

    Malte Schmidt; Karl S(o)ndenaa; John A Dumot; Steven Rosenblatt; Trygve Hausken; Maria Ramnefjell; Gro Nj(o)lstad

    2012-01-01

    AIM:To classify gallstone disease as a basis for assessment of post-cholecystectomy symptoms.METHODS:One hundred and fifty three patients with a clinical and ultrasonographic diagnosis of gallstones filled out a structured questionnaire on abdominal pain symptoms and functional gastrointestinal disorder (FGID) before and at six months after cholecystectomy.Symptom frequency groups (SFG) were categorized according to frequency of pain attacks.According to certain pain characteristics in gallstone patients,a gallstone symptom score was accorded on a scale from one to ten.A visual analogue scale was used to quantify pain.Operative specimens were examined for size and magnitude of stone contents as well as presence of bacteria.Follow-up took place after six months with either a consultation or via a mailed questionnaire.Resuits were compared with those obtained pre-operatively to describe and analyze symptomatic outcome.RESULTS:SFG groups were categorized as severe (24.2%),moderate (38.6%),and mild (22.2%) attack frequency,and a chronic pain condition (15%).Pain was cured or improved in about 90% of patients and two-thirds of patients obtained complete symptom relief.Patients with the most frequent pain episodes were less likely to obtain symptom relief.FGID was present in 88% of patients pre-operatively and in 57% postoperatively (P =0.244).Those that became asymptomatic or improved with regard to pain also had most relief from FGID (P =0.001).No pre-operative FGID meant almost complete cure.CONCLUSION:Only one third of patients with FGID experienced postoperative relief,indicating that FGID was a dominant cause of post-cholecystectomy symptoms.

  11. Indications for computerized tomography in the case of headache

    International Nuclear Information System (INIS)

    Of the large number of patients with headache only very few suffer from an intracranial tumor. On the other hand, brain tumors may grow silently for a long period of time. Clinical analysis of patients with headache has demonstrated that a CT-scan is not indicated in cases where an adequate cause can be found and when the headache disappears together with the underlaying cause in a reasonable amount of time. A CT-scan, however, should be performed when an adequate cause is missing, when the headache recurs with increasing frequency, intensity and duration, when it is accentuated in the morning and in certain positions, and when it is associated with personality chances, dizziness and blurred vision. In chronic headache a CT-scan is indicated when a change in the character of the headache and its various qualities (location, frequency and duration of attacks, temporal coincidence etc.) can be detected. A thorough history, including the family history, of the complains together with an accurate clinical examination will deliver the criteria to avoid unnecessary CT-scanning. (orig.)

  12. Headaches and Migraines: Headache Symptoms, Diagnosis, and Treatment

    Science.gov (United States)

    ... of other disorders, ranging from sinus infection to stroke. Treatment When headaches occur three or more times a ... Researchers hope this will lead to new, targeted treatments. Gene mutations have ... Spring 2009 Issue: Volume 4 Number 2 ...

  13. A boy with sudden headache.

    Science.gov (United States)

    Norbedo, Stefania; Naviglio, Samuele; Murru, Flora Maria; Cavallin, Roberta; Giurici, Nagua; Rabusin, Marco; Barbi, Egidio

    2014-03-01

    Headache is a common presenting complaint in pediatric emergency departments. The goal of emergent evaluation is to identify those children with potentially life-threatening conditions. We present the case of an adolescent boy presenting with headache and hypertension who was diagnosed with a catecholamine-secreting abdominal paraganglioma. Genetic testing eventually led to the diagnosis of SDHB-related hereditary paraganglioma-pheochromocytoma syndrome. Alarm features ("red flags") in children presenting with headache are reviewed, as well as the main features of paragangliomas and the indications for genetic testing. PMID:24589807

  14. Proposals for new standardized general diagnostic criteria for the secondary headaches

    DEFF Research Database (Denmark)

    Olesen, J; Steiner, T; Bousser, M-G;

    2009-01-01

    Headache classification is a dynamic process through clinical testing and re-testing of current and proposed criteria. After publication of the second edition of the International Classification of Headache Disorders (ICHD-II), need arose for revisions in the classification of medication overuse...... headache and chronic migraine. These changes made apparent a further need for broader revisions to the standard formulation of diagnostic criteria for the secondary headaches. Currently, the fourth criterion makes impossible the definitive diagnosis of a secondary headache until the underlying cause has...... propose maintaining a standard approach to the secondary headaches using a set of four criteria A, B, C and D, but we construct these so that the requirement for resolution or successful treatment is removed. The proposal for general diagnostic criteria for the secondary headaches will be entered...

  15. Management of patients with headache and cervicalgia in outpatient practice

    Directory of Open Access Journals (Sweden)

    E. A. Chechet

    2015-01-01

    Full Text Available The management of patients with headache (cephalgia concurrent with neck pain (cervicalgia remains an urgent problem of modern medicine. Concurrent cervicalgia in cephalgia substantially lowers quality of life in these patients and is encountered in more than half the patients. Cervicalgia is considered as a risk factor of migraine and tension headache attacks. Cervicogenic headache is assigned to one of the most common forms of secondary cephalgias. It is shown that patients with daily headache have functional insufficiency of the antinociceptive system that plays an important role in the maintenance and chronization of neck pain. The diagnosis of different cephalgic syndromes and the identification of causes of cervicalgia commonly raise problems in a physician; the rate of misdiagnoses and hence inadequate treatment has been high so far. The detection of various comorbid conditions, including cervicalgia, in a patient with cephalgia makes it possible to use effective treatment and to achieve good results.

  16. [Post-dural puncture headache].

    Science.gov (United States)

    Radke, K; Radke, O C

    2013-02-01

    Headache following dural puncture is a typical complication of neuraxial analgesia and can impair the ability to perform activities of daily living up to incapacitation. The use of thin, atraumatic needles and special puncture techniques (e.g. reinsertion of the stylet) can prevent the majority of post-dural puncture headaches (PDPH). One of the most effective measures to prevent headache after accidental dural puncture is the intrathecal or epidural administration of morphine. When the diagnosis of PDPH is confirmed after excluding relevant differential diagnoses, some of which are potentially life-threatening, caffeine, theophylline and non-opioid analgesics are effective agents to reduce the severity of the symptoms. Traditional measures, such as strict bed rest and hyperhydration can no longer be recommended. If invasive treatment of the headache is warranted an epidural blood patch is still the method of choice with a high rate of success. PMID:23400710

  17. Headaches and Complementary Health Approaches

    Science.gov (United States)

    ... training of investigators in the basic and clinical neurosciences, and seeks better understanding, diagnosis, treatment, and prevention ... type headache in adults: are they beneficial? CNS Neuroscience & Therapeutics. 2009;15(2):183–205. Vickers AJ, ...

  18. Managing tension headaches at home

    Science.gov (United States)

    ... headache occurs when neck and scalp muscles become tense, or contract. The muscle contractions can be a ... posture when reading, working, or doing other activities. Exercise and stretch your back, neck, and shoulders often ...

  19. Cervicogenic headache: Josey's cases revisited Cefaléia cervicogênica: revisão dos casos de Josey

    OpenAIRE

    Maurice Vincent; Renato A. Luna

    1997-01-01

    Before Sjaastad coined the term cervicogenic headache (CH) 15 years ago, neck-related headaches have been considered by different authors for many years. Even after the publication of diagnostic criteria, dispute on the clinical picture, differential diagnosis, pathophysiology and treatment of CH still persists. A paper published in 1949 by Josey reports on 6 "illustrative" cases of cervical-related headaches. Indeed, looked from a more recent perspective, those cases could eventually corresp...

  20. The persistent circulation of enterovirus 71 in People's Republic of China: causing emerging nationwide epidemics since 2008.

    Directory of Open Access Journals (Sweden)

    Xiaojuan Tan

    Full Text Available Emerging epidemics of hand-foot-and-mouth disease (HFMD associated with enterovirus 71 (EV71 has become a serious concern in mainland China. It caused 126 and 353 fatalities in 2008 and 2009, respectively. The epidemiologic and pathogenic data of the outbreak collected from national laboratory network and notifiable disease surveillance system. To understand the virological evolution of this emerging outbreak, 326 VP1 gene sequences of EV71 detected in China from 1987 to 2009 were collected for genetic analyses. Evidence from both traditional and molecular epidemiology confirmed that the recent HFMD outbreak was an emerging one caused by EV71 of subgenotype C4. This emerging HFMD outbreak is associated with EV71 of subgenotype C4, circulating persistently in mainland China since 1998, but not attributed to the importation of new genotype. Originating from 1992, subgenotype C4 has been the predominant genotype since 1998 in mainland China, with an evolutionary rate of 4.6∼4.8×10⁻³ nucleotide substitutions/site/year. The phylogenetic analysis revealed that the majority of the virus during this epidemic was the most recent descendant of subgenotype C4 (clade C4a. It suggests that the evolution might be one of the potential reasons for this native virus to cause the emerging outbreak in China. However, strong negative selective pressure on VP1 protein of EV71 suggested that immune escape might not be the evolving strategy of EV71, predicting a light future for vaccine development. Nonetheless, long-term antigenic and genetic surveillance is still necessary for further understanding.

  1. Headache associated with cough: a review

    OpenAIRE

    Cordenier, Ann; De Hertogh, Willem; De Keyser, Jacques; Versijpt, Jan

    2013-01-01

    Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected by coughing. The diagnosis of primary cough headache is made when headache is brought on and occurs only in association with coughing, straining or a Valsalva manoeuvre and in the absence of any ab...

  2. Association of acetazolamide infusion with headache and cranial artery dilation in healthy volunteers

    DEFF Research Database (Denmark)

    Arngrim, Nanna; Schytz, Henrik Winther; Asghar, Mohammad Sohail; Amin, Faisal Mohammad; Hougaard, Anders; Larsen, Vibeke Andrée; de Koning, Patrick J H; Larsson, Henrik Bo Wiberg; Olesen, Jes; Ashina, Messoud

    2014-01-01

    The carbonic anhydrase inhibitor acetazolamide causes extracellular acidosis and dilatation of cerebral arterioles. In this study, we tested the hypothesis that acetazolamide also may induce headache and dilatation of cranial arteries. In a randomized double-blind crossover study design, 12 young...... acetazolamide causes sensitization of cephalic perivascular nociceptors, which, in combination with vasodilatation, leads to delayed headache....

  3. Persistent trigeminal artery supply to an intrinsic trigeminal nerve arteriovenous malformation: a rare cause of trigeminal neuralgia.

    Science.gov (United States)

    Choudhri, Omar; Heit, Jeremy J; Feroze, Abdullah H; Chang, Steven D; Dodd, Robert L; Steinberg, Gary K

    2015-02-01

    Infratentorial arteriovenous malformations (AVM) associated with the trigeminal nerve root entry zone are a known cause of secondary trigeminal neuralgia (TN). The treatment of both TN and AVM can be challenging, especially if the AVM is embedded within the trigeminal nerve. A persistent trigeminal artery (PTA) can rarely supply these intrinsic trigeminal nerve AVM. We present a 64-year-old man with TN from a right trigeminal nerve AVM supplied by a PTA variant. The patient underwent microvascular decompression and a partial resection of the AVM with relief of facial pain symptoms. His residual AVM was subsequently treated with CyberKnife radiosurgery (Accuray, Sunnyvale, CA, USA). A multimodality approach may be required for the treatment of trigeminal nerve associated PTA AVM and important anatomic patterns need to be recognized before any treatment. Herein, we report to our knowledge the third documented patient with a posterior fossa AVM supplied by a PTA and the first PTA AVM presenting as facial pain. PMID:25070632

  4. Evaluation of Helicobacter pylori infection in patients with common migraine headache

    OpenAIRE

    Hosseinzadeh, Morteza; Khosravi, Afra; Saki, Kourosh; Ranjbar, Reza

    2011-01-01

    Introduction Migraine can cause headache in different communities so that 12-15% are suffering worldwide. Recently the relationship between infectious diseases such as Helicobacter pylori infection and migraine headache has been the focus of many studies. The current study was designed to evaluate IgG and IgM antibodies to H. pylori in patients suffering from migraine headaches. Material and methods Patients who had diagnostic criteria for migraine were chosen as cases compared to some health...

  5. Characteristics and treatment of headache after traumatic brain injury: a focused review.

    Science.gov (United States)

    Lew, Henry L; Lin, Pei-Hsin; Fuh, Jong-Ling; Wang, Shuu-Jiun; Clark, David J; Walker, William C

    2006-07-01

    Headache is one of the most common complaints in patients with traumatic brain injury. By definition, headache that develops within 1 wk after head trauma (or within 1 wk after regaining consciousness) is referred to as posttraumatic headache (PTH). Although most PTH resolves within 6-12 mos after injury, approximately 18-33% of PTH persists beyond 1 yr. We performed a systematic literature review on this topic and found that many patients with PTH had clinical presentations very similar to tension-type headache (37% of all PTH) and migraine (29% of all PTH). Although there is no universally accepted protocol for treating PTH, many clinicians treat PTH as if they were managing primary headache. As a result of the heterogeneity in the terminology and paucity in prospective, well-controlled studies in this field, there is a definite need for conducting double-blind, placebo-controlled treatment trials in patients with PTH. PMID:16788394

  6. Headache and sleep disorders: review and clinical implications for headache management.

    Science.gov (United States)

    Rains, Jeanetta C; Poceta, J Steven

    2006-10-01

    Review of epidemiological and clinical studies suggests that sleep disorders are disproportionately observed in specific headache diagnoses (eg, migraine, tension-type, cluster) and other nonspecific headache patterns (ie, chronic daily headache, "awakening" or morning headache). Interestingly, the sleep disorders associated with headache are of varied types, including obstructive sleep apnea (OSA), periodic limb movement disorder, circadian rhythm disorder, insomnia, and hypersomnia. Headache, particularly morning headache and chronic headache, may be consequent to, or aggravated by, a sleep disorder, and management of the sleep disorder may improve or resolve the headache. Sleep-disordered breathing is the best example of this relationship. Insomnia is the sleep disorder most often cited by clinical headache populations. Depression and anxiety are comorbid with both headache and sleep disorders (especially insomnia) and consideration of the full headache-sleep-affective symptom constellation may yield opportunities to maximize treatment. This paper reviews the comorbidity of headache and sleep disorders (including coexisting psychiatric symptoms where available). Clinical implications for headache evaluation are presented. Sleep screening strategies conducive to headache practice are described. Consideration of the spectrum of sleep-disordered breathing is encouraged in the headache population, including awareness of potential upper airway resistance syndrome in headache patients lacking traditional risk factors for OSA. Pharmacologic and behavioral sleep regulation strategies are offered that are also compatible with treatment of primary headache. PMID:17040332

  7. Radiological diagnosis and differential diagnosis of headache; Radiologische Diagnostik und Differenzialdiagnostik bei Kopfschmerzen im Erwachsenenalter

    Energy Technology Data Exchange (ETDEWEB)

    Langner, S.; Kirsch, M. [University Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology

    2015-10-15

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  8. Nitric oxide-related drug targets in headache

    DEFF Research Database (Denmark)

    Olesen, Jes

    2010-01-01

    SUMMARY: Nitric oxide (NO) is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. It is also involved in nociceptive processing. Glyceryl trinitrate (GTN), a pro-drug for NO, causes headache in normal volunteers and a so-called del......SUMMARY: Nitric oxide (NO) is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. It is also involved in nociceptive processing. Glyceryl trinitrate (GTN), a pro-drug for NO, causes headache in normal volunteers and a so...... experimentation make it highly likely that antagonizing NO effects will be effective in the treatment of primary headaches. Nonselective NOS inhibitors are likely to have side effects whereas selective compounds are now in early clinical trials. Antagonizing the rate limiting cofactor tetrahydrobiopterin seems...

  9. Persistent shigellosis.

    OpenAIRE

    Clements, D.; Ellis, C J; Allan, R N

    1988-01-01

    Shigella usually causes a self-limited infection which untreated lasts on average seven days (range one to 30 days). We report a patient who had persistent symptoms for 10 months caused by Shigella flexneri which was finally identified on cultures from a rectal swab.

  10. Headaches and Migraines: Migraine 101 Quiz

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Headaches and Migraines Migraine 101 Quiz Past Issues / Spring 2009 Table of ... the facts when it comes to headaches and migraines? Test your knowledge with this quick quiz. True/ ...

  11. Effect of Headache on Academic Performance

    OpenAIRE

    J Gordon Millichap

    2012-01-01

    Researchers at University of Pernambuco, Recife, Brazil interviewed 344 randomly selected, university, social communication students to determine the 1-year prevalence of headache, types of headache, and the effects on academic performance.

  12. Controversies in Headache Medicine: Migraine Prevention Diets

    Science.gov (United States)

    ... Print Email Controversies in Headache Medicine: Migraine Prevention Diets ACHE Newsletter Sign up for our newsletter by ... address below. Controversies in Headache Medicine: Migraine Prevention Diets Merle L. Diamond, MD and Dawn A. Marcus, ...

  13. Altitude, Acute Mountain Sickness and Headache

    Science.gov (United States)

    ... Follow us on Instagram DONATE TODAY Altitude, Acute Mountain Sickness and Headache Abuse, Maltreatment, and PTSD and Their Relationship to Migraine Altitude, Acute Mountain Sickness and Headache Alcohol and Migraine Anxiety and ...

  14. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  15. Acute treatment of migraine headaches.

    Science.gov (United States)

    Taylor, Frederick R

    2010-04-01

    Optimum acute treatment of migraine requires prevention of headache as a top priority. Recognition of the multitude of migraine presentations, the frequency of total headache attacks, and number of days of headache disability are critical. Successful treatment requires excellent patient-clinician communication enhancing confidence and mutual trust based on patient needs and preferences. Optimum management of acute migraine nearly always requires pharmacologic treatment for rapid resolution. Migraine-specific triptans, dihydroergotamine, and several antiinflammatories have substantial empirical clinical efficacy. Older nonspecific drugs, particularly butalbital and opioids, contribute to medication overuse headache and are to be avoided. Clinicians should utilize evidence-based acute migraine-specific therapy stressing the imperative acute treatment goal of early intervention, but not too often with the correct drug, formulation, and dose. This therapy needs to provide cost-effective fast results, meaningful to the patient while minimizing the need for additional drugs. Migraine-ACT evaluates 2-hour pain freedom with return to normal function, comfort with treatment, and consistency of response. Employ a thoroughly educated patient, formulary, testimonials, stratification, and rational cotherapy against the race to central sensitization for optimum outcomes. PMID:20352584

  16. Influence of caffeine and caffeine withdrawal on headache and cerebral blood flow velocities

    NARCIS (Netherlands)

    Couturier, EGM; Laman, DM; vanDuijn, MAJ; vanDuijn, H

    1997-01-01

    Caffeine consumption may cause headache, particularly migraine. Its withdrawal also produces headaches and may be related to weekend migraine attacks. Transcranial Doppler sonography (TCD) has shown changes in cerebral blood flow velocities (BFV) during and between attacks of migraine. In order to e

  17. Headache among medical and psychology students

    OpenAIRE

    João Eliezer Ferri-de-Barros; Mauricio José de Alencar; Luis Felipe Berchielli; Luis Carlos Castelhano Junior

    2011-01-01

    Headaches occur frequently and thus are a key component of sociocentric medical education. OBJECTIVE: To study headaches among students of medicine and psychology in a single university. METHOD: This was a questionnaire-based survey of a cohort of students of medicine and psychology. RESULTS: The overall lifetime prevalence of headache was 98% and over the last year, 91%. Tensional headache accounted for 59% and migraine 22% in medicine; and 48.5% and 32% respectively in psychology. Forty-fiv...

  18. Cluster headache attacks and multiple sclerosis

    OpenAIRE

    Gentile, Salvatore; Ferrero, Margherita; Vaula, Giovanna; Rainero, Innocenzo; Pinessi, Lorenzo

    2007-01-01

    We report the case of a patient who developed typical cluster headache attacks and was diagnosed as having multiple sclerosis (MS) at the same time. The headache attacks resolved after i.v. treatment with methylprednisolone. MR imaging showed a pontine demyelinating lesion involving the trigeminal nerve root inlet area, on the same side as the pain. The association between cluster headache and MS has been rarely described before. This case suggests that in patients with cluster headache neuro...

  19. Headache associated with cough : a review

    NARCIS (Netherlands)

    Cordenier, Ann; De Hertogh, Willem; De Keyser, Jacques; Versijpt, Jan

    2013-01-01

    Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected

  20. A Rare Cause of Persistent Pulmonary Hypertension Resistant to Therapy in The Newborn: Short-Rib Polydactyly Syndrome

    Directory of Open Access Journals (Sweden)

    Nihat Demir

    2015-01-01

    Full Text Available Short-rib polydactyly syndrome is an autosomal recessively inherited lethal skeletal dysplasia. The syndrome is characterized by marked narrow fetal thorax, short extremities, micromelia, cleft palate/lip, polydactyly, cardiac and renal abnormalities, and genital malformations. In cases with pulmonary hypoplasia, persistent pulmonary hypertension of the newborn can develop. In this paper, we present a term newborn with persistent pulmonary hypertension of the newborn, which has developed secondary to short-rib polydactyly syndrome and was resistant to therapy with inhaled nitric oxide and oral sildenafil.

  1. Headaches as somatoform disorders in children and adolescents

    Directory of Open Access Journals (Sweden)

    Anna Kostorz

    2012-01-01

    Full Text Available Somatoform disorders are often the main cause for seeking professional advice and performing a number of specialist checks. The aim of the study was to determine the frequency of somatoform disorders in the form of headaches in children and adolescents neurologically diagnosed and the risk factors thereof. Analysis of the biological and situational risk factors were established. Somatoform disorders were diagnosed in 27 out of 276 children with headaches. We concluded that in the differential diagnosis of headaches, somatoform headaches should not be omitted as every 10th patient in the developmental age diagnosed on the neurological ward because of headache shows signs of somatoform heada - ches. In diagnostically difficult cases it is recommended that analysis of biological and situational risk factors be performed with special attention paid to chronic disease of the patient and/or in his immediate family, the patient’s psychological disorders and dysfunctional or low social status families. The creation of separate criteria for somatoform disorders of the developmental age should be considered.

  2. Medication overuse headache: history, features, prevention and management strategies.

    Science.gov (United States)

    Saper, Joel R; Da Silva, Arnaldo Neves

    2013-11-01

    Medication overuse headache (MOH) is a daily, or almost daily, headache form that arises from overuse of one or more classes of migraine-abortive or analgesic medication. The main classes of drugs that cause MOH are opioids, butalbital-containing mixed analgesics, triptans, ergotamine tartrate derivatives, simple analgesics (except for plain aspirin), and perhaps non-steroidal anti-inflammatory drugs. MOH can be debilitating and results from biochemical and functional brain changes induced by certain medications taken too frequently. At this time, migraine and other primary headache disorders in which migraine or migraine-like elements occur seem exclusively vulnerable to the development of MOH. Other primary headache disorders are not currently believed to be vulnerable. The treatment of MOH consists of discontinuation of the offending drug(s), acute treatment of the withdrawal symptoms and escalating pain, establishing a preventive treatment when necessary, and the implementation of educational and behavioral programs to prevent recidivism. In most patients, MOH can be treated in the outpatient setting but, for the most difficult cases, including those with opioid or butalbital overuse, or in patients with serious medical or behavioral disturbances, effective treatment requires a multidisciplinary, comprehensive headache program, either day-hospital with infusion or an inpatient hospital setting. PMID:23925669

  3. A Review of Herbal Medicine in Iranian Traditional Manuscripts for Treatment of Participatory Gastric Headache

    Science.gov (United States)

    Jafarpour, Mehrnaz; Yousefi, Gholamhossein; Hamedi, Azadeh

    2016-01-01

    Background: Participatory gastric headache is a type of headache described in Iranian traditional medicine. It is defined as a headache not originated from the head and neck disorders; rather the pain in the head is caused by gastric dysfunction and its disorders. Treatment of this type of headache is completely reliant on the treatment of the gastric complaint. Reviewing Iranian traditional medicine (ITM) literature, a broad spectrum of herbal medicines that could be useful in the treatment of this type of headache is described. Accordingly, this review was performed to gather and discuss the therapeutic management of this disorder in ITM and evaluating related characteristics of each medicinal herb. Methods: In this study, medicinal plants prescribed for gastric headache from different ancient Iranian literature is documented. The botanical name, family name, part used, temperaments, rout of administration and dosage forms are provided in this article. Results: About 40 plants, mainly used orally, were prescribed for the treatment of participatory gastric headache. Most of them have the astringent effect, which is related to their dryness temperament. Therefore, they could strengthen the stomach and prevent ascending vapors into the brain that in turn helps to get relief from headache. In addition, they possess reinforcement effect on the brain. Conclusion: In general, herbal medicines with tonic characteristics could be effective in participatory gastric headache.

  4. Cluster Headache and Its Cousins: A Family of Pain Management Problems

    Directory of Open Access Journals (Sweden)

    John Edmeads

    2000-01-01

    Full Text Available Cluster headache causes great misery because of the severity, frequency and repetitiveness of its attacks, and the fear (justified in a few sufferers that the attacks will respond to nothing and will never cease. For most people with cluster headaches there is effective treatment, both for the acute attacks (subcutaneous sumatriptan, injected dihydroergotamine and oxygen inhalation and for prophylaxis (verapamil, valproate, ergotamine, methysergide, lithium carbonate and corticosteroids. For the 10% of suffers who respond to no medications, or have to discontinue them because of serious adverse effects, surgical ablation of the trigeminal root or nervus intermedius is a last resort that helps only some. Correct diagnosis is an essential prelude to an appropriate treatment. Serious disease such as carotid dissection, and aneurysm may occasionally mimic cluster headache, but seldom perfectly enough to confuse a careful clinician. In terms of sorting out the diagnosis, the recently recognized relatives of cluster headache -- chronic and episodic paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome -- are more problematic. These are important to recognize because they do not respond to 'cluster treatment', but the paroxysmal hemicranias respond to indomethacin, whereas the cluster headache does not. A more distant family member, hemicrania continua, is usually, but not always, responsive to indomethacin and sometimes bears a passing resemblance to cluster headache. An unrelated entity, hypnic headache, has confused a few clinicians who did not bear in mind that a detailed history is the key to headache diagnosis.

  5. A case of iatrogenic ureteric injury presenting with headache

    DEFF Research Database (Denmark)

    Phipps, Simon; Roder, Martin A; Aslan, Peter;

    2008-01-01

    A 33-year-old woman was referred to the renal outpatient clinic with a headache caused by severe hypertension. She had given birth 3 months previously by emergency caesarean section after a labor complicated by uterine rupture. She had delivered by caesarean section twice previously....

  6. Recurrent headache in a five year old boy

    Directory of Open Access Journals (Sweden)

    Lokesh Saini

    2016-01-01

    Full Text Available Headache is infrequent in early childhood. Headache and neurological deficits associated with cerebrospinal fluid (CSF lymphocytosis (HaNDL, a variant of migraine, is a rare disorder. A 5-year-old boy presented with recurrent episodes of headache for 6 months. Each episode lasted for a week and in the current episode, he was symptomatic for 3 days. All the episodes were associated with paresthesias and CSF lymplocytosis with normal protein and sugar. There was history of migraine in his family. His magnetic resonance imaging (MRI brain with contrast with magnetic resonance (MR angiography and venography were normal. Work-up for relevant causes of infection and vasculitis were negative. His symptoms subsided on oral antimigraine prophylaxis and he has been on remission for last 8 months. HaNDL should be considered in relevant clinical scenarios, as it prevents unnecessary investigations, therapy, and hospitalization.

  7. Lifestyle, quality of life, nutritional status and headache in school-aged children

    Directory of Open Access Journals (Sweden)

    Kamila Castro

    2013-10-01

    Full Text Available Background: Headache has been described as a factor with significant negative impact on the quality of life of school-aged children with a high risk of developing in chronic and persistent form in adulthood. Among other headache associated triggers or aggravating factors, lifestyle and obesity has been investigated, but results are still conflicting. Objective: To evaluate the prevalence of headache in school-aged children and its relationship to anthropometric characteristics, lifestyle, and quality of life. Methods: A cross-sectional study was conducted in six schools located in two cities in southern Brazil, involving 750 students aged 7 to 14 years. Information was collected on sociodemographic characteristics, clinical variables (presence of headache and menarche, anthropometric data, lifestyle, and quality of life. Results: A total of 185 (24.7% students reported having headache crises in the last 3 months. Among students aged 10 to 14 years, presence of headache was associated with female sex, affecting 32.2% of girls vs. 23.3% of boys (p = 0.042, chi-square test. Anthropometric parameters (data on overweight/obesity were consistent with national prevalence rates, and there was no association between Body Mass Index (BMI and headache. Regarding lifestyle, 2.0% of students reported smoking and 1.6% consuming alcohol occasionally, and neither was associated with headache. Quality of life, especially aspects of social life, appeared to be affected by the presence of headache. Conclusion: This study found a high prevalence of headache in school-aged children, which was associated with female students aged 10-14 years and quality of life.

  8. Clinical characteristics and persistence of bovine mastitis caused by different species of coagulase-negative staphylococci identified with API or AFLP

    DEFF Research Database (Denmark)

    Taponen, S.; Simojoki, H.; Haveri, M.;

    2006-01-01

    The coagulase-negative staphylococcal species causing mastitis in lactating cattle were identified and possible differences in the clinical characteristics or persistence of mastitis caused by different CNS were evaluated. The effect of antimicrobial treatment was also assessed. In addition, AFLP...... strains of these species. Approximately half of the mastitis cases were clinical, and in the majority clinical signs were mild. The severity and persistence of intramammary infection were unaffected by CNS species. Fifty-nine percent of the quarter cases were treated with antimicrobials, and the rest were...... left without treatment. Mastitis due to P-lactamase-negative CNS was treated with penicillin G and that due to beta-lactamase-positive CNS with cloxacillin. Nineteen percent of the isolates were P-lactamase-positive. The bacterial cure rate for quarters treated with antimicrobials was high, 85.9%, as...

  9. [Tension headache--a review].

    Science.gov (United States)

    Pfaffenrath, V; Wermuth, A; Pöllmann, W

    1988-12-01

    Tension headache (TH) is an ill-defined headache syndrome, characterized by bilateral, daily headaches with fronto-occipital localisation. TH is often accompanied by a migraine and an abuse of analgesics and/or ergotamine. In the etiology of TH vascular, muscular and psychogenic factors are assumed. Floating transitions to common migraine are discussed. The increased muscle tension is not specific for TH, but more probably a consequence of TH. In addition a decrease of the pain threshold with a deficiency of the antinociceptive system is supposed. The efficacy of tricyclic antidepressives in TH is based on potentiation of serotonergic and noradrenergic mechanisms and - besides their analgetic potencies - upon an increase of the pain threshold. TH prophylaxis is indicated if patients suffer from TH more than ten times per month. Medication are tricyclic antidepressives of the amitriptyline-type. Prophylaxis of TH can only be successful if a simultaneous abuse of analgesics and/or ergotamine is discontinued. In addition, EMG-biofeedback, as well as relaxation - and vasoconstriction training might be helpful in specific cases. PMID:3069680

  10. [Multimodal pain management in a patient with atypical cervicogenic headache].

    Science.gov (United States)

    Flöther, Lilit; Raspé, Christoph; Bucher, Michael; Benndorf, Ralf A

    2015-11-01

    A 45-year-old patient presented with an eight-year history of persistent unilateral headache associated with recurrent episodes of ipsilateral conjunctival injections, eyelid edema and ptosis. Prior ineffective pharmacological treatment strategies included tramadol, non-steroidal anti-inflammatory drugs and triptans. Palpation of right suboccipital trigger points revealed tenderness in the area of the greater occipital nerve and reinforced the symptoms. The diagnosis of cervicogenic headache was confirmed by symptom resolution following right greater occipital nerve blockade. A multimodal treatment strategy (physical therapy, nerve blockade, pharmacological treatment) was chosen and an emphasis was put on optimizing pharmacological pain relief using the opioid analgesic tapentadol and the tricyclic antidepressant amitriptyline as an adjuvant analgesic. Importantly, the patient reported a substantial and consistent pain reduction and considerable quality of life improvement during implementation of the treatment regimen. PMID:26742212

  11. Chronic migraine headache prevention with noninvasive vagus nerve stimulation

    Science.gov (United States)

    Calhoun, Anne H.; Lipton, Richard B.; Grosberg, Brian M.; Cady, Roger K.; Dorlas, Stefanie; Simmons, Kristy A.; Mullin, Chris; Liebler, Eric J.; Goadsby, Peter J.; Saper, Joel R.

    2016-01-01

    Objective: To evaluate the feasibility, safety, and tolerability of noninvasive vagus nerve stimulation (nVNS) for the prevention of chronic migraine (CM) attacks. Methods: In this first prospective, multicenter, double-blind, sham-controlled pilot study of nVNS in CM prophylaxis, adults with CM (≥15 headache d/mo) entered the baseline phase (1 month) and were subsequently randomized to nVNS or sham treatment (2 months) before receiving open-label nVNS treatment (6 months). The primary endpoints were safety and tolerability. Efficacy endpoints in the intent-to-treat population included change in the number of headache days per 28 days and acute medication use. Results: Fifty-nine participants (mean age, 39.2 years; mean headache frequency, 21.5 d/mo) were enrolled. During the randomized phase, tolerability was similar for nVNS (n = 30) and sham treatment (n = 29). Most adverse events were mild/moderate and transient. Mean changes in the number of headache days were −1.4 (nVNS) and −0.2 (sham) (Δ = 1.2; p = 0.56). Twenty-seven participants completed the open-label phase. For the 15 completers initially assigned to nVNS, the mean change from baseline in headache days after 8 months of treatment was −7.9 (95% confidence interval −11.9 to −3.8; p < 0.01). Conclusions: Therapy with nVNS was well-tolerated with no safety issues. Persistent prophylactic use may reduce the number of headache days in CM; larger sham-controlled studies are needed. ClinicalTrials.gov identifier: NCT01667250. Classification of evidence: This study provides Class II evidence that for patients with CM, nVNS is safe, is well-tolerated, and did not significantly change the number of headache days. This pilot study lacked the precision to exclude important safety issues or benefits of nVNS. PMID:27412146

  12. Hangover headache: various manifestations and proposal for criteria. Vågå study of headache epidemiology

    OpenAIRE

    Sjaastad, Ottar; Bakketeig, Leiv S.

    2004-01-01

    Hangover headache has been focused upon in connection with the Vågå study of headache epidemiology, with 714 cases among 1122 dalesmen (64%). Most frequently the headache was global in location. It was more frequently located in the anterior (frontotemporal) than occipital area. A unilateral headache was present in only 3% of the dalesmen, many of whom were migraineurs. Headache seemed to be more intense in males than females. Headache usually seemed to be of a lower intensity than the pain o...

  13. Hangover headache: accompanying symptoms. Vågå study of headache epidemiology

    OpenAIRE

    Sjaastad, Ottar; Bakketeig, Leiv S.

    2004-01-01

    As part of the Vågå study of headache epidemiology, the symptomatology of hangover headache has been studied in 1122 parishioners in the age group 18–65 years; male/female ratio 1.14. The following criteria for hangover headache were adhered to: (1) intoxication by alcohol, (2) headache, and (3) onset of headache >3 hours after discontinuation of drinking. As demonstrated elsewhere, headache was present in 64% of the cases. Throbbing was present in 85% of those affected, nausea in 60% and vom...

  14. Carbon monoxide may be an important molecule in migraine and other headaches

    DEFF Research Database (Denmark)

    Arngrim, Nanna; Schytz, Henrik W; Hauge, Mette K;

    2014-01-01

    INTRODUCTION: Carbon monoxide was previously considered to just be a toxic gas. A wealth of recent information has, however, shown that it is also an important endogenously produced signalling molecule involved in multiple biological processes. Endogenously produced carbon monoxide may thus play an...... important role in nociceptive processing and in regulation of cerebral arterial tone. DISCUSSION: Carbon monoxide-induced headache shares many characteristics with migraine and other headaches. The mechanisms whereby carbon monoxide causes headache may include hypoxia, nitric oxide signalling and activation...... of cyclic guanosine monophosphate pathways. Here, we review the literature about carbon monoxide-induced headache and its possible mechanisms. CONCLUSION: We suggest, for the first time, that carbon monoxide may play an important role in the mechanisms of migraine and other headaches....

  15. Headaches

    Science.gov (United States)

    ... take an over-the-counter pain reliever like acetaminophen or ibuprofen. You can buy these in drugstores ... in the arms or legs) skin rash weakness, dizziness, or difficulty walking or standing neck pain or ...

  16. From Childhood Migraine Headache to Pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Y. M. Hazimeh

    2014-01-01

    Full Text Available Pheochromocytoma may have multiple clinical manifestations including paroxysmal hypertension, tachycardia, sweating, nausea, and headache (Phillips et al., 2002. Migraine has some of the manifestations seen with pheochromocytoma. We describe a patient who had a history of migraine headaches since childhood and was found to have pheochromocytoma. Resection of her tumor significantly improved her headache. The diagnoses of pheochromocytoma subsequently lead to diagnosing her with medullary thyroid cancer (MTC and multiple endocrine neoplasia type 2A (MEN-2A.

  17. White matter disintegration in cluster headache

    OpenAIRE

    Szabó, Nikoletta; Kincses, Zsigmond Tamás; Párdutz, Árpád; Tóth, Eszter; Szok, Délia; Csete, Gergő; Vécsei, László

    2013-01-01

    Background Previous studies in primary headache disorders showed microstructural alterations in the white matter as measured by diffusion imaging. However these investigations are not in full agreement and some of those, especially in cluster headache, restricted the analysis to only a limited number of diffusion parameters. Therefore, in the current study we examined white matter microstructure in cluster headache patients. Methods Diffusion weighted MRI images with 60 directions were acquir...

  18. Headache in Pregnancy: An Approach to Emergency Department Evaluation and Management

    OpenAIRE

    Schoen, Jessica C.; Campbell, Ronna L.; Sadosty, Annie T.

    2015-01-01

    Headache is a common presenting complaint in the emergency department. The differential diagnosis is broad and includes benign primary causes as well as ominous secondary causes. The diagnosis and management of headache in the pregnant patient presents several challenges. There are important unique considerations regarding the differential diagnosis, imaging options, and medical management. Physiologic changes induced by pregnancy increase the risk of cerebral venous thrombosis, dissection, a...

  19. Migraine, headache, and survival in women.

    OpenAIRE

    Waters, W E; Campbell, M. J.; Elwood, P. C.

    1983-01-01

    A population study of 1310 women aged 45-64 years determined the prevalence of headache and migraine in the preceding year. To investigate the hypothesis that women with migraine had a higher mortality rate, these women were followed up nearly 12 years later. Unexpectedly, the mortality was found to be higher in women without headaches. Women with headaches and migraine had a relative risk of dying of 0.72 (95% confidence interval 0.52-1.00) compared with those without headaches.

  20. Injection Therapy for Headache and Facial Pain.

    Science.gov (United States)

    Kleen, Jonathan K; Levin, Morris

    2016-08-01

    Peripheral nerve blocks are an increasingly viable treatment option for selected groups of headache patients, particularly those with intractable headache or facial pain. Greater occipital nerve block, the most widely used local anesthetic procedure in headache conditions, is particularly effective, safe, and easy to perform in the office. Adverse effects are few and infrequent. These procedures can result in rapid relief of pain and allodynia, and effects last for several weeks or months. Use of nerve block procedures and potentially onabotulinum toxin therapy should be expanded for patients with intractable headache disorders who may benefit, although more studies are needed for efficacy and clinical safety. PMID:27475516

  1. Post-myelogram headache - physiological or psychological?

    International Nuclear Information System (INIS)

    Psychological aspects of post-lumbar puncture headache have hitherto received little attention. A hundred consecutive patients admitted for elective myelography were studied. Post-myelogram headache was assessed by an independent observer and found to be strongly associated with normality of the test (P<0.001). Psychological testing showed a trend between Hospital Anxiety Depression score and normality of myelogram as well as development of headache, although this did not achieve statistical significance. This study suggestet that there is a large psychological as well as organic component to post-myelogram headache. (orig.)

  2. Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

    Directory of Open Access Journals (Sweden)

    Benjamin L Brown

    2012-01-01

    Full Text Available We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

  3. Clinical aspects of perimenstrual headaches.

    Science.gov (United States)

    Taylor, Frederick R

    2009-02-01

    Menstrual migraine (MM) is either pure, if attacks are limited solely during the perimenstrual window (PMW), or menstrually related (MRM), if two of three PMWs are associated with attacks with additional migraine events outside the PMW. Acute migraine specific therapy is equally effective in MM and non-MM. Although the International Classification of Headache Disorders-II classifies MM without aura, data suggest this needs revision. The studies on extended-cycle oral contraceptives suggest benefits for headache-prone individuals. Triptan mini-prophylaxis outcomes are positive, but a conclusion of "minimal net benefit compared to placebo" is not entirely unwarranted. In a 2008 evidence-based review, grade B recommendations exist for sumatriptan (50 and 100 mg), mefenamic acid (500 mg), and riza-triptan (10 mg) for the acute treatment of MRM. For the preventive mini-prophylactic treatment of MRM, grade B recommendations are provided for transcutaneous estrogen (1.5 mg), frovatriptan (2.5 mg twice daily), and naratriptan (1 mg twice daily). PMID:19126376

  4. Role of serotonin in pathogenesis of analgesic induced headache

    Energy Technology Data Exchange (ETDEWEB)

    Srikiatkhachorn, A.

    1999-12-16

    Analgesic abuse has recently been recognized as a cause of deterioration in primary headache patients. Although the pathogenesis of this headache transformation is still obscure, and alteration of central pain control system is one possible mechanism. A number of recent studies indicated that simple analgesics exert their effect by modulating the endogenous pain control system rather than the effect at the peripheral tissue, as previously suggested. Serotonin (5-hydroxytryptamine ; 5-HT) has long been known to play a pivotal role in the pain modulatory system in the brainstem. In the present study, we investigated the changes in 5-HT system in platelets and brain tissue. A significant decrease in platelet 5-HT concentration (221.8{+-}30.7, 445.3{+-}37.4 and 467.2{+-}38.5 ng/10{sup 9} platelets, for patients with analgesic-induced headache and migraine patients, respectively, p<0.02) were evident in patients with analgesic induced headache. Chronic paracetamol administration induced a decrease in 5-HT{sub 2} serotonin receptor in cortical and brain stem tissue in experimental animals (B{sub max}=0.93{+-}0.04 and 1.79{+-}0.61 pmol/mg protein for paracetamol treated rat and controls, respectively, p<0.05). Our preliminary results suggested that chronic administration of analgesics interferes with central and peripheral 5-HT system and therefore possibly alters the 5-HT dependent antinociceptive system. (author)

  5. Young adults' medicine use for headache

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Hansen, Ebba Holme; Andersen, Anette;

    2012-01-01

    Over-the-counter analgesic (OTCA) use is increasingly common and may have potential harmful side effects. The primary reason for using analgesics is headache symptoms. Whether OTCA use for headache is sensitive to psychosocial and social circumstances is an understudied topic....

  6. Neurotrophic factors in tension-type headache

    Directory of Open Access Journals (Sweden)

    Renan B. Domingues

    2015-05-01

    Full Text Available Neurotrophic factors (NF are involved in pain regulation and a few studies have suggested that they may play a pathophysiological role in primary headaches. The aim of this study was to investigate NF levels in patients with tension type headache (TTH. We carried out a cross sectional study including 48 TTH patients and 48 age and gender matched controls. Beck Depression and Anxiety Inventories, and Headache Impact Test were recorded. Serum levels of NF were determined by ELISA. There were not significant differences between NF levels between TTH patients and controls. Patients with chronic and episodic TTH had not significant differences in NF levels. The presence of headache at the time of evaluation did not significantly alter the levels of NF. Depression and anxiety scores as well as headache impact did not correlate with NF levels. Our study suggest that the serum levels of NF are not altered in TTH.

  7. Interventional Treatment for Post-traumatic Headache.

    Science.gov (United States)

    Conidi, Francis X

    2016-06-01

    Post-traumatic headache (migraine) is the most common symptom of concussion and traumatic brain injury. An expert opinion-based review along with a literature review (PubMed) was conducted looking at known interventional procedures for post-traumatic headache using the keywords post-traumatic headache, post-traumatic migraine headache, concussion, mild traumatic brain injury, and traumatic brain injury and the following categories: mechanism, pathophysiology, treatment, physical therapy, neurostimulation, Botox@/Onabotulinum toxin, and surgical intervention. The results returned a total of 181 articles of which 52 were selected. None of the articles included randomized placebo-controlled studies, and most were either prospective or retrospective case analysis and/or review articles or consensus opinion papers, with most studies yielding positive results. Despite a lack of hard evidence, interventional procedures, alone or in combination, appear to be an effective treatment for post-traumatic headaches. PMID:27130542

  8. Harry Potter and the curse of headache.

    Science.gov (United States)

    Sheftell, Fred; Steiner, Timothy J; Thomas, Hallie

    2007-06-01

    Headache disorders are common in children and adolescents. Even young male Wizards are disabled by them. In this article we review Harry Potter's headaches as described in the biographical series by JK Rowling. Moreover, we attempt to classify them. Regrettably we are not privy to the Wizard system of classifying headache disorders and are therefore limited to the Muggle method, the International Classification of Headache Disorders, 2nd edition (ICHD-II). Harry's headaches are recurrent. Although conforming to a basic stereotype, and constant in location, throughout the 6 years of his adolescence so far described they have shown a tendency to progression. Later descriptions include a range of accompanying symptoms. Despite some quite unusual features, they meet all but one of the ICHD-II criteria for migraine, so allowing the diagnosis of 1.6 Probable migraine. PMID:17578544

  9. The International Classification of Headache Disorders

    DEFF Research Database (Denmark)

    Olesen, J.

    2008-01-01

    A set of related medical disorders that lack a proper classification system and diagnostic criteria is like a society without laws. The result is incoherence at best, chaos at worst. For this reason, the International Classification of Headache Disorders (ICHD) is arguably the single most important...... universally accepted, and criticism of the classification has been minor relative to that directed at other disease classification systems. Over the 20 years following publication of the first edition of the ICHD, headache research has rapidly accelerated despite sparse allocation of resources to that effort...... breakthrough in headache medicine over the last 50 years. The ICHD identifies and categorizes more than a hundred different kinds of headache in a logical, hierarchal system. Even more important, it has provided explicit diagnostic criteria for all of the headache disorders listed. The ICHD quickly became...

  10. Oxygen treatment of cluster headache

    DEFF Research Database (Denmark)

    Petersen, Anja S; Barloese, Mads C J; Jensen, Rigmor H

    2014-01-01

    PURPOSE: Our aim was to review the existing literature to document oxygen's therapeutic effect on cluster headache. METHOD: A PubMed search resulted in 28 hits, and from these and their references we found in total 11 relevant studies. We included six studies that investigated the efficacy of...... oxygen treatment. One study is observational and the remaining five are RCTs. Another five studies were on hyperbaric oxygen treatment hereof two case studies. CONCLUSION: Oxygen therapy can be administered at different flow rates. Three studies investigate the effect of low-flow oxygen, 6-7 l/min, and...... found a positive response in 56%, 75% and 82%, respectively, of the patients. One study investigates high-flow oxygen, 12 l/min, and found efficacy in 78% of attacks. The effect of hyperbaric oxygen therapy has been investigated in a few small studies and there is evidence only for an acute, but not a...

  11. Noninvasive neuromodulation in cluster headache

    DEFF Research Database (Denmark)

    Láinez, Miguel J A; Jensen, Rigmor

    2015-01-01

    PURPOSE OF REVIEW: Neuromodulation is an alternative in the management of medically intractable cluster headache patients. Most of the techniques are invasive, but in the last 2 years, some studies using a noninvasive device have been presented. The objective of this article is to review the data...... using this approach. RECENT FINDINGS: Techniques as occipital nerve stimulation or sphenopalatine ganglion stimulation are recommended as first-line therapy in refractory cluster patients, but they are invasive and maybe associated with complications. Noninvasive vagal nerve stimulation with an external...... device has been tried in cluster patients. Results from clinical practice and a single randomized clinical trial have been presented showing a reduction of the number of cluster attacks/week in the patients treated with the device. The rate of adverse events was low and most of them were mild. SUMMARY...

  12. Cluster headache in childhood: case series from a pediatric headache center.

    Science.gov (United States)

    Mariani, Rosanna; Capuano, Alessandro; Torriero, Roberto; Tarantino, Samuela; Properzi, Enrico; Vigevano, Federico; Valeriani, Massimiliano

    2014-01-01

    Childhood-onset cluster headache is an excruciatingly painful and distressing condition. A retrospective study was conducted on charts of patients referring to our Headache Center. Those diagnosed as cluster headache were selected. We identified 11 children (6 males and 5 females). The mean age of cluster headache onset was 10 years (range: 5-16). All children had episodic cluster headache. All children had unilateral orbital pain; 7 patients had throbbing pain, whereas 4 children complained stabbing pain. The mean duration of the attack was 86 minutes (ranging from 30 to 180 minutes). The frequency of episodes was between 1 and 4 per day. All children had the typical cluster headache autonomic features, such as lacrimation, conjunctival injection, ptosis, and nostril rhinorrhea. Steroids showed a good clinical efficacy in interrupting cluster headache recurrence. As symptomatic drugs, acetaminophen as well as ibuprofen were ineffective; indomethacin was effective in 1 case. PMID:23307881

  13. Cervicalgia, cervicocranialgia, and cervicogenic headache

    Directory of Open Access Journals (Sweden)

    G.R. Tabeeva

    2014-01-01

    Full Text Available Pain syndromes in the neck and head regions are one of the most difficult conditions to be interpreted in clinical practice. Craniocervical anatomical and physiological features are a basis for development of mixed pain syndromes showing as a polymorphic clinical picture in the presence of not only painful, but also tonic muscle, autonomic, postural, vestibular, and other disorders. The current concept of cervicocranialgia is based on the views and convergence between cranial (trigeminal and upper cervical afferents, as supported by clinical and experimental data. These mechanisms are responsible for referred pain phenomena that are so characteristic of myofascial pain syndromes in the neck, head, and face. Myofascial pain may both be independent and occur in other types of primary headaches, specifically in migraine and tension headache. In these cases, the clinical symptomatology takes the features that are highly characteristic of myofascial pain: referred pain with a typical pattern of its spread, as well as trigger points and pain associated with postural loads and other physical factors. These peculiarities should be kept in mind when diagnosing pain syndromes in the craniocervical region. Current approaches to managing patients with cervicocranialgias encompass relief of pain and tonic muscle disorders and compensation for postural disturbances. For this, it is customary to use pharmacotherapy with antidepressants, nonsteroidal anti-inflammatory drugs, and myorelaxants. Effective analgesia in these patients still remains an unsolved problem. Analysis of clinical trials can identify the most effective analgesic and safe agents for pharmacotherapy. The phenomena of myofascial pain determine the expediency of using myorelaxants that exert an intrinsic analgesic effect and reduce tonic muscle phenomena.

  14. [Idiopathic headache in childhood and adolescence].

    Science.gov (United States)

    Karwautz, A; Wöber-Bingöl, C; Wöber, C

    1993-12-01

    This review of the literature covers classification, epidemiology and clinical aspects of idiopathic headache in childhood and adolescence. In addition, pathogenetic models taking into account the complex involvement of organic, psychological and psychosocial factors are critically reviewed. A general pathogenetic model of migraine may be characterized by a given predisposition, various co-factors which enhance the tendency, and finally, trigger mechanisms which induce an attack. No generally accepted model exists for tension-type headache. In assessing the importance of various factors thought to be related to idiopathic headache, it is necessary to differentiate between causal relation, unspecific association, and coincidence. The aim of this review is to present potential factors influencing headache in childhood and adolescence and to discuss these factors critically with regard to their etiopathogenetic importance. Organic factors seem to be most important in migraine, whereas psychological and (psycho)social factors may influence any type of headache. Briefly, migraine in childhood and adolescence seems to be definitively associated with vegetative dysfunction, abdominal symptoms and hormonal factors and possibly with allergic reactions, whereas a relation to epilepsy can be excluded. There is absolutely no evidence for a typical personality of migraine patients. Various psychic reactions, however, are important in all types of headache. Depression and anxiety in young headache patients seem to be related generally to pain, but not specifically to headache. However, school problems, learning disabilities and stress coping behaviour seem to be related directly to recurrent headache. Additionally, there is evidence that the prevalence of headache is associated with low economic status. PMID:8114976

  15. 儿童迁延性及慢性腹泻病因研究进展%Research progress in causes of persistent or chronic diarrhea in children

    Institute of Scientific and Technical Information of China (English)

    赵红梅

    2012-01-01

    The disease course of children with persistent or chronic diarrhea lasts from two weeks to two months or over. Diarrhea is a clinical syndrome caused by a group of multiple etiologies. This paper reviews common causes of persistent or chronic diarrhea in children, including intestinal infections, nonspecific inflammatory bowel diseases, food allergy, lactose intolerance, antibiotic-associated diarrhea, neural regulation abnormality, immunodeficiency disease, malnutrition, Celiac disease and zinc deficiency.%儿童迁延性、慢性腹泻的病程为2周至2个月或超过2个月,是一组多病因导致的临床综合征.本文对其常见病因进行了综述,常见病因包括感染、非特异性炎症性肠病、食物过敏、乳糖不耐受以及抗生素相关性腹泻、神经调节异常、免疫缺陷病、营养不良、乳糜泻、锌缺乏等.

  16. Commercially Available Mobile Phone Headache Diary Apps: A Systematic Review

    OpenAIRE

    Hundert, Amos S; Huguet, Anna; McGrath, Patrick J; Stinson, Jennifer N; Wheaton, Michael

    2014-01-01

    Background Headache diaries are often used by headache sufferers to self-monitor headaches. With advances in mobile technology, mobile electronic diary apps are becoming increasingly common. Objective This review aims to identify and evaluate all commercially available mobile headache diary apps for the two most popular mobile phone platforms, iOS and Android. Methods The authors developed a priori a set of 7 criteria that define an ideal headache diary app intended to help headache sufferers...

  17. The persistent food crisis in Ethiopis: causes, government responses and household strategies; the case of Enebse Sar Midir district

    OpenAIRE

    Lakew, Ejiga Jemberu

    2006-01-01

    This study looks into the underlying causes of household food shortage and coping and survival strategies of households. It also analyzes government intervention undertaken to address the problem. It was based on a field survey in three peasant associations of the Enebse Sar Midir district in Amhara Region. The findings of this study show that various and interrelated factors are responsible for the problem of household food shortage. There are many natural predisposing factors such as drough...

  18. The Persistent Circulation of Enterovirus 71 in People's Republic of China: Causing Emerging Nationwide Epidemics Since 2008

    OpenAIRE

    Xiaojuan Tan; Xueyong Huang; Shuangli Zhu; Hui Chen; Qiuli Yu; Haiyan Wang; Xixiang Huo; Jianhui Zhou; Yan Wu; Dongmei Yan; Yong Zhang; Dongyan Wang; Aili Cui; Hongqiu An; Wenbo Xu

    2011-01-01

    Emerging epidemics of hand-foot-and-mouth disease (HFMD) associated with enterovirus 71 (EV71) has become a serious concern in mainland China. It caused 126 and 353 fatalities in 2008 and 2009, respectively. The epidemiologic and pathogenic data of the outbreak collected from national laboratory network and notifiable disease surveillance system. To understand the virological evolution of this emerging outbreak, 326 VP1 gene sequences of EV71 detected in China from 1987 to 2009 were collected...

  19. Persistent after-effects of heavy rain on concentrations of ice nuclei and rainfall suggest a biological cause

    Science.gov (United States)

    Bigg, E. K.; Soubeyrand, S.; Morris, C. E.

    2015-03-01

    Rainfall is one of the most important aspects of climate, but the extent to which atmospheric ice nuclei (IN) influence its formation, quantity, frequency, and location is not clear. Microorganisms and other biological particles are released following rainfall and have been shown to serve as efficient IN, in turn impacting cloud and precipitation formation. Here we investigated potential long-term effects of IN on rainfall frequency and quantity. Differences in IN concentrations and rainfall after and before days of large rainfall accumulation (i.e., key days) were calculated for measurements made over the past century in southeastern and southwestern Australia. Cumulative differences in IN concentrations and daily rainfall quantity and frequency as a function of days from a key day demonstrated statistically significant increasing logarithmic trends (R2 > 0.97). Based on observations that cumulative effects of rainfall persisted for about 20 days, we calculated cumulative differences for the entire sequence of key days at each site to create a historical record of how the differences changed with time. Comparison of pre-1960 and post-1960 sequences most commonly showed smaller rainfall totals in the post-1960 sequences, particularly in regions downwind from coal-fired power stations. This led us to explore the hypothesis that the increased leaf surface populations of IN-active bacteria due to rain led to a sustained but slowly diminishing increase in atmospheric concentrations of IN that could potentially initiate or augment rainfall. This hypothesis is supported by previous research showing that leaf surface populations of the ice-nucleating bacterium Pseudomonas syringae increased by orders of magnitude after heavy rain and that microorganisms become airborne during and after rain in a forest ecosystem. At the sites studied in this work, aerosols that could have initiated rain from sources unrelated to previous rainfall events (such as power stations) would

  20. A concha bullosa mucopyocele manifesting as migraine headaches: a case report and literature review.

    Science.gov (United States)

    Shihada, Rabia; Luntz, Michal

    2012-05-01

    A concha bullosa is a common anatomic variant that represents an aerated turbinate, usually the middle turbinate. It is usually asymptomatic. When extensively pneumatized, a large concha bullosa may cause significant problems, including headache, nasal obstruction, and blockage of sinus drainage. We report a case of a large concha bullosa mucopyocele that manifested as recurring migraine headaches. It was successfully treated with surgical excision. We also review the available literature. PMID:22614562

  1. Cluster Headache and Its Cousins: A Family of Pain Management Problems

    OpenAIRE

    John Edmeads

    2000-01-01

    Cluster headache causes great misery because of the severity, frequency and repetitiveness of its attacks, and the fear (justified in a few sufferers) that the attacks will respond to nothing and will never cease. For most people with cluster headaches there is effective treatment, both for the acute attacks (subcutaneous sumatriptan, injected dihydroergotamine and oxygen inhalation) and for prophylaxis (verapamil, valproate, ergotamine, methysergide, lithium carbonate and corticosteroids). F...

  2. Subcutaneous delivery of sumatriptan in the treatment of migraine and primary headache

    Directory of Open Access Journals (Sweden)

    Moore JC

    2012-01-01

    Full Text Available Johanna C Moore, James R MinerDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USAAbstract: Subcutaneous sumatriptan is an effective treatment for pain from acute migraine headache, and can be used in patients with known migraine syndrome and in patients with primary headaches when secondary causes have been excluded. In limited comparative trials, subcutaneous sumatriptan performed in a manner comparable with oral eletriptan and intravenous metoclopramide, was superior to intravenous aspirin and intramuscular trimethobenzamide-diphenhydramine, and was inferior to intravenous prochlorperazine for pain relief. The most common side effects seen with subcutaneous sumatriptan are injection site reactions and triptan sensations. As with all triptans, there is a risk of rare cardiovascular events with subcutaneous sumatriptan and its use should be limited to those without known cerebrovascular disease and limited in those with known cardiovascular risk factors and unknown disease status. In studies of patient preference and tolerability, the subcutaneous formulation has a faster time of onset and high rate of efficacy when compared with the oral formulation, but the oral formulation appears to be better tolerated. It is important to consider the needs of the patient, their past medical history, and what aspects of migraine treatment are most important to the patient when considering treatment of acute migraine or primary headache. Subcutaneous sumatriptan is a good first-line agent for the treatment of pain from acute migraine headaches and primary headaches.Keywords: sumatriptan, subcutaneous, migraine headache, primary headache

  3. Cortical and subcortical hyperfusion during migraine and cluster headache measured by Xe CT-CBF

    International Nuclear Information System (INIS)

    High-resolution, color-coded images of local cerebral blood flow (LCBF) were made utilizing stable xenon-enhanced computed tomography among patients with common migraine (n=18), classic migraine (n=12) and cluster headache (n=5). During spontaneously occurring headache in common and classic migraine patients, LCBF values for cerebral cortex and subcortical gray and white matter were diffusely increased by 20-40% with the exception of the occipital lobes. LCBF increases involved both hemispheres whether the head pain was unilateral or bilateral. No significant differences were noted in the degree or pattern of LCBF increases during headaches of common and classic migraineurs. Similar cerebral hyperperfusion of greater magnitude was observed during cluster headaches but was more prominent on the side of the head pain. Present observations do not support the hypothesis of spreading cortical depression as a cause of classic migraine. From a hemodynamic viewpoint, LCBF increases during headaches of common or classic migraine or cluster appear similar. Evidence is adduced that sympathetic hypofunction with denervation hypersensitivity of cerebral vessels plays a role in the cerebral hyperperfusion of migraine headaches. More pronounced unilateral autonomic derangements appear to account for the symptoms and cerebral hyperperfusion associated with cluster headaches. (orig.)

  4. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain?

    Directory of Open Access Journals (Sweden)

    Sanjay Prakash

    2013-01-01

    Full Text Available Background: Headache, musculoskeletal symptoms, and vitamin D deficiency are common in the general population. However, the interrelations between these three have not been delineated in the literature. Materials and Methods: We retrospectively studied a consecutive series of patients who were diagnosed as having chronic tension-type headache (CTTH and were subjected to the estimation of serum vitamin D levels. The subjects were divided into two groups according to serum 25(OH D levels as normal (>20 ng/ml or vitamin D deficient (<20 ng/ml. Results: We identified 71 such patients. Fifty-two patients (73% had low serum 25(OH D (<20 ng/dl. Eighty-three percent patients reported musculoskeletal pain. Fifty-two percent patients fulfilled the American College of Rheumatology criteria for chronic widespread pain. About 50% patients fulfilled the criteria for biochemical osteomalacia. Low serum 25(OH D level (<20 ng/dl was significantly associated with headache, musculoskeletal pain, and osteomalacia. Discussion: These suggest that both chronic musculoskeletal pain and chronic headache may be related to vitamin D deficiency. Musculoskeletal pain associated with vitamin D deficiency is usually explained by osteomalacia of bones. Therefore, we speculate a possibility of osteomalacia of the skull for the generation of headache (osteomalacic cephalalgia?. It further suggests that both musculoskeletal pain and headaches may be the part of the same disease spectrum in a subset of patients with vitamin D deficiency (or osteomalacia, and vitamin D deficiency may be an important cause of secondary CTTH.

  5. Refractory migraine in a headache clinic population

    Directory of Open Access Journals (Sweden)

    Fernandez-Torron Roberto

    2011-08-01

    Full Text Available Abstract Background Many migraineurs who seek care in headache clinics are refractory to treatment, despite advances in headache therapies. Epidemiology is poorly characterized, because diagnostic criteria for refractory migraine were not available until recently. We aimed to determine the frequency of refractory migraine in patients attended in the Headache Unit in a tertiary care center, according to recently proposed criteria. Methods The study population consisted of a consecutive sample of 370 patients (60.8% females with a mean age of 43 years (range 14-86 evaluated for the first time in our headache unit over a one-year period (between October 2008 and October 2009. We recorded information on clinical features, previous treatments, Migraine Disability Assessment Score (MIDAS, and final diagnosis. Results Overall migraine and tension-type headache were found in 46.4% and 20.5% of patients, respectively. Refractory migraine was found in 5.1% of patients. In refractory migraineurs, the mean MIDAS score was 96, and 36.8% were medication-overusers. Conclusions Refractory migraine is a relatively common and very disabling condition between the patients attended in a headache unit. The proposed operational criteria may be useful in identifying those patients who require care in headache units, the selection of candidates for combinations of prophylactic drugs or invasive treatments such as neurostimulation, but also to facilitate clinical studies in this patient group.

  6. A pathophysiological view of primary headaches

    DEFF Research Database (Denmark)

    Edvinsson, L

    2000-01-01

    The cerebral circulation is innervated by sympathetic, parasympathetic and sensory nerves which store a considerable number of neurotransmitters. The role of these has been evaluated in primary headaches. A clear association between head pain and the release of calcitonin gene-related peptide (CG...... release normalised. These data show the involvement of sensory and parasympathetic mechanisms in the pathophysiology of primary headaches.......The cerebral circulation is innervated by sympathetic, parasympathetic and sensory nerves which store a considerable number of neurotransmitters. The role of these has been evaluated in primary headaches. A clear association between head pain and the release of calcitonin gene-related peptide (CGRP...

  7. CHRONIC HEADACHE - DIGITAL FUNDUS CHANGES IN EMMETROPIC TEENAGE AND ADULT PERSONS

    Directory of Open Access Journals (Sweden)

    Subba Rao

    2013-10-01

    Full Text Available ABSTRACT: Chronic headache is one of the commonest medical problem worldwide. 10 - 15 % of people are suffering from headache. Ocular headache is also one of the main cause for headache. Th e aim of this study is to find out clinical changes in the retina and in the optic nerve by digital fundus photography and by slit lamp fundus examination. 500 cases of headache with 13 to 38 years of age who have no refractive error are studied. Nidek Afc 210 auto focus and auto tracking digital fundus camera was used for taking fundus photographs and Nidek slit lamp with 135D mainster wide field lens of Ocular instruments. Inc was used. Out of 500 cases, 45% are males and 55% are females. 30% persons are from 13 to 20 years of age and 45% of persons are between 20 to 30 years of age and 25% of persons are from 30 to 38 years of age. 60 % of persons are from rural area and 40% of persons are from urban area. 80% of headache patients are having engorged and tortuous veins on optic disc and on retina. Mild to moderate arteriolar narrowing is present in 60% of persons. 80% of persons are having capillary insufficient and thin areas in the mid peripheral and in the peripheral retina. 70% of all headache patients are having eye strain. Cup disc ratio is more than 0.5 in 12% of headache patients. So, every case of chronic headache patient should be examined by non mydriatic digital fundus photography to know the changes in the optic disc and in retina for proper di agnosis and treatment.

  8. Migraine Headaches in Adults (Beyond the Basics)

    Science.gov (United States)

    ... Terms of Use ©2016 UpToDate, Inc. Patient education: Migraine headaches in adults (Beyond the Basics) Authors Zahid ... H Bajwa, MD Grant/Research Support: Amgen [Chronic migraine (Observational study)]. Consultant/Advisory Boards: Depomed [Chronic pain ( ...

  9. Headache Treatment in Adults (Beyond the Basics)

    Science.gov (United States)

    ... Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2000; 55:754. Silberstein, SD, Rosenberg, J. Multispecialty consensus on diagnosis and treatment of headache. Neurology 2000; 54:1553. Full text of guidelines available ...

  10. Reduced Baroreflex Sensitivity in Cluster Headache Patients

    DEFF Research Database (Denmark)

    Barloese, Mads C J; Mehlsen, Jesper; Brinth, Louise;

    2015-01-01

    OBJECTIVE AND BACKGROUND: Important elements of cluster headache (CH) pathophysiology may be seated in the posterior hypothalamus. Cranial autonomic features are inherent, but involvement of systemic autonomic control is still debated. We aimed to characterize autonomic function as investigated b...

  11. Neurobiology and sleep disorders in cluster headache

    DEFF Research Database (Denmark)

    Barloese, Mads Christian Johannes

    2015-01-01

    Cluster headache is characterized by unilateral attacks of severe pain accompanied by cranial autonomic features. Apart from these there are also sleep-related complaints and strong chronobiological features. The interaction between sleep and headache is complex at any level and evidence suggests...... that it may be of critical importance in our understanding of primary headache disorders. In cluster headache several interactions between sleep and the severe pain attacks have already been proposed. Supported by endocrinological and radiological findings as well as the chronobiological features......, predominant theories revolve around central pathology of the hypothalamus. We aimed to investigate the clinical presentation of chronobiological features, the presence of concurrent sleep disorders and the relationship with particular sleep phases or phenomena, the possible role of hypocretin as well as the...

  12. Neurostimulation therapies for primary headache disorders

    DEFF Research Database (Denmark)

    Magis, Delphine; Jensen, Rigmor; Schoenen, Jean

    2012-01-01

    Most pharmacological treatments of primary headache disorders are partially effective and have cumbersome side effects. Therapies with better efficacy and tolerance are needed. Neurostimulation techniques may have this potential. This is an attempt to summarize the latest clinical trial results...

  13. What Are Nerve Blocks for Headache?

    Science.gov (United States)

    ... Pain at the Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY. Matthew S. Robbins, MD, FAHS, is the director of the neurology service at the Einstein Division of Montefiore Medical ...

  14. What Are Nerve Blocks for Headache?

    Science.gov (United States)

    ... at the Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY. Matthew S. Robbins, MD, ... is an assistant professor of neurology at the Albert Einstein College of Medicine, and the current chair of ...

  15. Persistent Müllerian Duct Syndrome Caused by a Novel Mutation of an Anti-MüIlerian Hormone Receptor Gene: Case Presentation and Literature Review.

    Science.gov (United States)

    Elias-Assad, Ghadir; Elias, Marwan; Kanety, Hannah; Pressman, Asher; Tenenbaum-Rakover, Yardena

    2016-06-01

    Persistent Müllerian duct syndrome (PMDS) is a rare genetic disorder of male internal sexual development defined as lack of regression of Müllerian derivatives in the 46XY male with normally virilized external genitalia and unilateral or bilateral cryptorchidism. Approximately 85% of all cases are caused by mutations in genes encoding anti-Müllerian hormone (AMH) or its receptor (AMHR2) with autosomal recessive transmission. This condition is frequently diagnosed incidentally, during surgical repair of inguinal hernia or cryptorchidism. There is no consensus on surgical approach: malignancy risk in the Müllerian duct remnant or undescended testis encourages early removal of the former and bilateral orchiopexy; however, removal of Müllerian structures can impair testicular and vas deferens blood supply, potentially causing infertility. Herein, we report on a male infant with PMDS caused by a novel homozygous missense mutation in AMHR2 (c.928C>T; p.Q310X), review the literature, and discuss the diverse clinical and surgical approaches to this condition. PMID:27464416

  16. Deep brain stimulation for cluster headache

    DEFF Research Database (Denmark)

    Grover, Patrick J; Pereira, Erlick A C; Green, Alexander L;

    2009-01-01

    Cluster headache is a severely debilitating disorder that can remain unrelieved by current pharmacotherapy. Alongside ablative neurosurgical procedures, neuromodulatory treatments of deep brain stimulation (DBS) and occipital nerve simulation have emerged in the last few years as effective...... circumstances to intervene. Here we review current data on neurosurgical interventions for chronic cluster headache focusing upon DBS and occipital nerve stimulation, and discuss the indications for and putative mechanisms of DBS including translational insights from functional neuroimaging, diffusion weighted...

  17. Headache: A Symptom of Acute Myocardial Infarction

    OpenAIRE

    Yasmine Elgharably; Cesar Iliescu; Stefano Sdringola; Syed Wamique Yusuf

    2013-01-01

    ABSTRACT:We present a case of 55 year old man, with myocardial infarction and coronary thrombosis, whose initial presentation was with severe headache and review the literature.INTRODUCTION:Coronary ischemia typically presents with retrosternal pain that radiates to left arm (1). present atypically in various forms like indigestion (2), otalgia (3), facial pain (4) and syncope (5). Headache as the sole presentation of myocardial infarction (MI) is rare; however it has been reported previously...

  18. Chronic daily headache: biochemical and neurotransmitter abnormalities

    OpenAIRE

    Gallai, Virgilio; Sarchielli, Paola; Genco, Sergio; Alberti, Andrea; D'Andrea, Giovanni

    2000-01-01

    Although chronic daily headache (CDH) represents one of the most relevant complaints of patients in headache centers, the mechanisms underlying the chronicization of head pain are poorly understood. Experimental animal models of chronic pain suggest the involvement of a functional disturbance of several neuronal pathways. The disturbances include an abnormal excitability of nociceptive fibers supplying pain-sensitive structures in the brain responsible for peripheral sensitization (chronic ne...

  19. Regional cerebral blood flow in childhood headache

    International Nuclear Information System (INIS)

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical

  20. Guidelines for the organization of headache education in Europe: the headache school II

    DEFF Research Database (Denmark)

    Jensen, Rigmor; Mitsikostas, Dimos D; Valade, Dominique;

    2010-01-01

    In order to promote education on headache disorders, European Headache Federation (EHF) in conjunction with National Headache Societies organizes educational courses meeting uniform standards according to previous published guidelines. Based on six headache summer schools' experience, an EHF...... day-to-day program, and a multiple-choice test battery have now been outlined. It is recommended to include practical sessions with patient interviews and hands-on demonstrations of non-pharmacological treatment strategies. For countries that want a 'low cost' education program, a Video School program...... educational courses meeting uniform standards of excellence....

  1. Stabbing headache in an 8-year-old girl: primary or drug induced headache?

    Science.gov (United States)

    Biedroł, Agnieszka; Kaciłski, Marek; Skowronek-Bała, Barbara

    2014-04-01

    The occurrence of stabbing headaches in children requires a thorough diagnostic approach that excludes secondary headaches. The organic background should be taken into consideration when alarming symptoms occur, such as a purely 1-sided location, a change in the character of the headache, or possibly a link to physical activity. The current study describes the case of an 8-year-old girl who suffered short-lasting stabbing headache attacks. The headaches with increasing intensity and frequency started 1 month before her hospitalization and were usually preceded by physical activity (dancing, running). The pain, which was located in the right supraorbital region, lasted 1 second and occurred several times during the day. No associated symptoms were observed. In addition, the girl suffered from allergic rhinitis and was on antiallergic treatment (levocetirizine, fluticasone nasal spray). On admission she was in good general condition, and a pediatric and neurologic examination revealed no abnormalities. Her brain MRI was normal. The initial diagnosis was that the patient was suffering from primary stabbing headaches. However, during a follow-up visit 4 months later, a relationship was observed between the cessation of the headache attacks and the discontinuation of an antihistaminic drug. Six months later, the girl remained headache free. In cases involving differential diagnoses of stabbing headaches, it is important to consider the adverse reactions of the drugs used. PMID:24664098

  2. Successful treatment of spontaneous cerebrospinal fluid leak headache with fluoroscopically guided epidural blood patch: a report of four cases.

    Science.gov (United States)

    Hayek, Salim M; Fattouh, Maher; Dews, Teresa; Kapural, Leonardo; Malak, Osama; Mekhail, Nagy

    2003-12-01

    Spontaneous cerebrospinal fluid (CSF) leak is a rare clinical entity that may result in disabling headaches. It occurs as a result of dural defects, and the initial symptoms resemble those of postdural puncture headache. However, the positional headache can later evolve into a persistent chronic daily headache. The diagnosis of spontaneous CSF leak can be very challenging, but increasing awareness and improved diagnostic techniques are yielding ever more cases. When conservative management fails, the pain management clinician is called upon to administer an epidural blood patch. The success of this technique is dependent upon accurate diagnosis of the site of leakage and targeted epidural administration of the blood patch to this area. In this report, we describe four consecutive cases that were referred to our pain management department over an 18-month period and were successfully treated with site-directed epidural blood patches. PMID:14750917

  3. Pathophysiology of Headaches with a Prominent Vascular Component

    Directory of Open Access Journals (Sweden)

    Juan A Pareja

    1996-01-01

    Full Text Available Vascular changes, whether preliminary or secondary, seem to accompany most headaches. The literature concerning pathophysiological mechanisms in headaches where vascular phenomena are a major, integral part, ie, migraine and cluster headache syndrome, is reviewed and the most common forms of headache associated with cerebrovascular disease are discussed. Emphasis is placed on the vascular phenomena and on the abundant hypotheses and theories regarding headache mechanisms. This review also presents alternative explanatory models, and compares the available anatomical, physiological and biochemical results.

  4. A Practical Approach to Autonomic Dysfunction in Patients with Headache.

    Science.gov (United States)

    Ailani, Jessica

    2016-05-01

    The presence of autonomic symptoms can make the diagnosis of headache challenging. While commonly seen with the trigeminal autonomic cephalalgias, autonomic dysfunction can also be present in patients with migraine, or with a variety of secondary headaches. The pathophysiology of cranial autonomic symptoms in headache is based between the trigeminal system and the hypothalamus. This article will review the pathophysiology and presence of autonomic dysfunction in headache and will provide techniques to help in headache diagnosis in patients with autonomic dysfunction. PMID:27021770

  5. Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study

    Directory of Open Access Journals (Sweden)

    Toni Hesse

    2015-01-01

    Full Text Available Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10±2.6. Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84 of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling; no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.

  6. Prevalence and Characteristic of Headache in Dental Professionals: A Questionnaire Based Survey

    Science.gov (United States)

    Bhat, Nagesh; Singh, Arshdeep; Wadhwani, Avisha; Mansuri, Raena; Bhat, Surekha; Kaur, Harkiran; Gandhi, Neha

    2016-01-01

    Introduction Medical and dental streams in today’s date are considered highly demanding and stressful educational environments. Dental professionals, students and faculty, encounter great deal of stress in form of academic stress and job performance. Headache is a major and common neurological problem and is the main reason for decreased work performance, absenteeism and behavioral disturbances in dental professionals. Aim In current scenario of increasing stressful conditions in dental professionals, the present study was carried out with an aim to assess the prevalence and characteristic of headache in dental professionals in Udaipur, India. Materials and Methods A cross-sectional questionnaire based study was conducted in a private dental teaching hospital in Udaipur. The undergraduate, postgraduate dental students and faculty members, who gave consent, were included in the study. Information regarding the reason for headache and its various parameters was collected. Statistical analysis was done using SPSS version 22 and descriptive statistics was used to compare the results obtained. Results The headache was found to be prevalent in 87.1% of the subjects included in the study. Females (91.9%) were more frequently affected by headaches than males (87.1%). Conclusion It can be concluded from the present study that headache was the main cause of absenteeism at school and work, mood and behavioral changes and inappropriate work actions. PMID:27190942

  7. [Analgesic abuse and psychiatric comorbidity in headache patients].

    Science.gov (United States)

    Radat, F; Irachabal, S; Swendsen, J; Henry, P

    2002-01-01

    Headache patients frequently overuse analgesic medications: 20% of the patients from headache centers is concerned by this problem, which has been estimated to occur in four percent of the community migrainers. Frequent use of various types of headache medication may paradoxically cause an increase in headache attack frequency as well as their chronicisation due to potentially complex mechanisms of sensitization. Patients will enter into a self- perpetuating cycle of daily headaches and use of symptomatic medications which can lead to addiction and to social and occupational impairement. Indeed, many patients will experience pharmacological tolerance and dependence but also by some kind of craving. International Headache Society qualify these patients as abusers referring mostly to the amount of substance ingested. Hence patients are labelled analgesic abusers . However, as many of these analgesic medications contained psychotropic substances (i.e. caffeine, codeine.), these patients may fulfill DSM IV criteria of dependance. Nevertheless, the dependance criteria should be adapted to chronic pain patients. Indeed, if pharmacological dependence and tolerance criteria are easy to apply in such patients, it is not the case for the criteria a great deal of time spent to obtain substances, to use substances or to recover from substances effects . As analgesic medications are legally obtained from medical practitioners, drug seeking behaviours are mostly: obtaining medications from multiple providers, repeating episodes of prescription loss and multiplying requests for early refills. Moreover the detrimental effects of analgesic abuse on psychosocial functioning is likely to be related to pain rather than to medication overuse. Finally the best indicator of addictive behaviors in such patients, is the loss of control over the use of analgesic medication despite the adverse consequences over pain. Comorbidity with addiction to other substances has never been specifically

  8. Guidelines for the organization of headache education in Europe: the headache school II

    DEFF Research Database (Denmark)

    Jensen, Rigmor; Mitsikostas, Dimos D; Valade, Dominique;

    2010-01-01

    of a similar scientific standard has been developed. To be certified for CME credits, patronage, and financial support from EHF, it is highly recommended to adhere to the suggested teaching strategies. We hereby aim to promote and professionalize the education in headache disorders and endorse the......In order to promote education on headache disorders, European Headache Federation (EHF) in conjunction with National Headache Societies organizes educational courses meeting uniform standards according to previous published guidelines. Based on six headache summer schools' experience, an EHF...... day-to-day program, and a multiple-choice test battery have now been outlined. It is recommended to include practical sessions with patient interviews and hands-on demonstrations of non-pharmacological treatment strategies. For countries that want a 'low cost' education program, a Video School program...

  9. Occurrence and correlates of symptom persistence following acute dengue fever in Peru.

    Science.gov (United States)

    Halsey, Eric S; Williams, Maya; Laguna-Torres, V Alberto; Vilcarromero, Stalin; Ocaña, Victor; Kochel, Tadeusz J; Marks, Morgan A

    2014-03-01

    Dengue virus (DENV) infection causes an acute febrile illness generally considered to result in either complete recovery or death. Some reviews describe persistent symptoms after the febrile phase, although empirical data supporting this phenomenon is scarce. We evaluated symptom persistence in acute febrile DENV-infected and DENV-negative (controls) individuals from Peru. Self-reported solicited symptoms were evaluated at an acute and a follow-up visit, occurring 10-60 days after symptom onset. Rate of persistence of at least one symptom was 7.7% and 10.5% for DENV infected and control subjects, respectively (P < 0.01). The DENV-infected individuals had lower rates of persistent respiratory symptoms, gastrointestinal symptoms, headache, and fatigue, but higher rates of persistent rash compared with controls. Older age and female gender were positively associated with symptom persistence. As dengue cases continue to increase annually, even a relatively low frequency of persistent symptoms may represent a considerable worldwide morbidity burden. PMID:24470564

  10. The Reasons Of Patients With Headache Chosing The Neurosurgery Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Halil Murat Şen

    2014-09-01

    Full Text Available OBJECTIVE: We aimed to investigate the preference causes of the patients who were admitted to the neurosurgery clinic with complaints of headache for admission in this clinic. METHODS: The study population has been selected from brain surgery department outpatient clinic. One hundred patients with complaints of headache were enrolled in this study. RESULTS: Questioned the reasons for choosing the neurosurgical and most preferred cause of including word for brain surgery of the brain named (n=54, 54%. Patients were questioned about the information of the neurology and demostrated that there was not any knowledge about neurology (n=66, 66%. CONCLUSION: Headache causes loss of the financial and workforce. Preferences in the wrong departments of the patients, as a result of misdiagnosis and inadequate treatment, increasing the number of hospital admissions. This shows that how important names and introduction of the departments.

  11. Developmental exposure to a complex PAH mixture causes persistent behavioral effects in naive Fundulus heteroclitus (killifish) but not in a population of PAH-adapted killifish.

    Science.gov (United States)

    Brown, D R; Bailey, J M; Oliveri, A N; Levin, E D; Di Giulio, R T

    2016-01-01

    Acute exposures to some individual polycyclic aromatic hydrocarbons (PAHs) and complex PAH mixtures are known to cause cardiac malformations and edema in the developing fish embryo. However, the heart is not the only organ impacted by developmental PAH exposure. The developing brain is also affected, resulting in lasting behavioral dysfunction. While acute exposures to some PAHs are teratogenically lethal in fish, little is known about the later life consequences of early life, lower dose subteratogenic PAH exposures. We sought to determine and characterize the long-term behavioral consequences of subteratogenic developmental PAH mixture exposure in both naive killifish and PAH-adapted killifish using sediment pore water derived from the Atlantic Wood Industries Superfund Site. Killifish offspring were embryonically treated with two low-level PAH mixture dilutions of Elizabeth River sediment extract (ERSE) (TPAH 5.04 μg/L and 50.4 μg/L) at 24h post fertilization. Following exposure, killifish were raised to larval, juvenile, and adult life stages and subjected to a series of behavioral tests including: a locomotor activity test (4 days post-hatch), a sensorimotor response tap/habituation test (3 months post hatch), and a novel tank diving and exploration test (3months post hatch). Killifish were also monitored for survival at 1, 2, and 5 months over 5-month rearing period. Developmental PAH exposure caused short-term as well as persistent behavioral impairments in naive killifish. In contrast, the PAH-adapted killifish did not show behavioral alterations following PAH exposure. PAH mixture exposure caused increased mortality in reference killifish over time; yet, the PAH-adapted killifish, while demonstrating long-term rearing mortality, had no significant changes in mortality associated with ERSE exposure. This study demonstrated that early embryonic exposure to PAH-contaminated sediment pore water caused long-term locomotor and behavioral alterations in

  12. Sleep and chronobiology in cluster headache

    DEFF Research Database (Denmark)

    Barloese, M; Lund, N.; Petersen, A;

    2015-01-01

    BACKGROUND AND AIM: Cluster headache (CH) is the headache disorder with the strongest chronobiological traits. The severe attacks of pain occur with diurnal and annual rhythmicity but the precise rhythm and involvement of potential zeitgebers is unknown. Patients complain of poor sleep quality yet...... this has never been studied. We investigated triggers, rhythms, sleep quality and chronotypes in CH. METHODS: Patients and controls completed questionnaires and structured interviews composed of new and previously validated parts including the Pittsburgh Sleep Quality Index (PSQI) and Morningness......-Eveningness Questionnaire (MEQ). Patients were characterized by a CH index, a unified measure of headache burden. RESULTS: A total of 275 CH patients and 145 matched controls were included. The most common trigger was sleep (80%) and a relationship between clusters and daylight was identified. Of the patients, 82...

  13. Evaluation of headache service quality indicators

    DEFF Research Database (Denmark)

    Katsarava, Zaza; Gouveia, Raquel Gil; Jensen, Rigmor;

    2015-01-01

    BACKGROUND: Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so that deficienc......BACKGROUND: Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so...... of ensuring equal access to the services); and over protocols for reporting serious adverse events. CONCLUSION: This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service quality evaluation was successful. The project is ready to be taken into its next...

  14. What happens to the old headache medicines?

    Science.gov (United States)

    Rapoport, Alan M

    2012-04-01

    Old headache medicines never die; they either fade away or come back in disguise. The disguise is often a new route of administration, which may work better, faster, more completely, with fewer adverse events, and/or have certain other advantages. The clinical aspects of 3 of the oldest headache medicines (ergotamine tartrate, dihydroergotamine, and methysergide) will be discussed here. Sumatriptan will then be discussed as the prototype of the newest category of acute care therapy (triptans) for migraine. It will be compared with the older medications, and the new forms being developed will be briefly discussed. Diclofenac potassium for oral solution will be mentioned as the newest drug approved for migraine by the Food and Drug Administration, and a possible alternative to triptans in patients with frequent headaches or those with contraindications to vasoconstrictors. PMID:22486742

  15. Efficacy of Levothyroxine in Migraine Headaches in Children with Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Mehrdad MIROULIAEI

    2013-01-01

    attributed to hypothyroidism. Curr Pain Headache Rep. 2007 Aug;11(4:304-9.Toprak D, Demirkukan K, Ellidokuz H. Is it important to test thyroid function tests in migraineurs? TJFMPC. 2007;4:47-51.Hagen K, Bjøro T, Zwart JA, Vatten L, Stovner LJ, Bovim G. Low headache prevalence amongst women with high TSH values. Eur J Neurol. 2001 Nov;8(6:693-9.Oleson J. The International Classification of Headache Disorders: 2nd edition. Headache Classification Subcommittee of the International Headache Society. Cephalalgia 2004; 24 (Suppl : 9-160.LaFranchi S. Disorders of the Thyroid Gland. In: Kliegman RM, Stanton BF, Schor NF, St. Geme JW, Behrman RE. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders; 2011. p. 1894-908.Mavromichalis I, Anagnostopoulos D, Metaxas N, Papanastassiou E. Prevalence of migraine in schoolchildren and some clinical comparisons between migraine with and without aura. Headache. 1999 Nov-Dec;39(10:728-36.Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trøndelag Health Study (Head-HUNT-Youth, a large population-based epidemiological study. Cephalalgia. 2004 May;24(5:373-9.Bigal ME, Lipton RB, Winner P, Reed ML, Diamond S, Stewart WF. Migraine in adolescents: association with socioeconomic status and family history. Neurology. 2007 Jul;69(1:16-25.Singh SK. Prevalence of migraine in hypothyroidism. J Assoc Physicians India. 2002 Nov;50:1455-6.Moreau T, Manceau E, Giroud-Baleydier F, Dumas R, Giroud M. Headache in hypothyroidism. Prevalence and outcome under thyroid hormone therapy. Cephalalgia.1998 Dec;18(10:687-9.Iwasaki Y, Kinoshita M, Ikeda K, Takamiya K, Shiojima T. Thyroid function in patients with chronic headache. Int J Neurosci. 1991 Apr;57(3-4:263-7.Abend NS, Younkin D. Medical Causes of Headache in Children. Curr Pain Headache Rep. 2007 Oct;11(5:401-7.Abend NS, Younkin D, Lewis DW. Secondary headaches in children and adolescents. Semin Pediatr Neurol

  16. The role of muscles in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Fernández-de-la-Peñas, César

    2011-01-01

    sensitization of myofascial nociceptors could play a role in causing increased pain sensitivity, but firm evidence for a peripheral abnormality still is lacking. Peripheral mechanisms are most likely of major importance in episodic TTH. Sensitization of pain pathways in the central nervous system due to......The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation or...... relaxation therapy, which are most likely effective. Future studies should aim to identify the source of peripheral nociception....

  17. Blunted autonomic response in cluster headache patients

    DEFF Research Database (Denmark)

    Barloese, Mads; Brinth, Louise; Mehlsen, Jesper;

    2015-01-01

    BACKGROUND: Cluster headache (CH) is a disabling headache disorder with chronobiological features. The posterior hypothalamus is involved in CH pathophysiology and is a hub for autonomic control. We studied autonomic response to the head-up tilt table test (HUT) including heart rate variability...... (HRV) in CH patients and compared results to healthy controls. METHODS AND MATERIALS: Twenty-seven episodic and chronic CH patients and an equal number of age-, sex- and BMI-matched controls were included. We analyzed responses to HUT in the time and frequency domain and by non-linear analysis. RESULTS...

  18. Hangover headache. Prevalence: Vågå study of headache epidemiology

    OpenAIRE

    Sjaastad, Ottar; Bakketeig, Leiv S.

    2004-01-01

    In Vågå, Norway, with 3907 inhabitants, there were 2075 18–65-year-old dalesmen available for the headache epidemiology study. A total of 1838 dalesmen (88.6%) were personally examined. However, due to uncertainty whether hangover headache could be incorporated, this part of the study was started at no. 500. Of the remaining 1338 dalesmen, 1122, i. e., 83.9%, were questioned about hangover headache. The parochial “drinking culture” could probably best be characterised as binge drinking and no...

  19. Imaging: Do I Need an Imaging Study for My Headache?

    Science.gov (United States)

    ... an imaging study for my headache? Print Email Imaging: Do I need an imaging study for my headache? ACHE Newsletter Sign up ... newsletter by entering your e-mail address below. Imaging: Do I need an imaging study for my ...

  20. Primary headaches in restless legs syndrome patients

    Directory of Open Access Journals (Sweden)

    Ravi Gupta

    2012-01-01

    Full Text Available Earlier studies conducted among migraineurs have shown an association between migraine and restless legs syndrome (RLS. We chose RLS patients and looked for migraine to exclude sample bias. Materials and Methods: 99 consecutive subjects of idiopathic RLS were recruited from the sleep clinic during four months period. Physician diagnosis of headache and depressive disorder was made with the help of ICHD-2 and DSM-IV-TR criteria, respectively. Sleep history was gathered. Severity of RLS and insomnia was measured using IRLS (Hindi version and insomnia severity index Hindi version, respectively. Chi-square test, one way ANOVA and t-test were applied to find out the significance. Results: Primary headache was seen in 51.5% cases of RLS. Migraine was reported by 44.4% subjects and other types of ′primary headaches′ were reported by 7.1% subjects. Subjects were divided into- RLS; RLS with migraine and RLS with other headache. Females outnumbered in migraine subgroup (χ2 =16.46, P<0.001. Prevalence of depression (χ2 =3.12, P=0.21 and family history of RLS (χ2 =2.65, P=0.26 were not different among groups. Severity of RLS (P=0.22 or insomnia (P=0.43 were also similar. Conclusion: Migraine is frequently found in RLS patients in clinic based samples. Females with RLS are prone to develop migraine. Depression and severity of RLS or insomnia do not affect development of headache.

  1. Headaches from ear, nose and throat diseases

    Energy Technology Data Exchange (ETDEWEB)

    Reck, R.

    1984-08-01

    Headaches are a frequent symptom in ENT-patients. The complex sensory innervation of the ear, nose and paranasal sinuses is demonstrated. Heterotopic or referred pain must be differentiated from homotopic pain that is experienced at the point of injury. The nervous pathways of heterotopic otalgia are shown. The quality of pain of the most common rhinological and otological diseases is reported.

  2. Intravitreal Injection-Induced Migraine Headaches

    Science.gov (United States)

    Lerebours, Valerie C; Nguyen, Thanh-Giao; Sarup, Vimal; Rossi, Fabian

    2016-01-01

    A case of migraine headache triggered by intravitreal injection, and aborted by retrobulbar injection, is reported. To date, migraine and related cephalgia have not been reported after intravitreal injection. Ophthalmologists and neurologists should be aware of this potential sequela of a very common procedure. 

  3. Headaches and Migraines: Migraine 101 Quiz

    Science.gov (United States)

    ... begins with a visual disturbance called an aura (spots, dots or even zig zag lines). * True/False: All migraines involve only one side of the head. True/False: There is a cure for migraine headaches. Dietary triggers for migraines include: Chocolate Cheese Food additives such as MSG Alcohol A, B, ...

  4. Langerhans Cell Histiocytosis and Frontal Headache

    OpenAIRE

    J Gordon Millichap

    2002-01-01

    A most recent case record of the Massachusetts General Hospital involved a clinicopathological presentation of a 15-year-old boy admitted with frontal headache, right retro-orbital pain, and a retro-orbital mass that proved to be a Langerhans’ cell histiocytosis involving the right sphenoid sinus and orbit.

  5. Neuroimaging in childhood headache: a systematic review

    International Nuclear Information System (INIS)

    Headache is a common complaint in children, one that gives rise to considerable parental concern and fear of the presence of a space-occupying lesion. The evaluation and diagnosis of headache is very challenging for paediatricians, and neuroimaging by means of CT or MRI is often requested as part of the investigation. CT exposes children to radiation, while MRI is costly and sometimes requires sedation or general anaesthesia, especially in children younger than 6 years. This review of the literature on the value of neuroimaging in children with headache showed that the rate of pathological findings is generally low. Imaging findings that led to a change in patient management were in almost all cases reported in children with abnormal signs on neurological examination. Neuroimaging should be limited to children with a suspicious clinical history, abnormal neurological findings or other physical signs suggestive of intracranial pathology. Well-designed prospective studies are needed to better define the clinical findings that warrant neuroimaging in children with headache. (orig.)

  6. Neuroimaging in childhood headache: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Alexiou, George A. [University of Ioannina, Department of Neurosurgery, Medical School, P.O. Box 103, Ioannina (Greece); Argyropoulou, Maria I. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece)

    2013-07-15

    Headache is a common complaint in children, one that gives rise to considerable parental concern and fear of the presence of a space-occupying lesion. The evaluation and diagnosis of headache is very challenging for paediatricians, and neuroimaging by means of CT or MRI is often requested as part of the investigation. CT exposes children to radiation, while MRI is costly and sometimes requires sedation or general anaesthesia, especially in children younger than 6 years. This review of the literature on the value of neuroimaging in children with headache showed that the rate of pathological findings is generally low. Imaging findings that led to a change in patient management were in almost all cases reported in children with abnormal signs on neurological examination. Neuroimaging should be limited to children with a suspicious clinical history, abnormal neurological findings or other physical signs suggestive of intracranial pathology. Well-designed prospective studies are needed to better define the clinical findings that warrant neuroimaging in children with headache. (orig.)

  7. Cervicogenic headache: too important to be left un-diagnosed

    OpenAIRE

    Fredriksen, Torbjørn A; Antonaci, Fabio; Sjaastad, Ottar

    2015-01-01

    A comparison has been made between the cervicogenic headache criteria in the new IHS classification of headaches (3rd edition- beta version) and The Cervicogenic Headache International Study Group’s (GHISG) criteria from 1998. In a more recent version, the CHISG criteria consist of 7 different items. While “core cases” of cervicogenic headache (CEH) usually fulfill all 7 criteria, the IHS classification - 3rd edition beta version- fulfills only 3 criteria. Although the new three beta version ...

  8. Headaches in multiple sclerosis patients might imply an inflammatorial process.

    Directory of Open Access Journals (Sweden)

    Jan Möhrke

    Full Text Available Recent studies on Multiple Sclerosis (MS pathology mention the involvement of "tertiary B cell follicles" in MS pathogenesis. This inflammatory process, which occurs with interindividually great variance, might be a link between MS pathology and headaches. The aim of this study was to detect the prevalence of headaches and of subtypes of headaches (migraine, cluster, tension-type headache [TTH] in an unselected MS collective and to compile possibly influencing factors. Unselected MS patients (n = 180 with and without headache were examined by a semi-structured interview using a questionnaire about headache, depression and the health status. Additionally clinical MS data (expanded disability state score [EDSS], MS course, medication, disease duration were gathered. N = 98 MS patients (55.4% reported headaches in the previous 4 weeks. We subsequently grouped headache patients according to the IHS criteria and detected 16 (16.3% MS patients suffering from migraine (migraine with aura: 2 [2%]; migraine without aura: 14 [14.3%], 23 (23.5% suffering from TTH and none with a cluster headache. Thus, headaches of 59 (60.2% MS patients remained unclassified. When comparing MS patients with and without headaches significant differences in age, gender, MS course, physical functioning, pain and social functioning occurred. MS patients with headaches were significantly younger of age (p = 0.001, female (p = 0.001 and reported more often of a clinically isolated syndrome (CIS and relapsing/remitting MS (RRMS instead of secondary chronic progressive MS (SCP. EDSS was significantly lower in MS patients suffering from headaches compared to the MS patients without headaches (p = 0.001. In conclusion headache in MS patients is a relevant symptom, especially in early stages of the MS disease. Especially unclassified headache seems to represent an important symptom in MS course and requires increased attention.

  9. Headache associated with transient or permanent cerebrovascular disease

    OpenAIRE

    Hamdy, S.M.; Barrada, H.O.; Fahmy, M.S.; Samir, H.

    2002-01-01

    Headache is a common symptom in stroke, however the frequency, location, duration and other characteristics of the patients who developed headache during stroke are difficult to define. We studied headache characteristics in patients with first-ever acute stroke (hemorrhagic or ischemic) or transient ischemic attack (TIA) and assessed the relationship between headache, stroke location, and etiology. The study included 104 consecutive patients (mean age 55.8±0.8 years; range, 40–70 years) admi...

  10. Epidemiology, etiology and study of clinical findings of headache

    Directory of Open Access Journals (Sweden)

    Ghaffarpoor M

    1998-09-01

    Full Text Available In a cross-sectional epidemiological study of headache disorders in neurology clinic of Fatemieh hospital of Semnan (August 22-November 20.1996, information on types of headaches, quality, severity, location, duration, frequency, precipitating factors, age of onset, influence of menstruation and pregnancy, positive familial history, use of oral contraceptive pills and other epidemiological factors including socioeconomic and age/sex composition was collected. The presence of any types of headaches was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headaches Society. The prevalence of migraine and tension type headache was also analysed in relation to variables of life style (physical activity and sleep pattern and associated signs and symptoms (nausea, vomiting, photophobia and phonophobia. In this study migraine and tension headache were also compared in variable aspects with each other. 1 Headache was more prevalent in women than men (F/M=3/1. 2 The most common types of headache included: tension type headache (41.4%, migraine (31.2% and unclassified headaches (17.2%. 3 Migraine and T.T.H were more prevalent in early adult life and middle ages. 4 In both migraine and tension type headache the time profiles (duration, frequency, age of onset, quality and location were like that noted in textbook and previous studies. 5 In both migraine and tension type headache the most conspicuous precipitating factor was stress and mental tension and frequent headaches were accompanied with psychiatric problems (e.g depression and or anxiety. 6 Nausea, vomiting, phonophobia and photophobia were the most common associated symptoms in both of them. 7 Positive familial history and aggravation of headache in perimenstual period were more commonly seen in patients with migraine than tension type headache. In conclusion using the operational diagnostic criteria of International Headache Society in

  11. ACUPUNCTURE TREATMENT OF 80 CASES OF ANGIONEUROTIC HEADACHE

    Institute of Scientific and Technical Information of China (English)

    郭蕴屏; 冉茂东

    2000-01-01

    Angioneurotie headache is a paroxysmal violent distending headache due to disturbance of vascular diastolic and systolic functions. It belongs to the category of "headache" in traditional Chinese medicine (TCM) and often results from stagnation of the liverqi and deficiency of the kidney-yin. The author adopted acupuncture therapy to treat 80 cases of angioneurotic headache and achieved satisfactory therapeutic results. Here is the summary.

  12. A Case of Cluster Headache Accompanied by Myoclonus and Hemiparesis

    OpenAIRE

    Yang, Ji Won; Park, Suk Gyung; Jung, In Hae; Sung, Young Hee; Park, Kee Hyung; Lee, Yeong Bae; Shin, Dong Jin; Park, Hyeon Mi

    2012-01-01

    Background Cluster headache is a primary headache disorder characterized by periodic episodes of intense headache accompanied by autonomic symptoms. We report an unusual clinical presentation of cluster headache that was preceded by myoclonus and accompanied by hemiparesis. Case Report A 26-year-old man visited hospital due to recurrent jerky movements on the left side of his face and neck area lasting 3 days. These jerky movements had disappeared spontaneously without specific treatment. On ...

  13. Headaches related to triptans therapy in patients of migrainous vertigo

    OpenAIRE

    Prakash, Sanjay; Chavda, Bhavana V.; Mandalia, Hiren; Dhawan, Rishi; Padmanabhan, Deepak

    2008-01-01

    Dizziness and vertigo are frequently reported by patients with migraine. In migrainous vertigo (MV), vertigo is causally related to migraine. Patients of MV usually have an attenuated or absent headache with their vertigo as compared with their usual headache of migraine. Here we report three female patients of MV in which administration of triptan was associated with induction (two patients) or exacerbation (one patient) of headache with disappearance of vertigo. We suggest that headache and...

  14. Comparison of Paracetamol (Apotel®) and Morphine in Reducing Post Pure Head Trauma Headache

    Science.gov (United States)

    Shams Vahdati, Samad; Morteza Baghi, Hamid Reza; Ghobadi, Jaffar; Rajaei Ghafouri, Rouzbeh; Habibollahi, Paria

    2014-01-01

    Background: This randomized, clinical trial evaluates the analgesic and safety of paracetamol and Morphine in management of headache. Objectives: This study aimed to evaluate the analgesic and safety effects of intravenous single dose of paracetamol, versus morphine in post trauma headache in emergency departments. Patients and Methods: This study was a single-center, prospective, randomized, double-blind clinical trial conducted on two groups treated with intravenous paracetamol and intravenous morphine. Thirty patients were enrolled in each group. Patients (18-55 years-old adults) complaining from headaches due to pure trauma were included in the study. The inclusion criteria required patients to have headachesof more than 40 mm on a 100 mm visual analogue scale without any pathological findings in their clinical examinations and imaging studies. Results: Mean duration required to treat the headache was 37.43 and 71.93 minutes in the groups administered paracetamol (group A) and morphine (group B), respectively. After 15 minutes of treatment, this changed to 31.7 ± 18.0 mm (95% CI 8.2 to 25.2) and 48.3 ± 14.1 mm (95% CI 8.2 to 25.2) in groups A and B, respectively. Headache of the patients of group A significantly mitigated in comparison with group B (P < 0.005). Headache of group Apatients was significantly mitigated 30 minutes after treatment (P < 0.005). Conclusions: Intravenous paracetamol is an effective and safe treatment for patients admitted to the emergency department with headaches caused by head trauma. PMID:25237630

  15. Aspects on the pathophysiology of migraine and cluster headache

    DEFF Research Database (Denmark)

    Edvinsson, L

    2001-01-01

    release of the neuropeptide calcitonin gene-related peptide, probably from C fibres. In cluster headache and in a case of chronic paroxysmal headache there was in addition release of the parasympathetic neuropeptide vasoactive intestinal peptide, which was associated with headache, nasal congestion and...

  16. Ice cream headache in students and family history of headache: a cross-sectional epidemiological study.

    Science.gov (United States)

    Zierz, Antonia Maria; Mehl, Theresa; Kraya, Torsten; Wienke, Andreas; Zierz, Stephan

    2016-06-01

    Headache attributed to ingestion of a cold stimulus (ICHD-3 beta 4.5.1) is also known as ice cream headache (ICH). This cross-sectional epidemiological study included 283 students (10-14-year-olds) attending a grammar school in Germany, their parents (n = 401), and 41 teachers. A self-administered questionnaire was used to analyze the prevalence and characteristics of ICH based on the ICHD classification. Additionally, the association between ICH and other headaches was investigated in students and parents. Prevalence of ICH in students was 62 % without gender difference. In adults, only 36 % of females and 22 % of males reported ICH. There was an increased risk for ICH in students when mother (OR 10.7) or father (OR 8.4) had ICH. Other headaches in parents had no influence on the prevalence of ICH in students. However, in the groups of students and parents itself there was a highly significant association between ICH and other headaches (students: OR 2.4, mothers: OR 2.9, fathers: OR 6.8). There was a decreased risk for ICH when parents and students had no headache at all (OR history seems to be a protective factor for ICH. PMID:27039390

  17. Prevalence and clinical characteristics of headache in dental students of a tertiary care teaching dental hospital in Northern India

    OpenAIRE

    Ruchika Nandha; Mahinder K. Chhabra

    2013-01-01

    Background: Chronic headache is as much as a problem in India as elsewhere in the world with a rising trend in young adults which negatively affects the quality of life of the affected person. In current scenario of increasing prevalence of headache in students, most of them have been found to practice self medication leading to inappropriate management and sometimes analgesic overuse causing treatment refractoriness. Methods: A questionnaire based survey was done on undergraduate dental stud...

  18. A rare case of orthostatic headache due to spontaneous intracranial hypotension.

    Science.gov (United States)

    Arshed, Sabrina; Enakuaa, Souad; Nai, Qiang; Hossain, Mohammad Amir; Tulpule, Sunil; Yousif, Abdalla

    2016-02-01

    Headache is one of the most common clinical entities, and has a long list of differential diagnoses; however, one of the more uncommon causes of postural headache is spontaneous intracranial hypotension. It is important that clinicians be aware of this condition, as it is often overlooked, leading to invasive and unnecessary diagnostic testing. A good history and physical exam, paired with an MRI of the brain is sufficient to make the diagnosis of SIH, relieve the symptomology of the patient in a quick and efficient manner, and avoid costly invasive procedures. PMID:26862421

  19. Ehlers-Danlos syndrome: correlation with headache disorders in a young woman.

    Science.gov (United States)

    Di Palma, F; Cronin, A H

    2005-12-01

    Ehlers-Danlos syndrome is a rare inherited illness, which includes an autosomal dominant and also a recessive X-linked variant. Its main clinical characteristic is a generalised connective tissue involving collagen and elastin, causing fragile and hyperextensible skin, loose jointedness and bruising. Many clinical subtypes are described, each of a different severity degree pattern. The correlation of this syndrome and headache disorders is rare. In this paper we describe the case of a young woman with Type II (less severe) Ehlers-Danlos Syndrome and headache. PMID:16388346

  20. Diagnosis and treatment of headache in the ambulatory care setting: a review of classic presentations and new considerations in diagnosis and management.

    Science.gov (United States)

    Hale, Natalie; Paauw, Douglas S

    2014-05-01

    Headaches represent the most common constellation of neurologic disorders and are a very common cause of morbidity, lost work time, and decreased quality of life among sufferers. In this article, the diagnostic features, workup, and treatment of common, nuanced, and difficult-to-diagnose headache conditions were addressed. The future will hold a number of changes, with respect to both the diagnosis and treatment of headache disorders. As the aging population continues to grow, primary care providers will need to become increasingly familiar with differentiating between benign primary and more serious secondary headache disorders and will need to be able to treat the headache disorders unique to the elderly. With respect to therapeutic options, the future for treatment of the various headache disorders is promising. With the rise in popularity of complementary medical practices, there is likely to be more research on the roles of acupuncture, herbal and alternative remedies, massage therapy, and mind-body techniques. Further, new research is suggesting that neurostimulation may be useful in certain chronic, intractable headache conditions. Finally, the pathophysiology of headache disorders is still poorly understood and there is great hope that better understanding of the underlying mechanics of headache might contribute to improved treatment modalities and better quality of life for patients. PMID:24758958

  1. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks

    DEFF Research Database (Denmark)

    Olesen, J; Friberg, L; Olsen, T S; Iversen, Helle Klingenberg; Lassen, N A; Andersen, A R; Karle, A

    1990-01-01

    Ten years of study has resulted in considerable but fragmented knowledge about regional cerebral blood flow in migraine with aura (classic migraine). In the present study, the number of repeatedly studied patients (n = 63) was large enough to determine statistically significant sequences of event...... nociceptors. Bilateral headache caused by a unilateral cerebral disturbance may be explained by recent neuroanatomical and neurophysiological findings....

  2. Neuroimaging and clinical neurophysiology in cluster headache and trigeminal autonomic cephalalgias

    DEFF Research Database (Denmark)

    Friberg, Lars; Sandrini, Giorgio; Perrotta, Armando

    2010-01-01

    pathophysiology of primary headaches, and of TACs in particular, focusing on a cerebrovascular dysfunction hypothesis toward a central triggering cause. The introduction of single-photon emission computed tomography (SPECT), positron emission tomography (PET), and voxel-based morphometry has allowed us new...

  3. Predictors of outcome of the treatment programme in a multidisciplinary headache centre

    DEFF Research Database (Denmark)

    Jensen, Rigmor; Zeeberg, Peter; Dehlendorff, Christian;

    2010-01-01

    Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. The objective was to characterise patients and treatment results in a tertiary headache centre.......Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. The objective was to characterise patients and treatment results in a tertiary headache centre....

  4. Employment persistence

    OpenAIRE

    Fleischman, Charles A.; Joshua H. Gallin

    2001-01-01

    The recent U.S. expansion has provided employment experience to individuals at tail of the skill distribution. Will these opportunities bestow persistent benefits in the form of greater future employability? Using synthetic cohorts constructed from the CPS, this paper estimates the degree of persistence in cohort-level employment rates in excess of persistence in aggregate macroeconomic conditions. This approach is in some ways superior to testing for hysteresis in the aggregate unemployment ...

  5. Psychological predictors of headache remission in children and adolescents

    Science.gov (United States)

    Carasco, Marcel; Kröner-Herwig, Birgit

    2016-01-01

    Objective Longitudinal studies on headaches often focus on the identification of risk factors for headache occurrence or “chronification”. This study in particular examines psychological variables as potential predictors of headache remission in children and adolescents. Methods Data on biological, social, and psychological variables were gathered by questionnaire as part of a large population-based study (N=5,474). Children aged 9 to 15 years who suffered from weekly headaches were selected for this study sample, N=509. A logistic regression analysis was conducted with remission as the dependent variable. In the first step sex, age, headache type, and parental headache history were entered as the control variables as some data already existed showing their predictive power. Psychological factors (dysfunctional coping strategies, internalizing symptoms, externalizing symptoms, anxiety sensitivity, somatosensory amplification) were entered in the second step to evaluate their additional predictive value. Results Highly dysfunctional coping strategies reduced the relative probability of headache remission. All other selected psychological variables reached no significance, ie, did not contribute additionally to the explanation of variance of the basic model containing sex and headache type. Surprisingly, parental headache and age were not predictive. The model explained only a small proportion of the variance regarding headache remission (R2=0.09 [Nagelkerke]). Conclusion Successful coping with stress in general contributed to remission of pediatric headache after 2 years in children aged between 9 and 15 years. Psychological characteristics in general had only small predictive value. The issue of remission definitely needs more scientific attention in empirical studies.

  6. Headache symptoms and indoor environmental parameters: Results from the EPA BASE study

    Directory of Open Access Journals (Sweden)

    Gretchen E Tietjen

    2012-01-01

    Full Text Available Objective: The objective of this investigation was to determine the prevalence of migraine and headache symptoms in a national sample of US office employees. Also, we explored the association of headache symptoms with indoor environmental parameters of the work place. Background: Sick building syndrome (SBS, which includes headache, is a common global phenomenon, but the underlying environmental cause is uncertain. Materials and Methods: We used data from the 1994-1998 US Environmental Protection Agency′s (EPA Building Assessment and Survey Evaluation, a cross-sectional study of workers employed in 100 public and private office buildings across 25 states. The study used a self-administered questionnaire to assess headache frequency and prevalence of self-reported physician-diagnosed (SRPD migraine. Indoor environmental parameters (IEP were collected per EPA protocol from each building over a 1-week period and included carbon dioxide, carbon monoxide, temperature, relative humidity, particulate matter, volatile organic compound, illuminance, and sound level. The standards of American Society of Heating, Refrigerating and Air Conditioning Engineers were used to categorize IEP as either within- or out-of-comfort range for human dwelling. These limits delineate whether a parameter value is safe for human dwelling. Out-of-comfort range IEPs are associated with SBS and other human diseases. SRPD migraine and headache frequency were the primary outcome measures of the study. Multivariate logistic regression analyses were employed for the purpose of assessing the association between the outcome variable and IEPs. Results: Of the 4326 participants, 66% were females and 60% were between 30 and 49 years. Headache frequency during the last 4 weeks was as follows: None in 31%, 1-3 days in 38%, 1-3 days per week in 18%, and every or almost every workday in 8%. Females had higher SRPD migraine prevalence compared to males (27% vs. 11%, P<0.001 and were more

  7. Sildenafil can induce the onset of a cluster headache bout.

    Science.gov (United States)

    Lin, Guan-Yu; Lee, Jiunn-Tay; Peng, Giia-Sheun; Yang, Fu-Chi

    2014-05-01

    About 25% of patients who are prescribed sildenafil, the phosphodiesterase type 5 (PDE-5) inhibitor, for erectile dysfunction (ED) experience headaches. These migraine effects are well-described, including cluster headaches. We report the case of a man who experienced a cluster headache attack following each of 2 sildenafil doses. His symptoms were resolved by adding naproxen to his treatment regimen and changing his ED treatment from 50 mg of sildenafil to 5 mg of vardenafil. To our knowledge, no study has reported cluster headaches triggered by the less commonly used PDE-5 inhibitors, namely vardenafil and tadalafil. Urologists should be cautious in prescribing sildenafil to patients with ED and with a history of cluster headaches. In these patients, they should consider prescribing low-dose vardenafil or tadalafil instead. Failure to recognize sildenafil risks could result in unnecessary headache bouts in patients with a history of cluster headaches. PMID:24940471

  8. Young adolescents' use of medicine for headache:

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Andersen, Anette; Krølner, Rikke;

    2008-01-01

    associated with medicine use. METHODS: Cross-sectional study in eight schools where all fifth and seventh grade students (11- and 13-year-olds) answered a questionnaire about socio-demographic factors, health and medicine use. Response rate: 84.0%, n = 595. RESULTS: The reported prevalence of headache at...... children who mentioned three or more sources of supply was 4.53 (95% CI 2.63-7.83) in a multivariate model controlled for sex, age and prevalence of headache. Use of medicine was also associated with availability at home (OR = 1.51, 1.01-2.27) and accessibility (OR = 2.49, 1.57-3.93). CONCLUSION: Medicine...

  9. Critical path case management: the headache clinic.

    Science.gov (United States)

    Sobkowski, D A; Maquera, V

    1996-01-01

    A practical application of a neurology case management healthcare delivery mode results in increased access to specialty providers, shorter follow-up periods, and improved continuity of medical care. The program described in the following sections was developed at a naval hospital for the ongoing evaluation of therapeutic schemes to optimize headache therapy and, 1 year after implementation, shows improvement in patient outcomes and resource use. PMID:9192570

  10. The classification of chronic daily headache in French children and adolescents: A comparison between the second edition of the International Classification of Headache Disorders and Silberstein-Lipton criteria

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Cuvellier

    2008-05-01

    Full Text Available Jean-Christophe Cuvellier1, Frédéric Couttenier2, Stéphane Auvin1, Louis Vallée11Department of Child Neurology, Pediatric Clinic, University Hospital, Lille, France; 2Division of Gastroenterology, Hepatology and Nutrition, Pediatric Clinic, University Hospital, Lille, FranceAbstract: Few data are available on the applicability of both the criteria proposed by Silberstein and Lipton (S-L and the International Classification of Headache Disorders-II (ICHD-II in the classification of children and adolescents with chronic daily headache (CDH. The International Headache Society recently added revised criteria (ICHD-IIR for chronic migraine to its Appendix. We retrospectively reviewed all charts of 34 children and adolescents (<17 years with primary CDH presenting to the outpatient clinic of the Universitary Department of Neuropediatrics of Lille between February 2004 and February 2006 and tried to classify their CDH according to both S-L criteria and the recently published ICHD-IIR. Thirty-two children (94% and 33 children (97% could respectively be successfully classified into one subtype of CDH according to the S-L classification and the ICHD-IIR. Transformed migraine was the most common diagnosis (61.8%, followed by new daily-persistent headache (20.6% when the S-L criteria were used. Twenty-three children and adolescents (67.6% could be classified under one of the migraine categories according to the ICHD-IIR classification. We think that both S-L and ICHD-II classifications, when used with detailed headache histories and diaries, are adequate to classify chronic daily headache in children and adolescents.Keywords: chronic daily headache, classification, children, adolescents

  11. Autism/Broken Symbiosis: Persistent Avoidance of Eye Contact with the Mother. Causes, Consequences, Prevention and Cure of Autistiform Behavior in Babies through "Mother-Child Holding."

    Science.gov (United States)

    Stades-Veth, Joanna

    A case study is reported in which early "autistiform behavior" in a 4-week-old baby was reversed through intensive mothering. The baby, who had been developing normally, was bottlefed by "strangers" for 2 days and then began to avert her eyes from all people, an autistiform behavior which persisted and grew worse as the mother tried to…

  12. Types of headache and those remedies in traditional persian medicine

    Directory of Open Access Journals (Sweden)

    Mohammad M Zarshenas

    2013-01-01

    Full Text Available The history of headache, as a common neurological complication, goes back to almost 9000 years ago. Many ancient civilizations present references to headaches and the coherent treatment strategies. Accordingly, several documents comprising headache complications embodying precise medical information stem from Traditional Persian Medicine (TPM that can provide useful opportunities for more comprehensive treatment. We conducted a survey on headache through original important pharmacopeias and other important medical manuscripts of TPM which were written during 9 th to 19 th centuries and have derived all headache categories and herbal remedies. An extensive search of scientific data banks, such as Medline and Scopus, has also been exercised to find results relating to the anti-inflammatory, anti-nociceptive, and analgesic effects of denoted medicinal herbs. The concept of headache and treatments in TPM covers over 20 various types of headache and more than 160 different medicinal plants administered for oral, topical, and nasal application according to 1000 years of the subject documents. Nearly, 60% of remarked medicinal herbs have related anti-inflammatory or analgesic effects and some current headache types have similarities and conformities to those of traditional types. Beside historical approaches, there are many possible and available strategies that can lead to development of new and effective headache treatment from medicinal plants so that this study can provide beneficial information on clinical remedies based on centuries of experience in the field of headache which can stand as a new candidate for further investigations.

  13. Headache and inflammatory disorders of the central nervous system.

    Science.gov (United States)

    La Mantia, L; Erbetta, A

    2004-10-01

    The subcommittee of the International Headache Society for headache classification (ICHD-II) has recently recognised that secondary headaches may occur in patients affected by inflammatory diseases (ID) of the central nervous system (CNS), classifying them among the headaches attributed to non-vascular intracranial disorders. The aim of the study was to verify the association between headache and inflammatory non-infectious diseases of the CNS, by a review of the literature data on the topic, integrated by personal cases and data. Secondary headaches may occur in four main disorders: neurosarcoidosis (sec 7.3.1), aseptic (non-infectious) meningitis (7.3.2), other non-infectious ID (7.3.3) and lymphocytic hypophysitis (7.3.4). Headache and/or primary headaches are frequently reported in patients with neurosarcoidosis (30%), Behcet's syndrome (BS) (55%) and acute disseminated encephalomyelitis (45-58%). Recent data show a high incidence of headache also in multiple sclerosis (MS) (58%) (not mentioned in ICHD-II). The association between headache and inflammatory dysimmune diseases of the CNS, in particular BS and MS, might suggest a pathogenetic relationship. PMID:15549526

  14. Phantom headache: pain-memory-emotion hypothesis for chronic daily headache?

    OpenAIRE

    Prakash, Sanjay; Golwala, Purva

    2011-01-01

    The neurobiology of chronic pain, including chronic daily headache (CDH) is not completely understood. “Pain memory” hypothesis is one of the mechanisms for phantom limb pain. We reviewed the literature to delineate a relation of “pain memory” for the development of CDH. There is a direct relation of pain to memory. Patients with poor memory have less chance to develop “pain memory”, hence less possibility to develop chronic pain. Progressive memory impairment may lead to decline in headache ...

  15. Medicine use for headache in adolescence predicts medicine use for headache in young adulthood

    DEFF Research Database (Denmark)

    Andersen, Anette; Holstein, Bjørn E; Due, Pernille; Hansen, Ebba Holme

    2009-01-01

    BACKGROUND: Health risk behaviours such as smoking and binge drinking track from adolescence to adulthood. Medicine use is associated with smoking and binge drinking among adolescents. Whether medicine-use behaviour tracks from adolescence to adulthood is unknown. AIM: To examine tracking of...... increased if medicine was used at age 15 or 19. However, use increased substantially if medicine for headache was used at both age 15 and 19 (OR = 5.83, 95%CI: 1.99-17.14 for males and OR = 4.67, 95%CI: 2.59-8.43 for females). CONCLUSION: Medicine use for headache is a behavioural pattern that may track...

  16. 2012 European Thyroid Association Guidelines for the Management of Familial and Persistent Sporadic Non-Autoimmune Hyperthyroidism Caused by Thyroid-Stimulating Hormone Receptor Germline Mutations

    Science.gov (United States)

    Paschke, R.; Niedziela, M.; Vaidya, B.; Persani, L.; Rapoport, B.; Leclere, J.

    2012-01-01

    All cases of familial thyrotoxicosis with absence of evidence of autoimmunity and all children with persistent isolated neonatal hyperthyroidism should be evaluated for familial non-autoimmune autosomal dominant hyperthyroidism (FNAH) or persistent sporadic non-autoimmune hyperthyroidism (PSNAH). First, all index patients should be analysed for the presence/absence of a thyroid-stimulating hormone (TSH) receptor (TSHR) germline mutation, and if they display a TSHR germline mutation, all other family members including asymptomatic and euthyroid family members should also be analysed. A functional characterization of all new TSHR mutations is necessary. Appropriate ablative therapy is recommended to avoid relapses of hyperthyroidism and its consequences, especially in children. Therefore, in children the diagnosis of FNAH or PSNAH needs to be established as early as possible in the presence of the clinical hallmarks of the disease. PMID:24783013

  17. Persistent photoconductivity in AlGaN/GaN heterojunction channels caused by the ionization of deep levels in the AlGaN barrier layer

    International Nuclear Information System (INIS)

    Time-dependent responses of drain current (Id) in an AlGaN/GaN HEMT under UV (3.3 eV) and red (2.0 eV) light illumination have been studied at 300 K and 250 K. UV illumination enhances Id by about 10 %, indicating that the density of two-dimensional electrons is raised by about 1012 cm−2. When UV light is turned off at 300 K, a part of increased Id decays quickly but the other part of increment is persistent, showing a slow decay. At 250 K, the majority of increment remains persistent. It is found that such a persistent increase of Id at 250 K can be partially erased by the illumination of red light. These photo-responses are explained by a simple band-bending model in which deep levels in the AlGaN barrier get positively charged by the UV light, resulting in a parabolic band bending in the AlGaN layer, while some potion of those deep levels are neutralized by the red light

  18. Productivity impact of headache on a heavy-manufacturing workforce in Turkey

    OpenAIRE

    Selekler, Macit H; Gökmen, Gürsel; Steiner, Timothy J.

    2013-01-01

    Background Headache disorders cause substantial productivity losses through absenteeism and impaired effectiveness at work (presenteeism). We measured productivity losses from both causes at a heavy-manufacturing company with a largely male workforce in north-western Turkey. Methods We used the HALT Index as the survey instrument. We first assessed productivity losses by surveying the entire workforce. Because we anticipated much non-participation, we also applied HALT at the annual health-ch...

  19. Central pain processing in chronic tension-type headache

    DEFF Research Database (Denmark)

    Lindelof, Kim; Ellrich, Jens; Jensen, Rigmor;

    2009-01-01

    OBJECTIVE: Chronic tension-type headache (CTTH) affects 3% of the population. Directly and indirectly it causes high costs and considerable loss of quality of life. The mechanisms of this disorder are poorly understood and the treatment possibilities are therefore limited. The blink reflex (BR) r...... combined homotopic and heterotopic effect of the conditioning pain onto the blink reflex could account for this finding.......) reflects neuronal excitability due to nociceptive input in the brainstem. The aim of this study was to investigate nociceptive processing at the level of the brainstem in an experimental pain model of CTTH symptoms. METHODS: The effect of conditioning pain, 5 min infusion of hypertonic saline into the neck...... muscles, was investigated in 20 patients with CTTH and 20 healthy controls. In addition, a pilot study with isotonic saline was performed with 5 subjects in each group. The BR was elicited by electrical stimuli with an intensity of four times the pain threshold, with a superficial concentric electrode. We...

  20. Acupuncture for episodic cluster headache: a trigeminal approach.

    Science.gov (United States)

    Hayhoe, Simon

    2016-02-01

    Following evidence that acupuncture is clinically feasible and cost-effective in the treatment of headache, the UK National Institute for Health and Care Excellence recommends acupuncture as prophylactic treatment for migraine and tension headache. There has thus been expectation that other forms of headache should benefit also. Unfortunately, acupuncture has not generally been successful for cluster headache. This may be due to acupuncturists approaching the problem as one of severe migraine. In fact, cluster headache is classed as a trigeminal autonomic cephalgia. In this case report, episodic cluster headache is treated in the same way as has been shown effective for trigeminal neuralgia. Acupuncture is applied to the contralateral side at points appropriate for stimulating branches of the trigeminal nerve. Thus, ST2 is used for the infraorbital nerve, BL2 and Yuyao for the supratrochlear and supraorbital nerves, and Taiyang for the temporal branch of the zygomatic nerve. PMID:26846705

  1. Cluster headache and sleep, is there a connection?

    DEFF Research Database (Denmark)

    Barløse, Mads; Jennum, P; Knudsen, S;

    2012-01-01

    PURPOSE OF REVIEW: Sleep and the chronobiological disease cluster headache are believed to be interconnected. Despite efforts, the precise nature of the relationship remains obscured. A better understanding of this relation may lead to more effective therapeutic regimes for patients suffering from...... this debilitating disease. This review aims to evaluate the existing literature on the subject of cluster headache and sleep. LATEST FINDINGS: Several previous studies describe an association between episodic cluster headache and distinct macrostructural sleep phases. This association was not confirmed...... in a recent study of seven episodic cluster headache patients, but it was suggested that further studies into the correlation between cluster headache attacks and the microstructure of sleep are relevant. The connection between cluster headache and the hypocretins is currently under investigation...

  2. Prevalence and clinical characteristics of headache in dental students of a tertiary care teaching dental hospital in Northern India

    Directory of Open Access Journals (Sweden)

    Ruchika Nandha

    2013-02-01

    Full Text Available Background: Chronic headache is as much as a problem in India as elsewhere in the world with a rising trend in young adults which negatively affects the quality of life of the affected person. In current scenario of increasing prevalence of headache in students, most of them have been found to practice self medication leading to inappropriate management and sometimes analgesic overuse causing treatment refractoriness. Methods: A questionnaire based survey was done on undergraduate dental students at a tertiary care dental teaching hospital in Northern India. Severity of headache was assessed by Numeric Rating Scale. Data collected was analyzed to assess the prevalence, pattern & triggering factors of headache along with awareness of dental students regarding treatment. Prevalence and characteristics of migraine were also assessed along with the therapeutic strategies opted by students. Results: Our study (n=186 demonstrated headache prevalence of 63.9% which was higher in females (74.3% as compared to males (32.6%. Headache experienced by majority of student population was bilateral (36.13%, sharp stabbing (38.65% and of moderate intensity (57.98%. Common associated symptoms were nausea/ vomiting (24.36% and scalp tenderness (22.68%. Stress (82.3% &irregular sleep (81.5% were the most common triggering factors. Prevalence of migraine was 13.44% with female preponderance (87.5%. Practice of self medication was reported by 88.2% of students. Most commonly used drugs were paracetamol (36.76%, aspirin (26.47% and combination of ibuprofen and paracetamol (25%. Specific medication use in migraineurs was found to be low (25% showing inadequate management of migraine headache in our study population. Conclusions: The results in this study demonstrate high headache prevalence in dental students with self medication being practiced by the majority. [Int J Basic Clin Pharmacol 2013; 2(1.000: 51-55

  3. Nitrate-Induced Headache in Patients with Stable Angina Pectoris: Beneficial Effect of Starting on a Low Dosage.

    Science.gov (United States)

    Cleophas, Ton J.M.; Niemeyer, Menco G.; van Der Wall, Ernst E.

    1996-12-01

    BACKGROUND: Nitrates, although important for the management of angina pectoris, cause significant headache in many patients. METHODS: In a randomized, double-blind crossover study, 89 patients with stable angina pectoris were used to compare two different dosage strategies of isosorbide-5-mononitrate (5-ISMN). Patients were randomized to either 60 mg 5-ISMN once daily (o.d.) for 2 weeks or 30 mg 5-ISMN o.d. for 1 week followed by 60 mg 5-ISMN o.d. for 1 week. A 2-week placebo wash-out ensued, after which the alternative treatment was given. We assessed the occurrence of angina pectoris and headache by diary cards while taking into account the numbers of isosorbide dinitrate sublingual puffs and paracetamole tables required. Data were assessed for carryover and time effects. RESULTS: The two dosage regimens were equally efficient for the relief of angina pectoris without development of tolerance. Thirty percent of the patients never experienced headache from the given dosages. The remainder showed a highly significant time-effect: The total numbers of headache attacks in the 1st period of active treatment were 2,380 vs 1,400 attacks is the 2nd period (p < 0.003), yet significantly fewer patients had headaches on low dosages than high ones (45 vs 57, p < 0.02). CONCLUSIONS: Starting on a low dosage was associated with reduced frequency and severity of headache and did not notably influence the beneficial effect of nitrates on angina pectoris. One in three patients never experienced headache from the given dosages. The overall number of headache attacks in the 1st period of active treatment was significantly higher than that of the 2nd period, irrespective of the dosages given. PMID:11862241

  4. [A retrospective study of infant headache].

    Science.gov (United States)

    Sánchez-Precioso, S; García-Cantó, E; Villaescusa, O; Barbero, P; Moreno, J A; Mulas, F

    1995-01-01

    Headache either as an isolated syndrome or as part of a symptomatic grouping is a frequent reason for medical consultation or hospitalization during childhood and adolescence. We review 94 clinical histories of patients between three and thirteen years of age. Headache was the reason for being hospitalized in all cases. Our aim was to assess its incidence rate, epidemiology, clinical characteristics and etiology in addition to evaluating as to whether complementary examinations carried out during hospitalization were worthwhile. Among the most significant results were the following: age (73 patients were over seven years old, 77.6%), time elapsed for symptomatology to evolve (exactly or less than one week in 45% of cases); family history of migraine in 55 cases (58.5%). The most frequent accompanying symptoms were vomiting (38.2%), nausea (22.3%) and abdominal pain (19.1%). Physical exam was normal in 63 cases (67%) while sixteen patients (17%) had neurological focal signs and/or signs of endocranial hypertension (ECHT). Electroencephalography was performed on 94.6% of the patients and proved pathological in 22 cases (25%). Brain computerized tomography (CT) scan was carried out on 92.5% of the patients with space occupying lesions in 3.2% of the cases. The most frequent final diagnosis (52% of patients) was one of migraine. We did not find any patients with intracranial expansionary processes not showing signs of ECHT and/or neurological focalization, for which reason we doubt the profitability of the almost routine practice of carrying out brain CT scan on patients when severe headache is the sole symptom and where there are no specific findings during physical examination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7497236

  5. [Persistent diarrhea

    Science.gov (United States)

    Andrade, J A; Moreira, C; Fagundes Neto, U

    2000-07-01

    INTRODUCTION: Persistent diarrhea has high impact on infantile morbidity and mortality rates in developing countries. Several studies have shown that 3 to 20% of acute diarrheal episodes in children under 5 years of age become persistent. DEFINITION: Persistent diarrhea is defined as an episode that lasts more than 14 days. ETIOLOGY: The most important agents isolated in persistent diarrhea are: Enteropathogenic E. coli (EPEC), Salmonella, Enteroaggregative E. coli (EAEC), Klebisiella and Cryptosporidium. CLINICAL ASPECTS: In general, the clinical characteristics of patients with persistent diarrhea do not change with the pathogenic agent. Persistent diarrhea seems to represent the final result of a several insults a infant suffers that predisposes to a more severe episode of diarrhea due to a combination of host factors and high rates of enviromental contamination. Therefore, efforts should be made to promptly treat all episodes of diarrhea with apropriate follow-up. THERAPY: The aim of the treatment is to restore hydroelectrolytic deficits and to replace losses until the diarrheal ceases. It is possible in the majority of the cases, using oral rehydration therapy and erly an appropriate type of diet. PREVENTION: It is imperative that management strategies also focus on preventive aspects. The most effective diarrheal prevention strategy in young infants worldwide is promotion of exclusive breast feeding. PMID:14676915

  6. [Thrombocyte function in vasomotor and migraine headaches].

    Science.gov (United States)

    Grotemeyer, K H; Viand, R; Beykirch, K

    1983-05-20

    The number of circulating platelet aggregates was assessed using a modification of the method of Wu and Hoak. The index for the number of circulating aggregates was 1.04 +/- 0.12 for 35 healthy probands aged 35 +/- 11 years and was different from the index of 25 patients with vasomotor headache aged 37 +/- 14 years of 1.1 +/- 0.14 (P less than 0.1). The number of circulating platelet aggregates with an index of 1.38 +/- 0.24 was significantly higher (P less than 0.001) in 48 migraine patients aged 36 +/- 12 years. PMID:6840009

  7. Payroll: A Headache You Can Cure!

    Science.gov (United States)

    Miller, Rita J; Mattern, Jay

    2015-01-01

    Payroll is not only an expense for your practice; it can be a headache for you or your practice manager. Payroll is also a major scope of audit procedures. Don't rely on the word of anyone else that your taxes were processed and remitted. Demand to see proof. By outsourcing your human resources and payroll functions to one company, you can free up valuable time to concentrate on your area of expertise, leaving the administrative hassles to the staffing firm. PMID:26856025

  8. Psychological predictors of headache remission in children and adolescents

    Directory of Open Access Journals (Sweden)

    Carasco M

    2016-04-01

    Full Text Available Marcel Carasco, Birgit Kröner-Herwig Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institut für Psychologie, Georg-August-Universität Göttingen, Göttingen, Germany Objective: Longitudinal studies on headaches often focus on the identification of risk factors for headache occurrence or “chronification”. This study in particular examines psychological variables as potential predictors of headache remission in children and adolescents. Methods: Data on biological, social, and psychological variables were gathered by questionnaire as part of a large population-based study (N=5,474. Children aged 9 to 15 years who suffered from weekly headaches were selected for this study sample, N=509. A logistic regression analysis was conducted with remission as the dependent variable. In the first step sex, age, headache type, and parental headache history were entered as the control variables as some data already existed showing their predictive power. Psychological factors (dysfunctional coping strategies, internalizing symptoms, externalizing symptoms, anxiety sensitivity, somatosensory amplification were entered in the second step to evaluate their additional predictive value. Results: Highly dysfunctional coping strategies reduced the relative probability of headache remission. All other selected psychological variables reached no significance, ie, did not contribute additionally to the explanation of variance of the basic model containing sex and headache type. Surprisingly, parental headache and age were not predictive. The model explained only a small proportion of the variance regarding headache remission (R2=0.09 [Nagelkerke]. Conclusion: Successful coping with stress in general contributed to remission of pediatric headache after 2 years in children aged between 9 and 15 years. Psychological characteristics in general had only small predictive value. The issue of remission definitely needs more scientific attention

  9. Reducing the costs of headache: an Italian approach

    OpenAIRE

    Citterio, Antonietta; Sances, Grazia; Sandrini, Giorgio; Repossi, Tiziana; Nappi, Giuseppe

    2003-01-01

    Headache is the most frequent reason for neurological consultation, but also a comorbidity often encountered by GPs. The costs of headache are considerable: direct and indirect costs contribute to varying degrees to the overall definition of costs in different countries. DRGs related to headache account for a large percentage of hospital admissions (7.67% in 2000 in Lombardy). A recent Italian law defined certain DRGs as “at risk” for frequent inappropriateness of admission: some of these are...

  10. Primary headache in yemen: prevalence and common medications used.

    Science.gov (United States)

    Abdo, Salah A; Amood Al-Kamarany, Mohammed; Alzoubi, Karem H; Al-Maktari, Mohamed T; Al-Baidani, Abdulrhman H

    2014-01-01

    Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen. Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society's diagnostic criteria (2004). Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH) was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH) was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P 0.05). In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL). 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist) regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%). Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45%) were unknown agents. Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen. PMID:25538854

  11. Primary Headache in Yemen: Prevalence and Common Medications Used

    Directory of Open Access Journals (Sweden)

    Salah A. Abdo

    2014-01-01

    Full Text Available Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen. Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004. Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P0.05. In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL. 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%. Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45% were unknown agents. Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.

  12. Management of patients with headache and cervicalgia in outpatient practice

    OpenAIRE

    E. A. Chechet; A. I. Isaikin

    2016-01-01

    The management of patients with headache (cephalgia) concurrent with neck pain (cervicalgia) remains an urgent problem of modern medicine. Concurrent cervicalgia in cephalgia substantially lowers quality of life in these patients and is encountered in more than half the patients. Cervicalgia is considered as a risk factor of migraine and tension headache attacks. Cervicogenic headache is assigned to one of the most common forms of secondary cephalgias. It is shown that patients with daily hea...

  13. Neurometabolic correlates of depression and disability in episodic cluster headache

    OpenAIRE

    Seifert, Christian L.; Valet, Michael; Pfaffenrath, Volker; Boecker, Henning; Rüther, Katharina V.; Tölle, Thomas R.; Sprenger, Till

    2011-01-01

    A close association between pain, depression and disability has been shown. However, the neurometabolic correlates of this association have been barely investigated in disease states. Episodic cluster headache is a severe headache syndrome and represents a suitable disease model for the investigation of episodic pain. The aim of this study was to explore the relationship between depression and disability as well as pain scores and brain metabolism in patients with cluster headache during the ...

  14. Neurometabolic correlates of depression and disability in episodic cluster headache

    OpenAIRE

    Seifert, Christian L.; Valet, Michael; Pfaffenrath, Volker; Boecker, Henning; Rüther, Katharina V.; Tölle, Thomas R.; Sprenger, Till

    2010-01-01

    A close association between pain, depression and disability has been shown. However, the neurometabolic correlates of this association have been barely investigated in disease states. Episodic cluster headache is a severe headache syndrome and represents a suitable disease model for the investigation of episodic pain. The aim of this study was to explore the relationship between depression and disability as well as pain scores and brain metabolism in patients with cluster headache during the ...

  15. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

    Science.gov (United States)

    Conti, P C R; Costa, Y M; Gonçalves, D A; Svensson, P

    2016-09-01

    There are relevant clinical overlaps between some of the painful temporomandibular disorders (TMD) and headache conditions that may hamper the diagnostic process and treatment. A non-systematic search for studies on the relationship between TMD and headaches was carried out in the following databases: PubMed, Cochrane Library and Embase. Important pain mechanisms contributing to the close association and complex relationship between TMD and headache disorders are as follows: processes of peripheral and central sensitisation which take place in similar anatomical areas, the possible impairment of the descending modulatory pain pathways and the processes of referred pain. In addition, the clinical examination does not always provide distinguishing information to differentiate between headaches and TMD. So, considering the pathophysiology and the clinical presentation of some types of headache and myofascial TMD, such overlap can be considered not only a matter of comorbid relationship, but rather a question of disorders where the distinction lines are sometimes hard to identify. These concerns are certainly reflected in the current classification systems of both TMD and headache where the clinical consequences of diagnosis such as headache attributed to or associated with TMD are uncertain. There are several similarities in terms of therapeutic strategies used to manage myofascial TMD and headaches. Considering all these possible levels of interaction, we reinforce the recommendation for multidisciplinary approaches, by a team of oro-facial pain specialists and a neurologist (headache specialist), to attain the most precise differential diagnosis and initiate the best and most efficient treatment. PMID:27191928

  16. Neuroimaging and other investigations in patients presenting with headache

    Directory of Open Access Journals (Sweden)

    Callum W Duncan

    2012-01-01

    Full Text Available Headache is very common. In the United Kingdom, it accounts for 4.4% of primary care consultations, 30% of referrals to neurology services and 0.5-0.8% of alert patients presenting to emergency departments. Primary headache disorders account for the majority of patients and most patients do not require investigation. Warning features (red flags in the history and on examination help target those who need investigation and what investigations are required. This article summarizes the typical presentations of the common secondary headaches and what neuroimaging and other investigations are appropriate for each headache type.

  17. Quality in the provision of headache care. 2

    DEFF Research Database (Denmark)

    Peters, Michele; Jenkinson, Crispin; Perera, Suraj;

    2012-01-01

    The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and U......." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.......The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK......, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the...

  18. Prevalence of Migraine Headache in Epileptic Patients.

    Directory of Open Access Journals (Sweden)

    Sayena Jabbehdari

    2015-06-01

    Full Text Available Epilepsy is one of the most common neurological disorders which a physician might come across in his career life. On the other hand, migraine is common disorders in society chronic headache such as migraine in epileptic patients give ride to difficulties in seizure treatment due to altering the sleeping pattern and calmness disarrangement. Therefore, early diagnosis and suitable treatment in epileptic patients is definitely inevitable, and it will help in a more desirable patients' treatment. So we aimed to evaluate the prevalence of migraine in epileptic patients and relation between these two disorders. Number of 150 epileptic patients attended to neurology clinic of Shohadaye Tajrish Hospital and Iranian Epilepsy Association between June 2010 to May 2011 were fulfilled the questionnaire, and the data has been assessed by SPSS software. In this study, we used MS-Q (migraine screening -questionnaire designed for early diagnosis of migraine in the general population. From all patients filling the questionnaire, the prevalence of migraine (with or without aura was as follows: 23 persons had criteria compatible with migraine with aura; 26 patients had migraine without aura. Migraine was more common in these patients: persons with academic degrees, women, patients who were used 2 antiepileptic drugs, and patients with high BMI. In this study, we showed that migraine in epileptic patients is more prevalent than the general population. Thus, early diagnosis and efficient treatment of migraine headache in these patients is mandatory. More studies are needed for evaluation of this issue.

  19. Cluster headache or narrow angle glaucoma?

    Directory of Open Access Journals (Sweden)

    Prasad Palimar

    1991-01-01

    Full Text Available A 47 year old man with episodes of attacks of pain, redness and mild blurring of vision was investigated for narrow angle glaucoma in view of shallow anterior chambers and a cupped optic disc. The history was reviewed following a spontaneous attack in hospital, which had features other than acute glaucoma. A diagnosis of cluster headache was made on the basis of tests. Cluster headache has been defined as unilateral intense pain, involving the eye and head on one side, usually associated with flushing, nasal congestion and lacrimation; the attacks recurring one or more times daily and lasting 20 - 120 minutes. Such attacks commonly continue for weeks or months and are separated by an asymptomatic period of months to years. This episodic nature, together with unilaterality and tendency to occur at night, closely mimics narrow angle glaucoma. Further, if patients have shallow anterior chambers and disc cupping, the differentiation becomes more difficult yet critical. Resource to provocative tests is often the only answer as the following case report demonstrates.

  20. Disruption of an M. tuberculosis Membrane Protein Causes a Magnesium-dependent Cell Division Defect and Failure to Persist in Mice

    Science.gov (United States)

    Goodsmith, Nichole; Guo, Xinzheng V.; Vandal, Omar H.; Vaubourgeix, Julien; Wang, Ruojun; Botella, Hélène; Song, Shuang; Bhatt, Kamlesh; Liba, Amir; Salgame, Padmini; Schnappinger, Dirk; Ehrt, Sabine

    2015-01-01

    The identification of Mycobacterium tuberculosis genes necessary for persistence in vivo provides insight into bacterial biology as well as host defense strategies. We show that disruption of M. tuberculosis membrane protein PerM (Rv0955) resulted in an IFN-γ-dependent persistence defect in chronic mouse infection despite the mutant’s near normal growth during acute infection. The perM mutant required increased magnesium for replication and survival; incubation in low magnesium media resulted in cell elongation and lysis. Transcriptome analysis of the perM mutant grown in reduced magnesium revealed upregulation of cell division and cell wall biosynthesis genes, and live cell imaging showed PerM accumulation at the division septa in M. smegmatis. The mutant was acutely sensitive to β-lactam antibiotics, including specific inhibitors of cell division-associated peptidoglycan transpeptidase FtsI. Together, these data implicate PerM as a novel player in mycobacterial cell division and pathogenesis, and are consistent with the hypothesis that immune activation deprives M. tuberculosis of magnesium. PMID:25658098

  1. Superior vena caval syndrome caused by the tumor of the left hilum in a patient with unilateral persistent left superior vena cava diagnosed with multislice spiral computed tomography-a case report

    International Nuclear Information System (INIS)

    Unilateral persistent left superior vena cava (PLSVC) is an infrequent finding with incidence of 18-20% among the individuals with PLSVC. The persistence of the left-sided superior vena cava is an effect of disturbances in development of the connection between the precardinal veins (anterior cardinal veins) and formation of the sinus venosus in early stages of embryogenesis. The paper presents a case of a 62-year-old patient with a mass lesion of the left hilum, which caused left-sided superior vena caval syndrome in the presence of unilateral SVC. Developmental mechanisms of superior vena caval syndrome are discussed. The evolution of changes related to infiltration and occlusion of PLSVC is shown on the basis of three selected MSCT examinations. (author)

  2. Persistent Modelling

    DEFF Research Database (Denmark)

    2012-01-01

    The relationship between representation and the represented is examined here through the notion of persistent modelling. This notion is not novel to the activity of architectural design if it is considered as describing a continued active and iterative engagement with design concerns – an evident...... characteristic of architectural practice. But the persistence in persistent modelling can also be understood to apply in other ways, reflecting and anticipating extended roles for representation. This book identifies three principle areas in which these extensions are becoming apparent within contemporary....... It also provides critical insight into the use of contemporary modelling tools and methods, together with an examination of the implications their use has within the territories of architectural design, realisation and experience....

  3. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population

    Directory of Open Access Journals (Sweden)

    Ajai Kumar Singh

    2013-01-01

    Full Text Available Objective: To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity. Materials and Methods: Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI scale at the time of enrolment and at 3 months. Results: CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM accounted for 59 patients, chronic tension type headache (CTTH 22 patients, new daily persistent headache (NDPH 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7% as compared to CTTH (36.4%. Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients. Conclusion: Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.

  4. The Effect of Migraine Headache on Educational Attainment

    Science.gov (United States)

    Rees, Daniel I.; Sabia, Joseph J.

    2011-01-01

    Despite the fact that migraine headaches are common and debilitating, little is known about their effect on educational attainment. Using data drawn from the National Longitudinal Study of Adolescent Health, we estimate the relationship between migraine headache and three outcomes: high school grade point average, the probability of graduating…

  5. The art of history-taking in a headache patient

    Directory of Open Access Journals (Sweden)

    K Ravishankar

    2012-01-01

    Full Text Available Headache is a common complaint that makes up for approximately 25% of any neurologists outpatient practice. Yet, it is often underdiagnosed and undertreated. Ninety percent of headaches seen in practice are due to a primary headache disorder where there are no confirmatory tests, and neuroimaging studies, if done, are normal. In this situation, a good headache history allows the physician to recognize a pattern that in turn leads to the correct diagnosis. A comprehensive history needs time, interest, focus and establishment of rapport with the patient. When to ask what question to elicit which information, is an art that is acquired by practice and improves with experience. This review discusses the art of history-taking in headache patients across different settings. The nuances of headache history-taking are discussed in detail, particularly the questions related to the time, severity, location and frequency of the headache syndrome in general and the episode in particular. An emphasis is made on the recognition of red flags that help in the identification of secondary headaches.

  6. Headache classification and aspects of reproductive life in young women

    Directory of Open Access Journals (Sweden)

    Eliana M. Melhado

    2014-01-01

    Full Text Available Objective: To classify headaches as a function of the menstrual cycle and to contrast aspects relating to the reproductive cycle as a function of headache type. Method: Participants responded to a structured questionnaire consisting of 44 questions. Detailed headache information, enabling the classification of headaches, and questions relating to the menstrual cycle were obtained. Results: The sample consisted of 422 students. Menstrual headaches were experiencedby 31.8%. Migraine without aura (MO occurred in 13.3%, migraine with aura (MA in 7.8%, and probable migraine in 6.4%. Women with MA were significantly more likely to have reached menarche at earlier ages than women without headaches (p=0.03. Use of a hormonal contraceptive was related to the function of having MA headaches or not. Conclusion: Most female college students are affected by menstrualheadaches. Although the vast majority experience MO, other headaches also occur. Women with MA are equally likely to receive hormonal contraceptives as others.

  7. Headache associated with airplane travel: A rare entity

    Directory of Open Access Journals (Sweden)

    Ajith Cherian

    2013-01-01

    Full Text Available Airplane travel headache is rare and has recently been described as a new form of headache associated with a specific situation. Of the 1,208 patients with primary headaches attending a tertiary care neurology hospital, two (0.16% patients satisfied the criteria for headache related to airplane travel. Both the patients fulfilled the proposed diagnostic criteria for airplane travel headache. This unique headache had a mean duration of 24 minutes, localized to the medial supraorbital region described as having an intense jabbing or stabbing character that occurred exclusively and maximally during aircraft landing or take-off, following which pain intensity subsided . This rare headache felt on aircraft descent is probably due to the squeeze effect on the frontal sinus wall, when air trapped inside it contracts producing a negative pressure leading to mucosal edema, transudation and intense pain. Use of nasal decongestants either alone or in combination with naproxen sodium prior to ascent and descent abated the headache episodes. Awareness about this unique entity is essential to provide proper treatment and avoid patient suffering.

  8. Headache after exposure to ‘date-rape’ drugs

    OpenAIRE

    Peatfield, Richard; Villalón, Carlos M

    2013-01-01

    Summary We report two patients who developed a prolonged featureless headache, they think after a drink was ‘spiked’. We speculate that each was exposed to scopolamine, resulting in enhanced trigeminal release of vasodilator neuropeptides, including Calcitonin Gene-Related Peptide (CGRP), and thus the headache.

  9. Sense of coherence and medicine use for headache among adolescents

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Holstein, Bjørn E

    2009-01-01

    standardized questionnaire. The outcome measure was self-reported medicine use for headaches. The determinants were headache frequency and SOC measured by Wold and Torsheim's version for children of Antonovsky's 13-item SOC scale. RESULTS: Analyses adjusted for age group, family social class, exposure to...

  10. Diagnostic criteria for headache attributed to temporomandibular disorders

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas;

    2012-01-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD).......We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD)....

  11. Persistent dural cerebrospinal fluid leak shown by retrograde radionuclide myelography: case report

    International Nuclear Information System (INIS)

    Following inadvertent spinal anesthesia for delivery, a patient developed incapacitating post-lumbar puncture headache that persisted for 9 weeks. Scintigrams of the lumbar region, obtained after injection of /sup 99m/Tc-human serum albumin into the cisterna magna, showed the cerebrospinal fluid leak. Blood patch repair was carried out, with immediate relief of all symptoms. Because of subsequent atypical headaches, a second cisternogram was done by the same technique. This study confirmed that there was no further dural leak, and other evidence indicated that the recurrent headache was related to functional problems

  12. Habit persistence

    DEFF Research Database (Denmark)

    Vinther Møller, Stig

    2009-01-01

    This paper uses an iterated GMM approach to estimate and test the consumption based habit persistence model of Campbell and Cochrane (1999) on the US stock market. The empirical evidence shows that the model is able to explain the size premium, but fails to explain the value premium. Further, the...

  13. Treatment for chronic daily headache by using auxiliary and alternative methods

    Directory of Open Access Journals (Sweden)

    V. A. Golovacheva

    2015-06-01

    Full Text Available Chronic daily headache (CDH is one of the top 10 causes of adult disability and one of the 5 most common causes of female disability. To treat patients with CDH is one of the most difficult tasks in neurological practice. Difficulties in managing patients with CHD are associated with the high prevalence of comorbid mental disorders, analgesic abuse, pain syndromes at another site, and misconceptions of a patient about his/her disease. A combination of drug and non-drug therapies is the mainstay of the current approach to treating patients with CDH. Standard, alternative, and auxiliary therapies are identified. The paper describes different types of current auxiliary and alternative therapy used in the world’s leading headache centers and clinics. It describes experience with cerebrolysin used as auxiliary and alternative pharmacotherapies for CDH.

  14. Cluster Headache Secondary to Macroprolactinoma with Ipsilateral Cavernous Sinus Invasion

    Directory of Open Access Journals (Sweden)

    M. J. Levy

    2012-01-01

    Full Text Available We present a 25 year-old man with episodic cluster headache that was refractory to all standard pharmacological prophylactic and abortive treatments. Because of the lack of response, an MRI brain was performed which showed a large pituitary tumour with ipsilateral cavernous sinus invasion. The serum prolactin was significantly elevated at 54,700 miU/L (50–400 confirming a macro-prolactinoma. Within a few days of cabergoline therapy the headache resolved. He continues to be headache free several years after starting the dopamine agonist. This case highlights the importance of imaging the pituitary fossa in patients with refractory cluster headache, It also raises the potential anatomical importance of the cavernous sinus in pituitary-associated headache.

  15. Prevalence of chronic headache with and without medication overuse

    DEFF Research Database (Denmark)

    Westergaard, Maria Lurenda; Glümer, Charlotte; Hansen, Ebba Holme;

    2014-01-01

    Near-daily intake of acute symptomatic medication for frequent headache increases the risk for medication-overuse headache (MOH). Chronic headache (CH) and MOH prevalences are inversely related to socioeconomic position (SEP). It is not known how SEP influences the health status of people with...... mental health composite scores (SF-12) were summarized per headache group, stratified by SEP, and compared to the sample mean. Analyses were adjusted for stratified sampling and nonresponse. The response rate was 53.1%. CH prevalence was 3.3% with 53.0% of cases having concurrent medication overuse (MOH...... these headaches. This cross-sectional study examined the prevalence of CH in Denmark; possible associations between CH and education, work status, and income; and the health status of people with CH across socioeconomic strata. A total of 129,150 individuals aged ⩾16years were invited to the 2010 Danish...

  16. Chronic unremitting headache associated with Lyme disease-like illness

    Directory of Open Access Journals (Sweden)

    Pedro Andre Kowacs

    2013-07-01

    Full Text Available The Brazilian Lyme-disease-like illness (BLDLI or Baggio-Yoshinari syndrome is a unique zoonosis found in Brazil. It reproduces all the clinical symptoms of Lyme disease except for the high frequencies of relapse and the presence of autoimmune manifestations. Two cases of borreliosis manifesting with unremitting headache, which is a symptom associated with late-stage BLDLI, were presented. Clinical, therapeutic, and prognostic aspects of the BLDLI and its associated headaches were showed and discussed in this article. BLDLI diagnosis requires additional attention by physicians, since the disease has a tendency to progress to the late, recurrent stage or the chronic form, and the associated headache can be confused with chronic primary headache or with analgesic-overuse one. Special attention should be paid to patients with headaches who have traveled to endemic areas.

  17. Quality in the provision of headache care. 1

    DEFF Research Database (Denmark)

    Peters, Michele; Perera, Suraj; Loder, Elizabeth;

    2012-01-01

    37 evaluated processes of headache care. Most were relevant only to specific populations of patients and to care delivered in high-resource settings. Indicators had been used to describe overall quality of headache care at a national level, but not systematically applied to the evaluation and......Widely accepted quality indicators for headache care would provide a basis not only for assessment of care but also, and more importantly, for its improvement. The objective of the study was to identify and summarize existing information on such indicators: specifically, did indicators exist, how...... had they been developed, what aspects of headache care did they relate to and how and with what utility were they being used? A systematic review of the medical literature was performed. A total of 32 articles met criteria for inclusion. We identified 55 existing headache quality indicators of which...

  18. Cefalea en el niño: utilidad de la clasificación internacional de cefalea (IHS 1988 Headache in children: the utility of the International Classification of Headaches (IHS 1988

    Directory of Open Access Journals (Sweden)

    Eliana Rodillo B.

    2000-11-01

    Full Text Available El objetivo de este estudio prospectivo de cefalea en el niño fue conocer la prevalencia de consultas por cefalea en el policlínico de Neurología del Hospital Roberto del Río, las características clínicas, el tipo de cefalea y la utilidad en niños de la clasificación internacional de cefalea dada por la International Headache Society 1988. Entre enero y junio 1994, tuvimos 114 consultas por cefalea, de un total de 5 612, al policlínico de Neurología del Hospital de Niños Roberto del Río, lo que dio una prevalencia de 2%. Hubo 68 mujeres y 46 hombres, edades entre 3,5 y 14,8 años. Todos sufrían cefaleas recurrentes. La aplicación de la clasificación internacional nos permitió clasificar el 75% de los casos, con una distribución de 66% vascular, 8% tensional y 26% no definida.The purpose of this prospective study of headache in children was to determine the prevalence of headache in a Paedriatric Neurology outpatient clinic, clinical features, type of headache and the utility of using the classification of headaches by the IHS in 1988 in children. Between january and june 1994 we assessed 114 patients with headache out of a patient population of 5,612 in the Roberto del Rio Children’s Hospital, a prevalence of 2%. There were 68 females, 46 males aged between 3.5 and 14.8 years. All suffered recurrent headaches, using the IHS classifcation 74% of patients had a defined cause, 66% vascular, 8% tensional. 26% of children could not be classified

  19. [Treatment of primary empty sella with intractable headache via the transsphenoidal approach].

    Science.gov (United States)

    Hashimoto, N; Okamoto, S; Yamagami, T; Kojima, M; Nakahara, I; Handa, H

    1985-07-01

    Two cases of primary empty sella with intractable headache were treated via the transsphenoidal approach. One patient was a fifty-three-year-old female with right upper nasal quadrantanopsia and intractable retrobulbar pain and the other was fourty-six-year-old female with continuous retrobulbar pain with a history of transient right temporal hemianopsia. Both cases were diagnosed by metrizamide CT cisternography. They had normal endocrinological functions. They did not respond to drug therapy and were treated surgically. In each case, the dura mater of the floor of the sella was elevated with lyophilized human dura mater and bone fragments obtained during the procedure. In the former case, significant improvement of visual field defect was not obtained but the retrobulbar pain disappeared completely after the operation. In the latter case which had intractable headache for six months, the symptom disappeared just after the operation. Until now, retroorbital pain has not recurred in both cases for several months. Primary empty sella has been considered to be a benign condition except in some cases with CSF rhinorrhea or with visual disturbance. Headache which is often accompanied to primary empty sella has rarely been treated surgically because it is difficult to know whether the headache is related to the empty sella or not. Another reason may be that there is few available data concerning to the efficacy of surgical treatment. Headache caused by stretching of the dura of the floor of the sella is usually frontal or retrobulbar, continuous, profound and intractable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4047326

  20. Headache in acute ischaemic stroke: a lesion mapping study.

    Science.gov (United States)

    Seifert, Christian L; Schönbach, Etienne M; Magon, Stefano; Gross, Elena; Zimmer, Claus; Förschler, Anette; Tölle, Thomas R; Mühlau, Mark; Sprenger, Till; Poppert, Holger

    2016-01-01

    Headache is a common symptom in acute ischaemic stroke, but the underlying mechanisms are incompletely understood. The aim of this lesion mapping study was to identify brain regions, which are related to the development of headache in acute ischaemic stroke. Patients with acute ischaemic stroke (n = 100) were assessed by brain MRI at 3 T including diffusion weighted imaging. We included 50 patients with stroke and headache as well as 50 patients with stroke but no headache symptoms. Infarcts were manually outlined and images were transformed into standard stereotaxic space using non-linear warping. Voxel-wise overlap and subtraction analyses of lesions as well as non-parametric statistics were conducted. The same analyses were carried out by flipping of left-sided lesions, so that all strokes were transformed to the same hemisphere. Between the headache group as well as the non-headache there was no difference in infarct volumes, in the distribution of affected vascular beds or in the clinical severity of strokes. The headache phenotype was tension-type like in most cases. Subtraction analysis revealed that in headache sufferers infarctions were more often distributed in two well-known areas of the central pain matrix: the insula and the somatosensory cortex. This result was confirmed in the flipped analysis and by non-parametric statistical testing (whole brain corrected P-value Insular strokes turned out to be strongly associated with headache. As the insular cortex is a well-established region in pain processing, our results suggest that, at least in a subgroup of patients, acute stroke-related headache might be centrally driven. PMID:26603369

  1. Anger and emotional distress in patients with migraine and tension–type headache

    OpenAIRE

    Perozzo, P; Savi, L; L. Castelli; Valfrè, W.; Lo Giudice, R.; Gentile, S.; I. Rainero; Pinessi, L.

    2005-01-01

    The objective was to evaluate the prevalence and the characteristics of anger and emotional distress in migraine and tension– type headache patients. Two hundred and one headache patients attending the Headache Center of the University of Turin were selected for the study and divided into 5 groups: (1) migraine, (2) episodic tension–type headache, (3) chronic tension–type headache, (4) migraine associated with episodic tension–type headache and (5) migraine associated with chronic tension–typ...

  2. Primary headache in children and adolescents: update on pharmacotherapy of migraine and tension-type headache.

    Science.gov (United States)

    Bonfert, Michaela; Straube, Andreas; Schroeder, Andreas Sebastian; Reilich, Peter; Ebinger, Friedrich; Heinen, Florian

    2013-02-01

    Primary headache disorders are frequently encountered in the pediatric population. The therapeutic approach consists of a multimodal program, including lifestyle modification, psychotherapeutic intervention, pharmacotherapy, and complementary measures. This systematic review focuses on the pharmacotherapy of pediatric migraine and tension-type headache (TTH). In addition to the general treatment principles, the results of 33 clinical reports published on the topic since 2008 are outlined in detail. Furthermore, a tabular summary of previously investigated agents not studied since 2008 is given, as is an overview of promising pharmacologic approaches so far only evaluated in adults. A variety of pharmacologic options is available, but high-quality evidence is limited to single agents. At this time, approval is restricted to four triptans and flupirtine for the symptomatic treatment of pediatric acute migraine and TTH, respectively. No agent has been approved for the prevention of pediatric primary headaches. This review does not grade the drugs hierarchically because the complex profiles of many agents differ only slightly or even overlap. However, a detailed expert opinion is provided. On the basis of the outlined facts, the team of physician, patient, and parents has to decide on the most appropriate regimen for the individual situation in the sense of personalized medicine. PMID:23303551

  3. A COMPARISOM BETWEEN THE EFFECTTIVENESS OF RELAXATION TRAINING AND PHARMACOTHERAPY IN TREATMENT OF PATIENTS WITH TENSION HEADACHE

    Directory of Open Access Journals (Sweden)

    R BAGHERIAN

    2003-12-01

    Full Text Available

    Introduction: Headaches are the common cause of refferals to physicians, and among them, tension headache is the most prevalent. There is not consens us on the effectiveness of a specific therapeutic procedure. However, the purpose of this study was to identify the effects of relaxation training in comparison to pharmacotherapy in treatment of tension headache.
    Procedures: The study employed an experiment design with two treatment group (N=12 One treatment group gaticipated in a relaxation training program over an 8-week period. A second treatment group was only given Amitriptyline. Data collected over a 2 - week period before and after treatment by using a dialy headache scale used by patients and visual analog scale used by one of the patient";s relatives. Back depression scale and zung Anxietys scale were used for evaluating levels of depression and Anxiety in patients.
    Results: Mean score of improvement in relaxation training was significantly higher than that of Amitriptyline group (t=3.85 , P < 0.01 Also the relaxation group demonstrated lower mean score of headache peak than that of peak than that of Amitriptyline  group (t=2.6, p < 0.01. However, regarding to visual analog scale there was no statistically significant difference between two groups.in respect of distribution of patients among different improvement levels, the relaxation training group was significantly better than Amitriptyline group (x2=6.66, df=2, p < 0.01
    Discussion: The relaxation training was more effective than Amitriptuline in decreasing headach for patients with tension headache.

  4. Semibiotic Persistence

    OpenAIRE

    Prothmann, C.; Zauner, K.-P.

    2014-01-01

    From observation, we find four different strategies to successfully enable structures to persist over extended periods of time. If functionally relevant features are very large compared to the changes that can be effectuated by entropy, the functional structure itself has a high enough probability to erode only slowly over time. If the functionally relevant features are protected from environmental influence by sacrificial layers that absorb the impinging of the environment,deterioration can ...

  5. Headache attributed to temporomandibular disorders and masticatory myofascial pain.

    Science.gov (United States)

    Hara, Kazuhiko; Shinozaki, Takahiro; Okada-Ogawa, Akiko; Matsukawa, Yumiko; Dezawa, Ko; Nakaya, Yuka; Chen, Jui-Yen; Noma, Noboru; Oka, Shunichi; Iwata, Koichi; Imamura, Yoshiki

    2016-01-01

    We investigated the temporal association between temporomandibular disorders (TMD)-related symptoms and headache during TMD treatment for patients who fulfilled the diagnostic criteria for headache attributed to TMD (HATMD) specified in the Diagnostic criteria for TMD (DC/TMD) and International classification of headache disorders (ICHD)-3 beta. The study enrolled 34 patients with HATMD induced by masticatory myofascial pain but not by temporomandibular arthralgia. Facial pain intensity, the pressure pain threshold of pericranial muscles, and maximum unassisted opening of the jaw were assessed at an initial examination and before and after physical therapy. The intensity and frequency of headache episodes and tooth contact ratio were also recorded before and after the intervention. Headache intensity and frequency significantly decreased, and these reductions were temporally related to improvements in facial pain intensity, maximum unassisted opening, and pressure pain threshold during TMD treatment. Linear regression analysis showed significant correlations between facial pain intensity and headache intensity and between tooth contact ratio and pressure pain threshold. Among patients who fulfilled the DC/TMD and ICHD-3 beta diagnostic criteria for HATMD, headache improved during TMD treatment, and the improvement was temporally related to amelioration of TMD symptoms. These findings suggest that sensitization in the central and peripheral nervous systems is responsible for HATMD. (J Oral Sci 58, 195-204, 2016). PMID:27349540

  6. An attenuated Lassa vaccine in SIV-infected rhesus macaques does not persist or cause arenavirus disease but does elicit Lassa virus-specific immunity

    OpenAIRE

    Zapata, Juan C.; Poonia, Bhawna; Bryant, Joseph; Davis, Harry; Ateh, Eugene; George, Lanea; Crasta, Oswald R.; Yan ZHANG; Slezak, Tom; Jaing, Crystal; Pauza, C D; Goicochea, Marco; Moshkoff, Dmitry; Lukashevich, Igor S.; Salvato, Maria S.

    2013-01-01

    Abstract Background Lassa hemorrhagic fever (LHF) is a rodent-borne viral disease that can be fatal for human beings. In this study, an attenuated Lassa vaccine candidate, ML29, was tested in SIV-infected rhesus macaques for its ability to elicit immune responses without instigating signs pathognomonic for arenavirus disease. ML29 is a reassortant between Lassa and Mopeia viruses that causes a transient infection in non-human primates and confers sterilizing protection from lethal Lassa viral...

  7. Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study

    DEFF Research Database (Denmark)

    Buchgreitz, L.; Egsgaard, L.L.; Jensen, R.; Arendt-Nielsen, L.; Bendtsen, L.

    Central sensitization caused by prolonged nociceptive input from muscles is considered to play an important role for chronification of tension-type headache. In the present study we used a new high-density EEG brain mapping technique to investigate spatiotemporal aspects of brain activity in...

  8. DETECTION OF TREATMENT IN 35 CASES ClRVICAL VERTEBRAE DISEASE WITH COMPLAINT Of HEADACHE BY CERVICAL VERTEBRAL DRAW

    Institute of Scientific and Technical Information of China (English)

    LIU QIN; ZHOU JING; YU ZI FENG

    2000-01-01

    OBJECTION:To explore the effeetive therapy mechanisa of cervical vertebrae disease characteristic of the complaint of herdache by cervical vertebrae draw. HRTHODS: With the SR2 type multiple autotherapy mchine (made in Jianesue province),the patient was put on the drawing band of cervix and jaw,kept such aposition of cervical vertrbrae 15-30 degrees bent ahead,5. 5kg draving weight was used beginning and then incrcasing to 6-8kg as thc symptoms improved. Onc or two times aday, ever times 30 minutes,lO dags a therapg course.RESULT: Headache in these all treating patients had disappeared,other company symptoms had some degree changed or disappeared,such as dizzg ,eye flower and hand insensiliv elc. 6 cases of these patients recurred in a half of year after theatment.Affer cervical vertebrae draw 1 - 3 therapy course again, the somptoms disappeared too. DISCASION: Cervical vertebrae diserse with the complaint of herdache casyly misdiagnosed with other discase caused headache,especially aigraime, tt is important to note this. The main cause of cervical vertebrae disease headache is ossifg of those bones, which compressed the cervical nervous root and caused reflex headache and which caused vertebral- basilar atery ischemic attack and systolie- diastolic abnormal function of the brain blood vssel.So cervical vertebrae draw had more effective use of this. CONCLUSION: Cervical vertebraee draw is a simple, safly and effectivc way to trcat ccrvical vcrtcbrac discasc.

  9. Migraine and tension-type headache triggers in a Greek population

    Directory of Open Access Journals (Sweden)

    Vasilios Constantinides

    2015-08-01

    Full Text Available Migraine and tension type headache are the two most common primary headaches. The purpose of this study was to detect differences in clinical characteristics and headache triggers and in a Greek cohort of 51 migraineurs and 12 patients with tension-type headache. (TTH Migraine patients had a significantly lower age at headache onset and frequency, higher mean visual analogue scale (VAS and greater maximum duration of headache episodes compared to TTH patients. They did not differ from (TTH patients in quality of headache, laterality of pain, way of headache installation and progression and temporal pattern of headaches. Nausea, vomiting and phonophobia were more frequent in migraine. Triggering of headaches by dietary factors was associated with migraine, whereas there was no difference between the two groups in any of the other headache triggers. Stress, both physical and psychological, were particularly common in both patient groups.

  10. Prevalence and impact of headache in undergraduate students in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2010-12-01

    Full Text Available OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS, to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001. In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

  11. Headache in the writings of Elizabeth Gaskell (1810-1865).

    Science.gov (United States)

    Larner, A J

    2015-11-01

    Mrs Elizabeth Gaskell was a celebrated author of the Victorian era, a friend of both Charles Dickens and Charlotte Brontë and the latter's first biographer. References to headache in Mrs Gaskell's six major novels, published between 1848 and 1866 as well as some of her shorter fiction, have been collated. These multiple references suggest that Elizabeth Gaskell used headache as a narrative device, possibly based on her own experience of headache and that of female acquaintances, most notably Charlotte Brontë. PMID:24585607

  12. Postnatal day 7 ethanol treatment causes persistent reductions in adult mouse brain volume and cortical neurons with sex specific effects on neurogenesis

    OpenAIRE

    Coleman, Leon G.; Oguz, Ipek; Lee, Joohwi; Styner, Martin; Crews, Fulton T.

    2012-01-01

    Ethanol treatment on postnatal day seven (P7) causes robust brain cell death and is a model of late gestational alcohol exposure (Ikonomidou et al., 2000). To investigate the long-term effects of P7 ethanol treatment on adult brain, mice received either two doses of saline or ethanol on P7 (2.5g/kg, s.c., 2 hours apart) and were assessed as adults (P82) for brain volume (using postmortem MRI) and cellular architecture (using immunohistochemistry). Adult mice that received P7 ethanol had reduc...

  13. A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. a multicentre European and Latin American study

    DEFF Research Database (Denmark)

    Jensen, Rigmor Højland; Tassorelli, C; Rossi, P; Allena, M; Osipova, V; Steiner, Tj; Sandrini, G; Olesen, J; Nappi, G

    2011-01-01

    Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1:1 randomizat......Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1...

  14. Migraine Headache Treatment & Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Migraine Headaches Treatment & Research Past Issues / Fall 2015 Table of Contents Nondrug Options to Manage Migraine Pain Dr. Josephine P. Briggs discusses complementary migraine ...

  15. Headaches in antiquity and during the early scientific era.

    Science.gov (United States)

    Magiorkinis, Emmanouil; Diamantis, Aristidis; Mitsikostas, Dimos-Dimitrios; Androutsos, George

    2009-08-01

    This paper presents the evolution of ideas on headache symptoms from antiquity through the 19th century. A thorough study of texts, medical books and reports along with a review of the available literature in PubMed was undertaken: observations on headaches date back nearly 4,000 years to the ritual texts of Mesopotamia. Nicolaes Tulp, Thomas Willis and Gerhard van Swieten also made important contributions on various forms of headaches in the 17th and 18th centuries. Edward Liveing and William Gowers made the major contributions to the field in the late 19th century. Overall, observations on headaches span a timeline of nearly 9,000 years. The work of the physicians during the 18th and 19th century, however, set the basis for scientific research. PMID:19288044

  16. Scar neuromas as triggers for headache after craniotomy: clinical evidence

    Directory of Open Access Journals (Sweden)

    Karen dos Santos Ferreira

    2012-03-01

    Full Text Available We present four cases of headache with variable intensity, located in close proximity to a craniotomy incision which was performed for non-traumatic reasons. Since manual palpation of the scar often triggers pain, and infiltration with local anesthetics reduce or abolish the pain in some patients, we suggest that neuromas or nerve entrapment in the scars, as a result of the surgery, are responsible for headaches. Although local infiltrations or nerve blocks are often used for diagnostic reasons, herein we consider that they are also of therapeutic value. We review the current known pathophysiology of post-craniotomy headaches and present a hypothesis suggesting a greater recognition of the potential contribution of neuroma formation in areas of scars tissue to contribute to this kind of headache.

  17. Diagnostic outcome of patients presenting with severe thunderclap headache at saidu teaching hospital

    International Nuclear Information System (INIS)

    To find out the frequency of patients attending Casualty department of a Teaching Hospital with sudden severe thunderclap headache, their diagnostic out-come and follow up. The study was conducted in Casualty and Medical, Departments of Saidu Teaching Hospital, Saidu Sharif, from January 2006 to December 2006. Out of 22,000 patients with different Medical problems attended Casualty department during study period of which 128 cases had acute severe thunderclap headache. Age range was 15 to 80 years with mean age of 46+-10 years. Seventy eight patients (61%) were female and fifty (39%) were male. Protocol included proper clinical examination, basic laboratory investigations, admission to the General medical ward / Intensive care unit for observation, treatment and follow-up. CT scan of brain and or lumber puncture was performed in all the studied patients. The in-hospital follow up period was from two to fourteen days. The patients were reviewed one month later after discharge from hospital. Out of 120 patients twenty cases (15.6%) had Subarachnoid haemorrhage (SAH) seven patients (5.4%) had Cerebral infarction, five patients (3.9%) had an Intracerebral Haematoma. Five patients (3.9%) had aseptic meningitis. Two cases (1.5%) were reported as cerebral edema. One case (0.8%) had venous sinus thrombosis. As there was no specific finding on investigations and follow up of 88 cases (69%): these were labeled as idiopathic thunder-clap headache. Past history of not more than three similar episodes was present in 33 cases (25.78%). Out of these 33 cases, thirty belonged to the benign group of 88; other three cases had organic causes. Clinical diagnosis of Migraine was made in 37 cases out of these 88 cases. Attack of severe thunderclap headache is not an un-common emergency. Attack due to Subarachnoid haemorrhage (SAH) or other serious underlying disease cannot be distinguished from non specific headaches on clinical grounds alone. It is recommended that all such patients be

  18. Report of cluster headache in a pair of monozygous twins

    OpenAIRE

    Pedro A. Kowacs; Elcio J. Piovesan; Lineu C. Werneck; Fameli, Hudson; Marcos C. Lange; Raskin, Salmo

    2004-01-01

    A pair of identical twins with cluster headache is described. Monozygosity was confirmed by the identification of 14 DNA markers. In spite of harboring the same genes, the clinical picture presented by the twins was not exactly the same. Cluster headache is probably the best known trigeminal-autonomic cephalalgia, but several questions regarding its pathophysiology remain to be answered. The cases described herein reinforce the role of genetic aspects in its etiology.

  19. Refractory headaches treated with bilateral occipital and temporal region stimulation

    OpenAIRE

    Zach KJ; Trentman TL; Zimmerman RS; DW, Dodick

    2014-01-01

    Kelly J Zach,1 Terrence L Trentman,1 Richard S Zimmerman,2 David W Dodick31Department of Anesthesiology, 2Department of Neurosurgery, 3Department of Neurology, Mayo Clinic in Arizona, Phoenix, AZ, USAObjectives: To describe use of bilateral temporal and occipital stimulator leads for a refractory headache disorder.Materials and methods: A 31-year-old female had a 10-year history of chronic, severe occipital and temporal region headaches. The patient underwent permanent implant of an occipital...

  20. How to investigate and treat: headache and hyperprolactinemia.

    Science.gov (United States)

    Bussone, Gennaro; Usai, Susanna; Moschiano, Franca

    2012-08-01

    Hyperprolactinemia is a condition characterised by an increase of prolactin blood levels (more than 100-200 ng/ml). It is the most common endocrine disorder of the hypothalamic-pituitary axis. The clinical characteristics of the headache-hyperprolactinemia-hypophyseal-adenoma association are discussed, the various diagnostic and treatment possibilities are explored and the etiology of the headache is considered in the light of several pathogenetic possibilities. We present two cases. (1) A 35-year-old woman suffering from chronic tension-type headache interspersed with occasional episodes of migraine without aura (as defined by the International Headache Society criteria). She had also suffered menstrual cycle alterations since the age of 16. At the age of 30 she developed amenorrhea with hyperprolactinemia. Computed tomography (CT) and magnetic resonance imaging (MRI) scans revealed a median-left intrasellar mass. Treatment with cabergoline resulted in complete resolution of both types of headache and the menstrual cycle and prolactin levels returned to normal. The therapy also reduced the volume of the tumour. (2) The second case relates to a 47-year-old man who had been suffering from tension-type headaches for almost 3 months. The patient had never previously suffered from headaches. CT and MRI scans showed a large sellar and suprasellar lesion with raised serum prolactin levels. Treatment with cabergoline had significantly reduced the prolactin levels and had also improved the patient's headaches. High-resolution CT, with and without contrast, or MRI is necessary to visualise microprolactinomas (and other sellar lesions) and confirm the diagnosis. PMID:22639180

  1. The primary headaches: genetics, epigenetics and a behavioural genetic model

    OpenAIRE

    Montagna, Pasquale

    2008-01-01

    The primary headaches, migraine with (MA) and without aura (MO) and cluster headache, all carry a substantial genetic liability. Familial hemiplegic migraine (FHM), an autosomal dominant mendelian disorder classified as a subtype of MA, is due to mutations in genes encoding neural channel subunits. MA/MO are considered multifactorial genetic disorders, and FHM has been proposed as a model for migraine aetiology. However, a review of the genetic studies suggests that the FHM genes are not invo...

  2. Radiographic appearance of a post-epidural headache.

    LENUS (Irish Health Repository)

    Weekes, G

    2012-02-01

    We report the case of a 35-year-old lady who presented with a 6-day history of a postural headache following an uncomplicated epidural catheter insertion. Meningitis was initially suspected and a neurology review was obtained. CT and MRI brain revealed features suggestive of meningitis. However these radiological features are also consistent with post dural puncture headache (PDPH). This case highlights the under reported and possible misleading radiographical features of PDPH.

  3. Sphenopalatine ganglion stimulation for the treatment of cluster headache

    OpenAIRE

    Láinez, Miguel J. A.; Puche, Miguel; Garcia, Ana; Gascón, Francisco

    2014-01-01

    Cluster headache is a severe, debilitating disorder with pain that ranks among the most severe known to humans. Patients with cluster headaches have few therapeutic options and further, 10–20% develop drug-resistant attacks. The often brief duration of cluster attacks makes abortive therapy a challenge, and preventive medications are almost always provided to patients, but the side effects of these preventive medications can be significant. The sphenopalatine ganglion (SPG) is believed to pla...

  4. Will (or can) people pay for headache care in a poor country?

    DEFF Research Database (Denmark)

    Lampl, Christian; Steiner, Timothy Joseph; Mueller, Thomas;

    2012-01-01

    averaging USD 8 per month for effective headache treatment. WTP did not correlate with headache type or frequency, or with MIDAS or SF-36 scores. Headache is common and headache-attributed burden is high in Georgia, with a profound impact on HRQoL. Even those less affected indicated WTP for effective...

  5. Assymetry of temporal artery diameters during spontaneous attacks of cluster headache

    DEFF Research Database (Denmark)

    Nielsen, Thue H; Tfelt-Hansen, Peer; Iversen, Helle K

    2009-01-01

    is a bilateral or unilateral extracranial vasodilation during spontaneous cluster headache attacks. DESIGN AND METHODS: In 9 cluster headache patients, we investigated the luminal diameter of the superficial temporal artery with ultrasound on the headache and headache-free side during and outside...

  6. Migraine-like headache in cerebral venous sinus thrombosis.

    Science.gov (United States)

    Tan, Funda Uysal; Tellioglu, Serdar; Koc, Rabia Soylu; Leventoglu, Alev

    2015-01-01

    A 20-year-old female, university student presented with severe, throbbing, unilateral headache, nausea and vomiting that started 2 days ago. The pain was aggravated with physical activity and she had photophobia. She had been taking contraceptive pills due to polycystic ovary for 3 months. Cranial computed tomography was uninformative and she was considered to have the first attack of migraine. She did not benefit from triptan treatment and as the duration of pain exceeded 72 h further imaging was done. Cranial MRI and MR venography revealed a central filling defect and lack of flow in the left sigmoid sinus caused by venous sinus thrombosis. In search for precipitating factors besides the use of contraceptive pills, plasma protein C activity was found to be depressed (42%, normal 70-140%), homocystein was minimally elevated (12.7 μmol/L, normal 0-12 μmol/L) and anti-cardiolipin IgM antibody was close to the upper limit. PMID:25666780

  7. Behavioral management of headache in children and adolescents.

    Science.gov (United States)

    Faedda, Noemi; Cerutti, Rita; Verdecchia, Paola; Migliorini, Daniele; Arruda, Marco; Guidetti, Vincenzo

    2016-12-01

    Headache is the most frequent neurological symptom and the most prevalent pain in children and adolescents, and constitutes a serious health problem that may lead to impairment in several areas. Psychosocial factors, social environment, life events, school and family stressors are all closely related to headaches. A multidisciplinary strategy is fundamental in addressing headache in children and adolescents. Applying such a strategy can lead to reductions in frequency and severity of the pain, improving significantly the quality of life of these children.It has been demonstrated that behavioral intervention is highly effective, especially in the treatment of paediatric headache, and can enhance or replace pharmacotherapy, with the advantage of eliminating dangerous side effects and or reducing costs. Behavioral interventions appear to maximize long-term therapeutic benefits and improve compliance with pharmacological treatment, which has proven a significant problem with child and adolescent with headache.The goal of this review is to examine the existing literature on behavioral therapies used to treat headache in children and adolescents, and so provide an up-to-date picture of what behavioral therapy is and what its effectiveness is. PMID:27596923

  8. Treatment for chronic daily headache by using auxiliary and alternative methods

    OpenAIRE

    V. A. Golovacheva; V. A. Parfenov; Zakharov, V.V.

    2015-01-01

    Chronic daily headache (CDH) is one of the top 10 causes of adult disability and one of the 5 most common causes of female disability. To treat patients with CDH is one of the most difficult tasks in neurological practice. Difficulties in managing patients with CHD are associated with the high prevalence of comorbid mental disorders, analgesic abuse, pain syndromes at another site, and misconceptions of a patient about his/her disease. A combination of drug and non-drug therapies is the mains...

  9. Headache in the writings of Moses Maimonides and other Hebrew sages.

    Science.gov (United States)

    Rosner, F

    1993-06-01

    In the history of philosophy, theology, and medicine, Maimonides shares the limelight with Arabic scholars such as Ibn Rushd, Ibn Sinna and Ibn Zuhr, chronologically between the great intellectuals of classical Greece and Rome and those of the later Middle Ages and early Renaissance. Maimonides was a very great philosopher and theologian, usually underrated by the historians. He was also an outstanding medical practitioner and teacher. Moses Maimonides had an incredible literary ability and an encyclopedic knowledge. He wrote extensively in the fields of theology, mathematics, law, philosophy, astronomy, ethics, and, of course, medicine. His medical writings are varied, comprising extracts from Greek medicine, a series of monographs on health in general and several diseases in particular, and a pharmacopoiea. The present essay extracts, primarily from Maimonides' medical writings, his pronouncements dealing with headache. Since most of Maimonides' pronouncements about headache in his Medical Aphorisms were derived from Graeco-Roman medical writers such as Hippocrates, and especially Galen, in regard to these statements Maimonides was merely a compiler--not an innovator. Some of his concepts about the causes of headaches being related to a dysequilibrium of the body humors are clearly medieval in origin. Other statements demonstrate this concern with preventive medicine and the maintenance of a healthy regimen of daily living. Medications to treat illness should only be used if non-medicinal means such as diet and exercise are not effective. The heritage of Maimonides' writings is being more and more appreciated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8349474

  10. Psychopathology and quality of life burden in chronic daily headache: influence of migraine symptoms

    OpenAIRE

    Autret, A.; Roux, S.; Rimbaux-Lepage, S.; Valade, D; Debiais, S.; ,

    2010-01-01

    The aim of this study is to compare the psychopathology and the quality of life of chronic daily headache patients between those with migraine headache and those with tension-type headache. We enrolled 106 adults with chronic daily headache (CDH) who consulted for the first time in specialised centres. The patients were classified according to the IHS 2004 criteria and the propositions of the Headache Classification Committee (2006) with a computed algorithm: 8 had chronic migraine (without m...

  11. Chronic daily headache: personality study by means of computerized MMPI-2

    OpenAIRE

    De Fidio, Dario; Sciruicchio, Vittorio; Pastore, Beatrice; Prudenzano, Maria Pia; di Pietro, Elisa; Tramontano, Alfonso; Lorizio, Angelo; Granella, Franco; Bussone, Gennaro; Grazzi, Licia; Sarchielli, Paola

    2000-01-01

    Unresolved questions in headache research are the roles of drug abuse and psychopathology in headache disorder, especially in chronic daily headache. We investigated the utility of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2) for assessing psychopathology in chronic daily headache patients. Chronic headache sufferers gave characteristic responses on Hy (hypochondria), D (depression) and Hs (hysteria) scales which are known as the “neurotic triad”. Although o...

  12. The associations of migraines and other headaches with work performance: results from the National Comorbidity Survey Replication (NCS-R).

    Science.gov (United States)

    Kessler, R C; Shahly, V; Stang, P E; Lane, M C

    2010-06-01

    It is unknown if comorbid conditions account for the association between migraines and work performance. This issue was investigated in the National Comorbidity Survey Replication (n = 9282). Twelve-month severe or persistent migraines and other headaches were assessed with comorbid 12-month mental and physical disorders using the WHO Composite International Diagnostic Interview. Work performance was assessed using the WHO Health and Work Performance Questionnaire. Significant associations of these conditions with work disability disappeared with controls for comorbid disorders, but severe or persistent migraines continued to predict work loss days even with controls. Individual-level and societal-level annual human capital values were $1165 and $9.3 billion for this subset of migraines. Roughly 20% of these associations were due to comorbidity, 60% to direct effects and 20% to indirect effects through temporally secondary comorbidities. These strong associations suggest that workplace interventions for severe or persistent migraines might have a positive return-on-investment for employers. PMID:20511212

  13. Impact of primary headaches on subjective sleep parameters among adolescents

    Directory of Open Access Journals (Sweden)

    Gupta Ravi

    2008-01-01

    Full Text Available Context: Headache patients commonly report sleep disruption and sleep disorders. Available literature suggests that the sleep pattern of headache sufferers is different from the control group. Patients in these studies were recruited from headache clinics; they did not include tension type headache. Aims: The aim of this study is to find out whether primary headaches affect sleep patterns. Settings and Design: Community based cross sectional study Materials and Methods: This study was conducted in three high schools. Children in the 12-19 age group were allowed to participate. They were given a questionnaire in the presence of at least one of the authors, who assisted them in filling it. They were asked to provide responses based on most severe recurrent headache that they had experienced rather than the more frequent ones. The questionnaire included questions regarding demographic data and the characteristics of headache according to International Classification of Headache Disorders-2 criteria. Part B of the questionnaire contained questions regarding sleep habits. The children were asked to provide data regarding sleep habits on a normal school day. Diagnosis was based upon the information contained in the questionnaire. A telephonic interview was also done, where the information provided was found inadequate. Statistical Analysis Used: Analysis was done with the help of SPSS v. 11.0., descriptive analysis, Chi square, and one way ANOVA with post hoc analysis. Kruskall-Wallis tests were run. Results: A total of 1862 subjects were included in the study. Migraineurs and tension type headache sufferers comprised 35.7% and 13.4% of the group respectively. Migraineurs had the highest prevalence of nocturnal awakenings ( P < 0.001, abnormal movements ( P =0.001 and breathing problems during sleep ( P < 0.001. Approximately half the migraineurs felt sleepy during the day ( P < 0.001 and spent around 1.17 hours in sleep during the day ( P = 0

  14. On Level persistence (Relevant level persistence numbers)

    OpenAIRE

    Du, Dong

    2014-01-01

    The purpose of this note is to describe of a new set of numerical invariants, the relevant level persistence numbers, and make explicit their relationship with the four types of bar codes, a more familiar set of complete invariants for level persistence. The paper provides the opportunity to compare level persistence with the persistence introduced by Edelsbrunner- Letscher-Zomorodian called in this paper, as sub-level persistence.

  15. A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. a multicentre European and Latin American study

    DEFF Research Database (Denmark)

    Jensen, Rigmor Højland; Tassorelli, C; Rossi, P; Allena, M; Osipova, V; Steiner, Tj; Sandrini, G; Olesen, J; Nappi, G

    2011-01-01

    Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1...

  16. Precipitating and relieving factors of migraine versus tension type headache

    Directory of Open Access Journals (Sweden)

    Haque Badrul

    2012-08-01

    Full Text Available Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors. Results In this study, the female patients predominated (67%. Most of the patients were within 21–30 years age group (58.6%. About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH patients. But significant difference was demonstrated for fatigue (p  Conclusion The most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.

  17. Prescription pain medications and chronic headache in Denmark

    DEFF Research Database (Denmark)

    Westergaard, Maria Lurenda; Hansen, Ebba Holme; Glümer, Charlotte;

    2015-01-01

    medication per month (depending on the drug) were classified as having MOH. Associations between CH and other chronic pain conditions were analysed by logistic regression. RESULTS: Among those with CH (adjusted prevalence 3.3 %, CI 3.2-3.5 %), pain medications most commonly dispensed were paracetamol......PURPOSE: The aim of the present paper is to study which prescription pain medications are most commonly dispensed to people with chronic headache (CH), particularly those with medication-overuse headache (MOH). METHODS: This cross-sectional study analysed prescription pain medications dispensed...... within 1 year to 68,518 respondents of a national health survey. Participants with headache ≥15 days per month for 3 months were classified as having CH. Those with CH and over-the-counter analgesic use ≥15 days per month or purchase of ≥20 or ≥30 defined daily doses (DDDs) of prescription pain...

  18. Epidemiology of concurrent headache and sleep problems in Denmark

    DEFF Research Database (Denmark)

    Lund, Nunu; Westergaard, Maria Lurenda; Barloese, Mads;

    2014-01-01

    AIMS: There are no previous epidemiologic studies on concurrent headache and sleep problems (HSP). This cross-sectional study aimed to determine the prevalence of HSP in Denmark, broadly characterize those with HSP, and examine associations between HSP and socioeconomic/lifestyle factors. METHODS......: A total of 129,150 randomly selected individuals were invited to participate in the Danish National Health Survey 2010. Respondents were asked about headache, sleep problems, depression and anxiety in the last two weeks, health-related lifestyle and quality of life (SF-12). Socioeconomic data were...... retrieved from national registers. Prevalence proportions were adjusted for stratified sampling and non-response. Regression analyses examined associations between HSP and socioeconomic/lifestyle factors. RESULTS: Of 68,518 respondents, 16.3% reported only headache, 21.1% only sleep problems, and 18.1% HSP...

  19. Supratrochlear and Supraorbital Nerve Stimulation for Chronic Headache: a Review.

    Science.gov (United States)

    Goldberg, Stephanie Wrobel; Nahas, Stephanie J

    2015-07-01

    Chronic daily headache accounts for a significant socioeconomic burden due to decreased productivity, work absenteeism, multiple office and ER visits, and hospital admissions for pain control. Associated comorbidities add to this cost. Current traditional medical therapies may fail to provide adequate relief leading to the search for and use of other therapeutic modalities such as innovative medical devices. It is in this setting of the urgent demand for better pain control and to assimilate chronic headache sufferers back into society that a variety of neuromodulatory approaches have been emerging. This review aims to familiarize the reader with current literature regarding supraorbital and supratrochlear nerve stimulation for chronic headache, point out the advantages of this approach, address unanswered questions about this subject, and highlight future directions. PMID:26049769

  20. Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal

    OpenAIRE

    Dino Irawan; Doddy Tavianto; Eri Surahman

    2013-01-01

    The incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnan...

  1. Continuous epidural block of the cervical vertebrae for cervicogenic headache

    Institute of Scientific and Technical Information of China (English)

    HE Ming-wei; NI Jia-xiang; GUO Yu-na; WANG Qi; YANG Li-qiang; LIU Jing-jie

    2009-01-01

    Background Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra.Methods Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline (5 ml/min) for 3-4 weeks and triamcinolone acetonide 5 mg once weekly for 3-4 weeks. Pain was measured via the visual analogue scale (VAS) in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use (NSAID).Results In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was (3.20±0.75) times and the mean oral dosage of NSAID was (1267±325) mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment (P <0.01). By 12 months post-treatment, no significant difference in these three outcome measures was noted.Conclusions Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.

  2. Risk of placental abruption in relation to migraines and headaches

    Directory of Open Access Journals (Sweden)

    Ananth Cande V

    2010-10-01

    Full Text Available Abstract Background Migraine, a common chronic-intermittent disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, and placental abruption, the premature separation of the placenta, share many common pathophysiological characteristics. Moreover, endothelial dysfunction, platelet activation, hypercoagulation, and inflammation are common to both disorders. We assessed risk of placental abruption in relation to maternal history of migraine before and during pregnancy in Peruvian women. Methods Cases were 375 women with pregnancies complicated by placental abruption, and controls were 368 women without an abruption. During in-person interviews conducted following delivery, women were asked if they had physician-diagnosed migraine, and they were asked questions that allowed headaches and migraine to be classified according to criteria established by the International Headache Society. Logistic regression procedures were used to calculate odds ratios (aOR and 95% confidence intervals (CI adjusted for confounders. Results Overall, a lifetime history of any headaches or migraine was associated with an increased odds of placental abruption (aOR = 1.60; 95% CI 1.16-2.20. A lifetime history of migraine was associated with a 2.14-fold increased odds of placental abruption (aOR = 2.14; 95% CI 1.22-3.75. The odds of placental abruption was 2.11 (95% CI 1.00-4.45 for migraineurs without aura; and 1.59 (95% 0.70-3.62 for migraineurs with aura. A lifetime history of tension-type headache was also increased with placental abruption (aOR = 1.61; 95% CI 1.01-2.57. Conclusions This study adds placental abruption to a growing list of pregnancy complications associated with maternal headache/migraine disorders. Nevertheless, prospective cohort studies are needed to more rigorously evaluate the extent to which migraines and/or its treatments are associated with the occurrence of placental abruption.

  3. High Persister Mutants in Mycobacterium tuberculosis

    Science.gov (United States)

    Torrey, Heather L.; Keren, Iris; Via, Laura E.; Lee, Jong Seok; Lewis, Kim

    2016-01-01

    Mycobacterium tuberculosis forms drug-tolerant persister cells that are the probable cause of its recalcitrance to antibiotic therapy. While genetically identical to the rest of the population, persisters are dormant, which protects them from killing by bactericidal antibiotics. The mechanism of persister formation in M. tuberculosis is not well understood. In this study, we selected for high persister (hip) mutants and characterized them by whole genome sequencing and transcriptome analysis. In parallel, we identified and characterized clinical isolates that naturally produce high levels of persisters. We compared the hip mutants obtained in vitro with clinical isolates to identify candidate persister genes. Genes involved in lipid biosynthesis, carbon metabolism, toxin-antitoxin systems, and transcriptional regulators were among those identified. We also found that clinical hip isolates exhibited greater ex vivo survival than the low persister isolates. Our data suggest that M. tuberculosis persister formation involves multiple pathways, and hip mutants may contribute to the recalcitrance of the infection. PMID:27176494

  4. The Headache Under-Response to Treatment (HURT) Questionnaire

    DEFF Research Database (Denmark)

    Westergaard, Maria Ls; Steiner, Timothy J; Macgregor, E Anne;

    2013-01-01

    The HURT Questionnaire consists of eight questions which the patient answers as a measure of effectiveness of intervention against headache. This first assessment of clinical utility was conducted in headache specialist centres in three countries in order to demonstrate that HURT was responsive to...... that the best possible outcome had been achieved in each patient. Questionnaires were also answered by 42 patients at initial and final visits to a centre in Italy. Internal consistency reliability was very good (α = 0.85) while test-retest reliability was fair to low (κ = 0.38-0.62 and r(s) = 0...

  5. Convergence Insufficiency in Patients Visiting Eye OPD with Headache

    Directory of Open Access Journals (Sweden)

    Archana Gupta

    2008-07-01

    Full Text Available The present study was undertaken to find out the incidence of convergence insufficiency in patientspresenting in eye OPD with chief complaints of headache. Only patients with normal visual acuity andfundus picture were included in this study. All the 100 patients included in this study were subjected todetailed orthoptic examination which included tests for near point of convergence by RAF, Maddox rodtests and synaptophore examination. It was found that a substantial number of patients had convergenceinsufficiency and maximum no. of such patients (49% were in the age group of 20-40 years. The sudyhighlights the importance of ortoptic examination in all patients of strain and headache.

  6. Butalbital and pediatric headache: stay off the downward path.

    Science.gov (United States)

    Caruso, Alessandra; Lazdowsky, Lori; Rabner, Jonathan; Haberman, Jason; LeBel, Alyssa

    2015-02-01

    Despite limited evidence from the literature surrounding safety or efficacy, butalbital-containing medicines (BCMs) have maintained their rank as "go-to" prescribed migraine and headache relief drugs in the United States, despite bans on these barbiturates in Germany and other European countries. Providers at the Pediatric Headache Program at Boston Children's Hospital recommend that clinicians prescribe triptan-based medications instead of BCMs, given the known negative side effects of BCMs on the general population, and the uncertain longitudinal trajectory of BCMs on developing brains. PMID:25532552

  7. Neurotherapy for chronic headache following traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    David V Nelson; Mary Lee Esty

    2015-01-01

    Background:Chronic headache following traumatic brain injury (TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions, and it may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System (FNS), which involves minute pulses of electromagnetic energy stimulation of brainwave activity, has been suggested as a means to address symptoms of TBI. This study reports on a clinical series of patients with chronic headache following service-connected TBI treated with FNS. Methods: Nine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI complicated by posttraumatic stress symptoms were treated in 20 individual FNS sessions at the Brain Wellness and Biofeedback Center of Washington (in Bethesda, Maryland, USA). They periodically completed measures including the Brief Pain Inventory-Headache (BPI-HA), previous week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version (PCL-M), and an individual treatment session numerical rating scale (NRS) for the degree of cognitive dysfunction. Data analyses included beginning-to-end of treatmentt-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS. Results: All beginning-to-end of treatmentt-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS indicated statistically significant decreases. All but one participant experienced a reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing the virtual elimination of headaches. One participant obtained modest headache relief but no improvements in posttraumatic stress or cognitive dysfunction. Conclusions: FNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military

  8. Medication overuse, healthy lifestyle behaviour and stress in chronic headache

    DEFF Research Database (Denmark)

    Westergaard, Maria Lurenda; Glümer, Charlotte; Hansen, Ebba Holme;

    2016-01-01

    having CH then further described as having medication-overuse headache (MOH) or CH without medication overuse. Associations between headache and daily smoking, physical inactivity, obesity, excessive drinking, illicit drug use, and high stress were analysed by logistic regression. RESULTS: CH with and...... without medication overuse (prevalence 1.8% and 1.6%, respectively) had strong, graded associations with stress. Associations with daily smoking, physical inactivity, and obesity were significant only for MOH. Odds for MOH were highest among people who had all three factors compared to those who had none...

  9. The use of onabotulinum toxin A (Botox(®)) in the treatment of chronic migraine at the Parma Headache Centre: a prospective observational study.

    Science.gov (United States)

    Russo, Marco; Manzoni, Gian Camillo; Taga, Arens; Genovese, Antonio; Veronesi, Licia; Pasquarella, Cesira; Sansebastiano, Giuliano Ezio; Torelli, Paola

    2016-07-01

    Chronic migraine is a debilitating headache, whose treatment is often complicated by the concomitant overuse of symptomatic medication and by the poor efficacy of standard prophylactic treatments. The PREEMPT studies have demonstrated the efficacy and tolerability of onabotulinum toxin A (Botox(®)) in the treatment of this headache type. Data about its use in clinical practice are still scarce. Our study evaluated all subjects with chronic migraine who were treated with onabotulinum toxin A between February 2014 and November 2015 at the Parma Headache Centre. Botox was injected according to the PREEMPT paradigm every 3 months. The data about variations in the number of headache days and in symptomatic medication intake before and after the Botox injections were collected from the patients' headache diaries. The study also evaluated tolerability to treatment, disability, and depressive symptoms. Of the 52 treated subjects, 14 received Botox treatment for at least 9 months and showed a significant decrease in the median number of headache days (from 19 to 14.5, p = 0.011) and in the median number of days of symptomatic medications intake and symptomatic drugs. Overall, the treatment was well tolerated. The average MIDAS and BDI-II scores after 9 months were reduced, though not significantly. The treatment with Botox proved effective and well tolerated in our clinical practice. Further studies on larger patient samples will help shed light on the persistence of the drug's effect at long term and identify the predictive factors of response to treatment. PMID:27048312

  10. Headache classification and the Bible: Was St Paul's thorn in the flesh migraine?

    Science.gov (United States)

    Göbel, H; Isler, H; Hasenfratz, H P

    1995-06-01

    The conversion of Saul to Paul was a major event in the history of Western culture. Compared with its impact, any medical comments may seem redundant, but they have kept their place in the literature for many centuries. The flashing light that caused Saul to fall is often explained as solar retinopathy or keratitis, a seizure, or even a hysterical fit. These interpretations propose either a trivial injury or disease that would interfere with mental health. Neither version is quite compatible with the dramatic dimension of the event and with Paul's later achievements and sufferings. In later years, Paul became a great manager, preacher and writer who was able to carry on under any kind of duress, though not without very painful reactions. He was suffering from bouts of unilateral headache, and also from a chronic eye condition which gave great trouble to his followers but did not cause lasting damage; the descriptions fulfil the criteria for migraine without aura of the 1988 Headache Classification. If the flashing light that caused Paul to fall down is interpreted as a visual migraine aura, with the additional symptoms of "not seeing" or photophobia and anorexia, it falls into place with his later history of migraine. PMID:7553804

  11. Botulinum Toxin Type a as a Therapeutic Agent against Headache and Related Disorders.

    Science.gov (United States)

    Luvisetto, Siro; Gazerani, Parisa; Cianchetti, Carlo; Pavone, Flaminia

    2015-09-01

    Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a "glamour" drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A. PMID:26404377

  12. Surgical Treatment of Rhinogenic Contact Point Headache: An Experience from a Tertiary Care Hospital.

    Science.gov (United States)

    Peric, Aleksandar; Rasic, Dejan; Grgurevic, Ugljesa

    2016-04-01

    Introduction Even in the absence of inflammatory disease, facial pain often results from pressure of two opposing nasal mucosa surfaces. Objectives The objective of this study is to assess the efficacy of surgical treatment of contact point headache. Methods Our study enrolled patients with unilateral facial pain and without nasal/paranasal sinus disease. We confirmed the presence of mucosal contact by nasal endoscopy and by computed tomography. Forty-two subjects with the three most common anatomical variations underwent complete evaluation: 17 with concha bullosa (CB), 11 with septal deviation (SD), and 14 with septal spur (SS). All participants were treated by topical corticosteroid, adrenomimetic, and antihistamine. The patients without improvement were treated surgically. We assessed the severity of pain using a Visual Analogue Score (VAS) before surgical treatment and one, six, twelve, and twenty-four months after. Results The patients with SS had more severe facial pain in comparison with patients with CB (p = 0.049) and SD (p = 0.000). The subjects with CB had higher degree of facial pain than the ones with SD (p = 0.001). After an unsuccessful medical treatment and surgical removal of mucosal contacts, the decrease of headache severity was more intense in patients with CB and SS (p = 0.000) than in the patients with SD (p = 0.01). Conclusion Our results suggest that topical medications have no effects and that surgical removal of mucosal contacts could be effective in the treatment of contact point headache. The results of surgical treatment were better in cases of facial pain caused by SS and CB, than in those caused by SD. PMID:27096023

  13. Botulinum Toxin Type A as a Therapeutic Agent against Headache and Related Disorders

    Directory of Open Access Journals (Sweden)

    Siro Luvisetto

    2015-09-01

    Full Text Available Botulinum neurotoxin A (BoNT/A is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a “glamour” drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A.

  14. Inhaled Oxygen for Cluster Headache: Efficacy, Mechanism of Action, Utilization, and Economics.

    Science.gov (United States)

    Rozen, Todd D

    2012-01-29

    Inhaled normobaric oxygen is an essential abortive treatment of cluster headache. Recognition of its efficacy for cluster headache goes back a half a century, but very little has actually been written on the use of inhaled oxygen for cluster headache. This article examines various issues regarding inhaled oxygen and cluster headache, including efficacy, proposed mechanism of action, utilization, and the economics of oxygen usage for cluster headache patients. Much of the data analyzed comes from the recently published United States Cluster Headache Survey. This is the largest study of cluster headache patients ever published and is the first study to focus on inhaled oxygen and cluster headache in a large, non-clinic-based population. PMID:22286556

  15. Neuroendoscopic treatment of idiopathic occlusion of unilateral foramen of Monro presenting as chronic headache

    Directory of Open Access Journals (Sweden)

    Dhaval Shukla

    2016-01-01

    Full Text Available Asymmetric ventriculomegly due to idiopathic occlusion of the foramen of Monro is rare. Such patients present with clinical features of raised intracranial pressure (ICP. Presentation as chronic headache has not been previously described. In the absence of raised ICP, pursuing surgical treatment raises a clinical dilemma as the headache may be a primary headache with no improvement after surgery. A 21-year-old woman presented with chronic headache. She was found to have asymmetric ventriculomegaly due to the occlusion of the foramen of Monro. She underwent endoscopic septostomy and widening of the foramen of Monro. Her headache subsided after surgery. At 15 months of follow-up, she was free from headache without medications. Unilateral occlusion of the foramen of Monro can present with asymmetric ventriculomegaly resulting in chronic headache. Though the symptoms of raised ICP may not be present, still endoscopic relief of ventriculomegaly leads to cure of headache.

  16. [Asthenic disorders and cognitive dysfunction in patients with tension headache].

    Science.gov (United States)

    Chutko, L S; Surushkina, S Iu; Rozhkova, A V; Iakovenko, E A; Bykova, Iu L; Nikishina, I S

    2013-01-01

    The article is devoted to the study of cognitive dysfunction in patients suffering from tension headaches. Patients had attention and memory dysfunction, higher levels of anxiety, asthenia and subclinical symptoms of depression. The high efficacy of cerebrolysin in the restoration of cognitive dysfunction confirmed by the data of clinical, psychological and neuropsychological studies was shown. PMID:23739500

  17. Reduced CSF hypocretin-1 levels are associated with cluster headache

    DEFF Research Database (Denmark)

    Barloese, Mads; Jennum, Poul; Lund, Nunu;

    2015-01-01

    BACKGROUND: Cluster headache (CH) is a debilitating disorder characterized by unilateral, severe pain attacks with accompanying autonomic symptoms, often waking the patient from sleep. As it exhibits strong chronobiological traits and genetic studies have suggested a link with the hypocretin (HCR...

  18. Spontaneous low-pressure headache complicating bag-piping.

    Science.gov (United States)

    Patrick, Alasdair; McAuley, David; Roxburgh, Richard

    2007-04-01

    We describe an interesting case of a 40-year-old lady who developed a spontaneous low-pressure headache whilst playing the bag-pipes. Playing wind instruments requires the generation of significant intra-thoracic pressure, which may have contributed to this musician's condition. PMID:17445112

  19. Treating tension-type headache -- an expert opinion

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Jensen, Rigmor

    2011-01-01

    drugs of second choice. Triptans, muscle relaxants and opioids should not be used. It is crucial to avoid frequent and excessive use of analgesics to prevent the development of medication-overuse headache. The tricyclic antidepressant amitriptyline is the drug of first choice for the prophylactic...

  20. The cholinomimetic agent carbachol induces headache in healthy subjects

    DEFF Research Database (Denmark)

    Schytz, H W; Wienecke, Troels; Oturai, P S;

    2009-01-01

    The parasympathetic nervous system is likely to be involved in migraine pathogenesis. We hypothesized that the cholinomimetic agonist carbachol would induce headache and vasodilation of cephalic and radial arteries. Carbachol (3 microg/kg) or placebo was randomly infused into 12 healthy subjects ...

  1. Stimulation of the sphenopalatine ganglion in intractable cluster headache

    DEFF Research Database (Denmark)

    Jürgens, Tim P; Schoenen, Jean; Rostgaard, Jørgen; Hillerup, Søren; Láinez, Miguel J A; Assaf, Alexandre T; May, Arne; Jensen, Rigmor H

    2014-01-01

    some patients and the first commercially available CE-marked SPG neurostimulator system has been introduced for cluster headache, patient selection and care should be standardized to ensure maximal efficacy and safety. As only limited data have been published on SPG stimulation, standards of care based...

  2. Evaluating integrated headache care: a one-year follow-up observational study in patients treated at the Essen headache centre

    Directory of Open Access Journals (Sweden)

    Diener Hans C

    2011-10-01

    Full Text Available Abstract Background Outpatient integrated headache care was established in 2005 at the Essen Headache Centre in Germany. This paper reports outcome data for this approach. Methods Patients were seen by a neurologist for headache diagnosis and recommendation for drug treatment. Depending on clinical needs, patients were seen by a psychologist and/or physical therapist. A 5-day headache-specific multidisciplinary treatment programme (MTP was provided for patients with frequent or chronic migraine, tension type headache (TTH and medication overuse headache (MOH. Subsequent outpatient treatment was provided by neurologists in private practice. Results Follow-up data on headache frequency and burden of disease were prospectively obtained in 841 patients (mean age 41.5 years after 3, 6 and 12 months. At baseline mean headache frequency was 18.1 (SD = 1.6 days per month, compared to measurement at 1 year follow-up a mean reduction of 5.8 (SD = 11.9 headache days per month was observed in 486 patients (57.8% after one year (TTH patients mean: -8.5 days per month; migraine mean: -3.2 days per month, patients with migraine and TTH mean: -5.9 days per month. A reduction in headache days ≥ 50% was observed in 306 patients (36.4% independent of diagnosis, while headache frequency remains unchanged in 20.9% and increase in 21.3% of the patient. Conclusion Multidisciplinary outpatient headache centres offer an effective way to establish a three-tier treatment offer for difficult headache patients depending on clinical needs.

  3. 1例地震伤致植物生存状态患者的护理%1 case of persistent vegetative state caused by the earthquake injured patients nursing

    Institute of Scientific and Technical Information of China (English)

    唐芳; 朱世琼

    2010-01-01

    To investigate the effect of implementation of the overall care for patients with persistent vegetative state.1 patients caused by the 5.12 earthquake in persistent vegetative state was given overall care including the prevention of complications,long-term nursing awaking,family health care,education and participation in terms of overall patient care to reach the greatest degree of rehabilitation patients.After nearly two years of treatment and care,so far the patient had not suffered from urinary tract infections,lung infections,bedsores and other complications.And the nursing care model was transferred into the family care model,which would be benefitial to patient returning home and society.The implementation of targeted overall care,and effective mental health care and education to family members of patients would help promote the full rehabilitation of patient,prevent complications,improve quality of life of patient and their families,maintain the family's social function,and reduce health care consumption.%探讨对植物生存状态患者实施整体护理后的效果.对一例由5.12汶川地震致植物生存状态患者从预防并发症、长期坚持促醒护理、家属健康教育并参与护理等方面对患者实施有针对性的整体护理,使患者得到最大程度的康复.经过近2年的治疗和护理,患者目前为止无尿路感染、肺部感染、褥疮等并发症发生,并且由最初的护理人员照顾模式成功转型为家属照顾模式,有利于患者更好地回归家庭、回归社会.对植物生存状态患者实施有针对性的整体护理,并对患者家属实施有效的心理护理及健康教育,有助于促进患者的全面康复,预防并发症,改善患者及家属的生活质量,维持家庭的社会功能,降低医疗消耗.

  4. Relationship between insomnia and headache in community-based middle-aged Hong Kong Chinese women.

    OpenAIRE

    Yeung, Wing-Fai; Chung, Ka-Fai; Wong, Chun-Yue

    2010-01-01

    Limited studies have investigated the prevalence of insomnia symptoms among individuals with different headache diagnoses and the association between insomnia and headache in subjects with comorbid anxiety and depression. A total of 310 community-dwelling Hong Kong Chinese women aged 40-60 years completed a self-administered questionnaire on headache, sleep difficulties, mood disturbances, and functional impairment. About 31% of the sample complained of recurrent headache unrelated to influen...

  5. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications

    OpenAIRE

    Park, Jeong-Wook; Chu, Min Kyung; Kim, Jae-Moon; Park, Sang-Gue; Cho, Soo-Jin

    2016-01-01

    Background Various stimuli can trigger migraines in susceptible individuals. We examined migraine trigger factors by using a smartphone headache diary application. Method Episodic migraineurs who agreed to participate in our study downloaded smartphone headache diary application, which was designed to capture the details regarding headache trigger factors and characteristics for 3 months. The participants were asked to access the smartphone headache diary application daily and to confirm the ...

  6. IMPACT OF ACUTE MIGRAINE HEADACHE AMONGST UNIVERSITY STUDENTS IN NORTH-EASTERN NIGERIA

    OpenAIRE

    Timothy SY; Mava Y; Bashir HJ; Bwala AY

    2012-01-01

    Migraine is markedly disabling medical condition. Unfortunately the problem is poorly recognized and the majority of headache sufferers have not sought medical help even when their problem is severe. The aim of this study is to evaluate the impact of migraine headache in university students and suggest a simple school policy on headache that can be introduced to reduce this impact. One hundred and five students with migraine among 1000 students having headache that met the International Head...

  7. Cognitive, Personality, and Family Factors in Patients with Migraine Headache

    Directory of Open Access Journals (Sweden)

    Reza Johari-Fard

    2014-01-01

    Full Text Available Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly negative impact on sufferers’ quality of life. In the present research, we investigated the correlations and regressions of cognitive, personality, and family factors with migraine headache, to find predictor factors of migraine. In this study, the following questionnaires were used: For migraine: six-item Headache Impact Test (HIT-6, and Specific Quality of Life Questionnaire Version 2.1.; for cognitive factors: Irrational Beliefs Test and Dysfunctional Attitudes Scale; for personality factors: NEO Personality Inventory; and for family factors: Family Assessment Device. This project was on 58 women with migraine headaches, diagnosed by neurologist. The findings show that, there is a significant regression between cognitive, personality, and family factors and HIT-6. In cognitive factors, frustration reactivity and anxious overconcern, in personality factors, extraversion trait, and in family factors, affective involvement are significant. Moreover, there is a significant regression between cognitive, personality, and family factors and MSQ. In cognitive factors, frustration reactivity, anxious overconcern, and helplessness, in personality factors, agreeableness and consciousness, and in family factors, affective involvement and general functioning are significant. This project showed that cognitive, personality, and family factors have a correlation with migraine headache.

  8. A novel way of functional retraining of cervical motor control in a water polo player with combined cervicogenic and tension type headaches.

    Science.gov (United States)

    Graaf, Marloes Thoomes-de; Thoomes, Erik

    2016-02-01

    This case report introduces an innovative and novel way of functionally retraining the sport specific cervical function in a 13-year-old elite water polo player with a combined tension type headache and cervicogenic headache. After an evidence based assessment and manipulative physical therapy management regime, consisting of manual mobilization and exercise focused on retraining the deep cervical flexors and sub-occipital extensors, the patient was left with persistent residual complaints inhibiting competitive level sport participation. Re-assessment and subsequent retraining of a specific provocative functional task was facilitated by using the Cervical Trainer(™). Using a wireless sensor worn on the head, this device registers three-dimensional movement and displays this on a computer screen, providing direct feedback on movement performance. After a 6-week period of training sessions, the residual complaints subsided and her score on the Headache Impact Test-6 questionnaire improved from 51 to 36 signifying no impact of her headache on daily life activities. PMID:27252580

  9. Aspirin and tension-type headache

    OpenAIRE

    Farinelli, I.; Martelletti, P.

    2007-01-01

    Acetylsalicylic acid (ASA, Aspirin) is among the most used drugs worldwide. At present, Aspirin represents a quite versatile drug employed in the control of pain symptomatologies and in situations such as prevention of both ischaemic stroke and cardiovascular events. Aspirin causes inhibition of prostaglandin (PG) synthesis by inactivation of the cyclooxygenase (COX) enzyme. ASA constitutes the focus of new researches explaining more widely Aspirin’s control of inflammation. The induction of ...

  10. The comparison of sleep disturbances between the subjects with headache and healthy subjects

    Directory of Open Access Journals (Sweden)

    Arash Bostani

    2015-11-01

    Full Text Available Background: Headache is one of the most common complaints of the patients referring to the treatment centers. Also, some studies have reported the correlation of sleep disturbances with migraine and tension headaches. This study was aimed to analyze the association of sleep disturbances with migraine and tension headaches. Methods: In this cross-sectional study, 1005 students of Kermanshah University of Medical Sciences were selected by stratified random sampling during the academic year 2013-2014. Having attracted the participation and cooperation of the participants, sleep disorder and symptoms of headache (migraine and tension tests were administered. Results: The overall prevalence of headache, migraine headache and tension headache in students of medical science were 73.8 %, 16.7 % and 30.9 %, respectively. 20.3% of medical students had sleep disorder. Difficulty in sleep onset, daytime fatigue, apnea and sadness and anxiety were associated with headache. Total sleep disorder was directly associated with migraine headache (P<0.05.Conclusion: There was a correlation between sleep disorders and headache, especially migraine headache. Considering the importance of sleep in the incidence of headaches, sleep hygiene education and changes in the quality and patterns of sleep are essential for students, which can greatly affect their individual and social life.

  11. "A transcript of actual life": headache in the novels of Jane Austen.

    Science.gov (United States)

    Larner, Andrew J

    2010-04-01

    References to headache in the novels of Jane Austen have been examined. Nine characters, all female, suffer headache at one time or another, often in association with emotionally stressful situations. As an authorial device, headache may have served Jane Austen as a culturally sanctioned form of bodily expression. PMID:18070055

  12. Effects of Topiramate in the Prevention of Drug Resistant Migraine Headache

    Directory of Open Access Journals (Sweden)

    H Khani

    2009-04-01

    Full Text Available ABSTRACT Introduction & objective: Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate (TPM in the prevention of drug-resistant migraine headache. Materials & Methods: This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compared with the placebo group for 3 months. Collected data were analyzed using analysis of variance (ANOVA, Newman-Keuls and Spearman’s Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. Results: 66 of 70 patients completed the study. The mean age of the patients was 30.33±7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months (P < 0.0001 for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group (63.6%, P<0.0001 in the 3rd month of the treatment Side effects of treatment were transient and well tolerated. Conclusion: Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine.

  13. Persistent postoperative hiccups: a review

    DEFF Research Database (Denmark)

    Hansen, B J; Rosenberg, J

    1993-01-01

    The pathogenesis of persistent postoperative hiccups is not known. Hiccups can present as a symptom of a subphrenic abscess of gastric distention, and metabolic alterations may also cause hiccups. The hiccups may develop because of increased activity in neural reflex pathways not yet fully defined...

  14. Autism Spectrum Disorders May Be Due to Cerebral Toxoplasmosis Associated with Chronic Neuroinflammation Causing Persistent Hypercytokinemia that Resulted in an Increased Lipid Peroxidation, Oxidative Stress, and Depressed Metabolism of Endogenous and Exogenous Substances

    Science.gov (United States)

    Prandota, Joseph

    2010-01-01

    Worldwide, approximately 2 billion people are chronically infected with "Toxoplasma gondii" with largely yet unknown consequences. Patients with autism spectrum disorders (ASD) similarly as mice with chronic toxoplasmosis have persistent neuroinflammation, hypercytokinemia with hypermetabolism associated with enhanced lipid peroxidation, and…

  15. Verapamil for cluster headache. Clinical pharmacology and possible mode of action

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer; Tfelt-Hansen, Jacob

    2009-01-01

    Verapamil is used mainly in cardiovascular diseases. High-dose verapamil (360-720 mg) is, however, currently the mainstay in the prophylactic treatment of cluster headache. The oral pharmacokinetics are variable. The pharmacodynamic effect of verapamil, the effect on blood pressure, also varies...... is therefore limited. The clinical use of verapamil in cluster headache is reviewed and several relevant drug interactions are mentioned. Finally, its possible mode of action in cluster headache is discussed. The effect of verapamil in cluster headache most likely takes place in the hypothalamus...... certain mode of action of the drug in cluster headache....

  16. Headache epidemiology in Vitória, Espírito Santo

    Directory of Open Access Journals (Sweden)

    Domingues Renan Barros

    2004-01-01

    Full Text Available This is the first headache survey in the region of Vitória, ES Brazil. A high prevalence of headache sufferers was found (52.8%. Headache was more common among women (63.9% and less common among people older than 55 years old. The type of professional activity was not related with the headache prevalence. The most frequent causal attribution was stress. Most headache sufferers are not under regular medical treatment (9%, and most of them use analgesic drugs without proper orientation. The most used compounds are combinations with caffeine (33% and simple analgesics (52.3%.

  17. Indicators of quality of life and adaptation to chronic tense headaches

    OpenAIRE

    Abramenko Y.V.; Selyankina Y.N.; Zueva G.A.; Serebrova T.V.; Slyusar T.A.

    2012-01-01

    The goal of the research is the comparative analysis of a quality of life and quantitative characteristics of a chronic tense headache as well as the studying of adaptive reactions. 123 women (middle age 42,6±2,3) with initiatory stages of chronic tense headaches have been examined using diagnostic criteria of the International classifcation of headache disorders (ICDH — II, 2003), headache diary and the McGill Pain Questionnaire. Headache intensity was estimated by the Visual Analog...

  18. Prevalence of headache in adolescents and association with use of computer and videogames.

    Science.gov (United States)

    Xavier, Michelle Katherine Andrade; Pitangui, Ana Carolina Rodarti; Silva, Georgia Rodrigues Reis; Oliveira, Valéria Mayaly Alves de; Beltrão, Natália Barros; Araújo, Rodrigo Cappato de

    2015-11-01

    The aim of this study was to determine the prevalence of headache in adolescents and its association with excessive use of electronic devices and games. The sample comprised 954 adolescents of both sexes (14 to 19 years) who answered a questionnaire about use of computers and electronic games, presence of headache and physical activity. The binary and multinomial logistic regression, with significance level of 5% was used for inferential analysis. The prevalence of headache was 80.6%. The excessive use of electronics devices proved to be a risk factor (OR = 1.21) for headache. Subjects aged between 14 and 16 years were less likely to report headache (OR = 0.64). Regarding classification, 17.9% of adolescents had tension-type headache, 19.3% had migraine and 43.4% other types of headache. The adolescents aged form 14 to 16 years had lower chance (OR ≤ 0.68) to report the tension-type headache and other types of headache. The excessive use of digital equipment, electronic games and attending the third year of high school proved to be risk factors for migraine-type development (OR ≥ 1.84). There was a high prevalence of headache in adolescents and high-time use of electronic devices. We observed an association between excessive use of electronic devices and the presence of headache, and this habit is considered a risk factor, especially for the development of migraine-type. PMID:26602725

  19. Stress and Primary Headache: Review of the Research and Clinical Management.

    Science.gov (United States)

    Martin, Paul R

    2016-07-01

    This review begins with a discussion of the nature of stress and then presents the functional model of primary headache as a framework for conceptualizing the complex relationship between stress and headaches. Research is reviewed on stress as a trigger of headaches and how stress can play a role in the developmental and psychosocial context of headaches. Clinical management of headaches from a stress perspective is considered both at the level of trials of behavioral interventions that broadly fit into the stress management category and the additional strategies that might be useful for individual cases based on the research demonstrating associations between stress and headaches. The review concludes by suggesting that although some researchers have questioned whether stress can trigger headaches, overall, the literature is still supportive of such a link. Advances in methodology are discussed, the recent emphasis on protective factors is welcomed, and directions for future research suggested. PMID:27215628

  20. The efficacy of wet-cupping in the treatment of tension and migraine headache.

    Science.gov (United States)

    Ahmadi, Alireza; Schwebel, David C; Rezaei, Mansour

    2008-01-01

    Wet-cupping is an ancient medical technique still used in several contemporary societies, but little empirical study has been devoted to test its efficacy to treat tension and migraine headache. Using a pre-post research design, 70 patients with chronic tension or migraine headache were treated with wet-cupping. Three primary outcome measures were considered at the baseline and 3 months following treatment: headache severity, days of headache per month, and use of medication. Results suggest that, compared to the baseline, mean headache severity decreased by 66% following wet-cupping treatment. Treated patients also experienced the equivalent of 12.6 fewer days of headache per month. We conclude that wet-cupping leads to clinical relevant benefits for primary care patients with headache. Possible mechanisms of wet-cupping's efficacy, as well as directions for future research are discussed. PMID:18306448

  1. The headache to subjects with multiple sclerosis: clinical and imaging study

    International Nuclear Information System (INIS)

    The present study showed clinical and imaging particularities of primary headache to subjects with multiple sclerosis. From the total number of 28 patients included in this study 22 (78,57%) had headache accuses (3 men and 19 women). Was observed a high prevalence of tension type headache, present to 10 of the 22 patients (45.45%). Migraine was diagnosed to 8 respondents (36.36 %). In 4 cases was found a combination of migraine and tension type headache (8.1%). Headache was more common to women with multiple sclerosis (MS) than to men. Neuroimaging of MS patients indicates the fact that the presence of demyelinating disease in the brainstem, midbrain, periaqueductal gray substance is associated with an increased risk of headache, migraine characteristics (migraine-like). Psychometric test have revealed a high level of depression and anxiety in patients with MS and chronic headache. (authors)

  2. Persistent Organic Pollutants : Backyards to Borders

    OpenAIRE

    World Bank

    2004-01-01

    Chemicals are used in the production of many items that we depend on every day. Evidence demonstrates that certain organic chemicals are persistent, bioaccumulative and toxic and that these chemicals cause long-term harm to the health of human beings and the planet s environment. Throughout the world, people and their environments are exposed on a daily basis to Persistent Organic Pollutan...

  3. Revealing trap depth distributions in persistent phosphors

    NARCIS (Netherlands)

    Van den Eeckhout, K.; Bos, A.J.J.; Poelman, D.; Smet, P.F.

    2013-01-01

    Persistent luminescence or afterglow is caused by a gradual release of charge carriers from trapping centers. The energy needed to release these charge carriers is determined by the trap depths. Knowledge of these trap depths is therefore crucial in the understanding of the persistent luminescence m

  4. Pain perception studies in tension-type headache

    DEFF Research Database (Denmark)

    Bezov, David; Ashina, Sait; Jensen, Rigmor;

    2011-01-01

    Tension-type headache (TTH) is a disorder with high prevalence and significant impact on society. Understanding of pathophysiology of TTH is paramount for development of effective treatments and prevention of chronification of TTH. Our aim was to review the findings from pain perception studies of...... pathophysiology of TTH as well as to review the research of pathophysiology of TTH. Pain perception studies such as measurement of muscle tenderness, pain detection thresholds, pain tolerance thresholds, pain response to suprathreshold stimulation, temporal summation and diffuse noxious inhibitory control (DNIC...... integrate pain perception and imaging to confirm this finding. Pharmacological studies have shown that drugs like tricyclic anti-depressant amitriptyline and nitric oxide synthase inhibitors can reverse central sensitization and the chronicity of headache. Finally, low frequency electrical stimulation has...

  5. Pain perception studies in tension-type headache

    DEFF Research Database (Denmark)

    Bezov, David; Ashina, Sait; Jensen, Rigmor;

    2011-01-01

    integrate pain perception and imaging to confirm this finding. Pharmacological studies have shown that drugs like tricyclic anti-depressant amitriptyline and nitric oxide synthase inhibitors can reverse central sensitization and the chronicity of headache. Finally, low frequency electrical stimulation has......Tension-type headache (TTH) is a disorder with high prevalence and significant impact on society. Understanding of pathophysiology of TTH is paramount for development of effective treatments and prevention of chronification of TTH. Our aim was to review the findings from pain perception studies of...... pathophysiology of TTH as well as to review the research of pathophysiology of TTH. Pain perception studies such as measurement of muscle tenderness, pain detection thresholds, pain tolerance thresholds, pain response to suprathreshold stimulation, temporal summation and diffuse noxious inhibitory control (DNIC...

  6. Drug and Nondrug Treatment in Tension-type Headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    Tension-type headache (TTH) is a common primary headache with tremendous socioeconomic impact. Establishment of an accurate diagnosis is important before initiation of any treatment. Nondrug management is crucial. Information, reassurance and identification of trigger factors may be rewarding....... Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH...... efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient....

  7. Review: Drug and nondrug treatment in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    Tension-type headache (TTH) is a common primary headache with tremendous socioeconomic impact. Establishment of an accurate diagnosis is important before initiation of any treatment. Nondrug management is crucial. Information, reassurance and identification of trigger factors may be rewarding....... Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH...... efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient...

  8. A review of surgical treatment for migraine headaches

    Directory of Open Access Journals (Sweden)

    HAN Yan-qing

    2013-10-01

    Full Text Available Migraine headache is the most common type of headache in the clinic. The pain is serious and recurrent. It can affect patients' daily life, work and study, and even lead to depression, anxiety and other psychological disorders. Nowadays, the treatment of migraine mostly depends on drugs, which can not completely eliminate migraine. Furthermore, there are many side effects and complications in drug treatment. In order to cure magraine, scholars at home and abroad have actively explored in the surgical treatment of migraine, such as anatomy research and clinical curative effect. The occurrence of migraine is associated with four trigger sites, including supraorbital area, auriculotemporal area, occipital nerve area and intranasal trigger points. By the surgical decompression at the trigger sites, migraine can be cured or alleviated.

  9. Primary varicella infection presenting with headache and elevated intracranial pressure.

    Science.gov (United States)

    Gilad, Oded; Shefer-Averbuch, Noa; Garty, Ben Zion

    2015-05-01

    Primary varicella infection may be associated with neurologic complications, such as cerebritis and meningoencephalitis. Several cases of varicella infection with elevated intracranial pressure have been reported. We describe a 13-year-old immunocompetent girl who presented with a clinical picture of headaches and elevated intracranial pressure as the only manifestation of primary varicella zoster infection. The working diagnosis at first was pseudotumor cerebri based on complaints of headache of 2 weeks' duration, in addition to vomiting and papilledema, without fever or skin eruption. On lumbar puncture, opening pressure was 420 mmH2O, but mild pleocytosis and mildly elevated protein level ruled out the diagnosis of pseudotumor cerebri. Our patient had no history of previous varicella infection, and she did not receive the varicella zoster vaccine. Serology tests, done on admission and repeated 2 months later, suggested primary varicella infection. The literature on varicella infection associated with pseudotumor cerebri or elevated intracranial pressure is reviewed. PMID:24846901

  10. [Gastroenteritis with fever, headache and rash after travelling in India].

    Science.gov (United States)

    Hecht, A; Seilmaier, M; Guggemos, W; Löscher, T

    2011-05-01

    A 63-year-old patient presented to our emergency unit two days after returning from India suffering from watery diarrhea, nausea, fever and headache. On admission we found a maculopapular rash on his trunk and forehead. Laboratory findings revealed a leuko-thrombopenia and elevated levels of CRP and procalcitonin. We started treatment with ciprofloxacin. After 48 hours of treatment the diarrhea subsided, whereas the rush on his trunk increased. Under the suspicion of rickettsial fever we started doxycycline 200 mg/d. Because of an incipient pneumonia we added ceftriaxon. The patient improved rapidly and the laboratory abnormalities resolved. Serological investigations revealed a significant increase of specific antibodies against Rickettsia typhi. In conclusion, headache with fever and maculopapular rash after traveling to endemic countries should rise suspicion for murine typhus. PMID:20945058

  11. Potential neurogenic and vascular roles of nitric oxide in migraine headache and aura.

    Science.gov (United States)

    Myers, D E

    1999-02-01

    It has long been known that nitrate and nitrite medications consistently cause significant headache as a side effect. Classical research has shown that cerebral vasodilation accompanies the use of these medications. More modern studies suggest that these vasodilators exert their action on blood vessels via nitric oxide and its second messenger, cyclic guanosine monophosphate. This paper reviews research studies and theoretical articles which address the concept that nitric oxide plays a major role in the vasodilation associated with the headache phase of migraine with aura. A brief discussion of nitric oxide biochemistry and pharmacology follows. In addition, there is a review of evidence examining the possible contributions of nitric oxide to the neurogenic and vascular events associated with spreading cortical depression, an animal model of migraine aura. The paradoxical hypotheses that nitric oxide may contribute to both the propagation of spreading cortical depression and its limitation are presented. Finally, a rationale for the experimental use of nitric oxide agonists and antagonists in the abortion of migraine aura is introduced. PMID:15613204

  12. Association of mobile phone radiation with fatigue, headache, dizziness, tension and sleep disturbance in Saudi population

    International Nuclear Information System (INIS)

    The widespread use of mobile phones has been increased over the past decade; they are now an essential part of business, commerce and society. The use of mobile phones can cause health problems. Therefore, the aim of the present study is to investigate the association of using mobile phones with fatigue, headache, dizziness, tension and sleep disturbance in the Saudi population and provide health and social awareness in using these devices. This study was conducted in the Department of Physiology, College of Medicine, King Saudi University, Riyadh, Kingdom of Saudi Arabia during the year 2002 to 2003. In the present study, a total of 437 subjects (55.1% male and 39.9% female) were invited, they have and had been using mobile phones. A questionnaire was distributed regarding detailed history and association of mobile phones with health hazards. The results of the present study showed an association between the use of mobile phones and health hazards. The overall mean percentage for these clinical findings in all groups were headache (21.6%), sleep disturbance (4.%), tension (3.9%), fatigue (3%) and dizziness (2.4%). Based on the results of the present study, we conclude that the use of mobile phones is a risk factor for health hazards and suggest that long term or excessive use of mobile phones should be avoided by health promotion activities such as group discussions, public presentations and through electronic and print media sources. (author)

  13. Primary care direct access MRI for the investigation of chronic headache

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, T.R., E-mail: timt@nhs.net [Queens Medical Centre, Nottingham (United Kingdom); Evangelou, N. [Queens Medical Centre, Nottingham (United Kingdom); Porter, H. [Nottingham Cripps Health Centre, Nottingham (United Kingdom); Lenthall, R. [Queens Medical Centre, Nottingham (United Kingdom)

    2012-01-15

    Aim: To assess the efficacy of a primary-care imaging pathway for neurology outpatients, from inception to deployment, compared with traditional outpatient referral. Materials and methods: After local agreement, guidelines were generated providing pathways for diagnosis and treatment of common causes of headache, highlighting 'red-flag' features requiring urgent neurology referral, and selecting patients for direct magnetic resonance imaging (MRI) referral. In addition, reports were clarified and standardized. To evaluate the efficacy of the access pathway, a retrospective sequential review of 100 MRI investigations was performed comparing general practitioner (GP) referral, with traditional neurology referral plus imaging, acquired before the pathway started. Results: No statistically significant difference in rates of major abnormalities, incidental findings or ischaemic lesions were identified between the two cohorts. Reported patient satisfaction was high, with a cost reduction for groups using the pathway. Conclusion: The findings of the present study suggest that a defined access pathway for imaging to investigate chronic headache can be deployed appropriately in a primary-care setting.

  14. Autonomic features in cluster headache. Exploratory factor analysis

    OpenAIRE

    Gil Gouveia, R.; Parreira, E, et al.; Pavão Martins, I.

    2005-01-01

    The objective is to identify the pathogenesis of each autonomic manifestation in cluster headache (CH). Through a deductive statistics method (factor analysis) we analysed the type of autonomic symptoms reported by 157 CH patients. Three principal components were identified in the analysis: parasympathetic activation (lacrimation, conjunctival injection and rhinorrhoea), sympathetic defect (miosis and ptosis) and parasympathetic mediated effect (nasal congestion, eyelid oedema and forehead sw...

  15. Cognitive, Personality, and Family Factors in Patients with Migraine Headache

    OpenAIRE

    Reza Johari-Fard; Farzad Goli; Amirreza Boroumand

    2014-01-01

    Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly ...

  16. Treatment of Cervicogenic Headache with Cervical Epidural Steroid Injection

    OpenAIRE

    Wang, Eugene; Wang, Dajie

    2014-01-01

    Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat th...

  17. Cluster headache with Brugada electrocardiogram pattern: a case report

    OpenAIRE

    Matsuki, Yuka; Hirose, Munetaka; Nakano, Akira; Sarasawa, Katsuhiko; Hamada, Toshio

    2008-01-01

    Agents including the effect on sodium channel are restricted in patients with Brugada electrocardiogram (ECG) pattern or Brugada syndrome. On the other hand, many therapeutic agents for cluster headache (CH) block sodium channel. After recommended therapies without sodium channel blocking effect were failed in a 40-year-old male with CH whose ECG shows Brugada ECG pattern, clonazepam and codein phosphate, which are exceptional treatments for CH, were effective for severe unilateral orbital pain.

  18. Convergence Insufficiency in Patients Visiting Eye OPD with Headache

    OpenAIRE

    Archana Gupta; S K Kailwoo; Vijayawali

    2008-01-01

    The present study was undertaken to find out the incidence of convergence insufficiency in patientspresenting in eye OPD with chief complaints of headache. Only patients with normal visual acuity andfundus picture were included in this study. All the 100 patients included in this study were subjected todetailed orthoptic examination which included tests for near point of convergence by RAF, Maddox rodtests and synaptophore examination. It was found that a substantial number of patients had co...

  19. Chronic post-traumatic headache after mild head injury

    DEFF Research Database (Denmark)

    Kjeldgaard, Dorte; Forchhammer, Hysse; Teasdale, Tom;

    2014-01-01

    BACKGROUND: The aetiology behind chronic post-traumatic headache (CPTH) after mild head injury is unclear and management is complicated. In order to optimize treatment strategies we aimed to characterize a CPTH population. METHODS: Ninety patients with CPTH and 45 patients with chronic primary he...... levels of disability for the CPTH patients suggests directions for further research into what important factors are embedded in the patients' PTSD symptoms and might explain their prolonged illness....

  20. Cluster-like headache associated with vertebrobasilar dolichoectasia

    OpenAIRE

    Yüksel Kaplan; Özden Kamışlı; Sibel Altınayar

    2014-01-01

    Vertebrobasilar dolichoectasia (VBD) is characterized by marked elongation, dilatation, and tortuosity of the vertebral and basilar arteries. The etiology of VBD is unknown. VBD can be asymptomatic or associated with clinical manifestations, such as posterior circulation stroke, intracranial bleeding, cranial nerve disorders, brainstem compression, and obstructive hydrocephalus. However, cluster-like headache (CLH) associated with VBD has not been reported in the literature. We report a case ...

  1. Neck pain and headaches in a patient after a fall.

    Science.gov (United States)

    Young, Brian A; Ross, Michael D

    2009-05-01

    The patient was a 64-year-old woman who reported a sudden onset of neck pain and headaches following a fall 2.5 months prior to her initial physical therapy visit. Cervical spine radiographs, which were ordered by the referring physician, revealed extensive degenerative disc disease of the lower cervical spine. At her initial physical therapy evaluation, cervical spine range of motion was within functional limits except for bilateral rotation, which was limited to 45 degrees due to pain and stiffness. The patient's headache symptoms were abolished with the Sharp-Purser test. Although assessment of symptoms was not the intent of the Sharp-Purser test, a reduction of symptoms during the test would warrant further evaluation. Therefore, the physical therapist ordered cervical spine flexion-extension radiographic views to assess for atlantoaxial instability. The radiologist's report noted a stable atlantodens interval that did not change with cervical flexion and extension and a course of physical therapy was initiated. At the time of discharge from physical therapy, the patient reported no neck pain and only very mild occasional headaches, which she believed she could manage on her own. PMID:19411772

  2. Primary headaches interfere with the efficacy of temporomandibular disorders management

    Directory of Open Access Journals (Sweden)

    André Luís PORPORATTI

    2015-04-01

    Full Text Available OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache (PH on efficacy of a Temporomandibular Disorders (TMD conservative therapy and its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I Muscular TMD (n=64; II Muscular TMD+PH (n=48; III Muscular TMD+Articular TMD (n=173; IV Muscular TMD+Articular TMD+PH (n=115. All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. RESULTS: results of this study showed that: (1 A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2 Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3 no association between the presence of self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD management.

  3. Headache and muscle-skeletal pain in children and adolescents

    Directory of Open Access Journals (Sweden)

    Valeria Bachiocco

    2008-04-01

    Full Text Available Headache and muscle-skeletal pain are among the most diffuse kinds of pain in children and adolescents. To know the prevalence of these kinds of pain and the possible association with life habits in modern society, a study on 110 children attending a Tuscany secondary school has been carried out. Twenty-six students referred headache or muscle-skeletal pain and sixty-nine both of them. Headache had a higher prevalence in females (53% vs 46%, while muscle-skeletal pain was prevalent in males (54% vs 46%. Low back pain was present especially at the awakening (24% or following sitting position (11,5%, while the transport of school books was often accompanied by muscular pain (47%. Sport activity was associated to muscleskeletal pain (72%, as well as the forced and prolonged hypermotility (63%. From this study emerges that the presence of pain is particularly high in subjects in school age, and that some life habits are associated with its appearance.

  4. Prediction of antibody persistency from antibody titres to natalizumab

    DEFF Research Database (Denmark)

    Jensen, Poul Erik H; Koch-Henriksen, Nils; Sellebjerg, Finn; Sørensen, Per S

    2012-01-01

    In a subgroup of patients with multiple sclerosis natalizumab therapy causes generation of anti-natalizumab antibodies that may be transient or persistent. It is recommended to discontinue natalizumab therapy in persistently antibody-positive patients.......In a subgroup of patients with multiple sclerosis natalizumab therapy causes generation of anti-natalizumab antibodies that may be transient or persistent. It is recommended to discontinue natalizumab therapy in persistently antibody-positive patients....

  5. Medication overuse headache and chronic migraine in a specialized headache centre: field-testing proposed new appendix criteria

    DEFF Research Database (Denmark)

    Zeeberg, P; Olesen, Jes; Jensen, R

    2009-01-01

    and 785 (81%) as not having MOH after a 2-month drug-free period. Using the appendix criteria, 284 patients (29%) were now classified as MOH, no patients as probable MOH and 685 (71%) as not having MOH. For CM only 16 patients (3%) fulfilled the current diagnostic criteria. This increased to 42...... patients (7%) when we applied the appendix criteria. Using the less restrictive criteria of > or = 4 migraine days and > or = 15 headache days, 88 patients (14%) had CM, whereas the more restrictive criteria of > or = 15 headache days and > or = 50% migraine days resulted in 24 patients (4%) with CM. Our...... data suggest that the IHS has succeeded in choosing new criteria for CM which are neither too strict, nor too loose. For MOH, a shift to the appendix criteria will increase the number of MOH patients, but take into account the possibility of permanent changes in pain perception due to medication...

  6. Tratamento das cefaléias Treatment of headaches

    Directory of Open Access Journals (Sweden)

    José Luiz Dias Gherpelli

    2002-08-01

    Full Text Available Objetivo: realizar revisão bibliográfica sobre o tema tratamento da cefaléia na infância e adolescência. Fontes dos dados: revisão bibliográfica através do banco de dados Medline, utilizando os termos: cefaléia, enxaqueca ou migrânea, infância ou adolescência e tratamento, no período de 1966 a 2001, excluindo artigos de revisão e registros de casos. Foram selecionados artigos científicos que relataram estudos sobre a eficácia da terapêutica farmacológica e não farmacológica no tratamento das cefaléias primárias. Síntese dos dados: foram encontrados 104 artigos científicos, sendo selecionados aqueles que relataram estudos do tipo caso-controle, ou droga versus placebo, cegos ou abertos, e que estudassem crianças ou adolescentes. Conclusões: é digna de nota a pobreza de estudos controlados sobre o tema na faixa etária pediátrica, apesar da importância que as cefaléias primárias apresentam na prática clínica. Apenas algumas drogas foram estudadas de forma cientificamente adequada e, mesmo assim, o número de estudos é pequeno. Tanto o tratamento da crise álgica aguda quanto a profilaxia da cefaléia foram abordados.Objective: to perform a bibliographic review about headache treatment in childhood and adolescence. Sources: articles were searched through Medline database using the terms: migraine, or headache, childhood, or adolescence, and treatment, during the period between 1966 and 2001. Review articles and case reports were excluded. Only articles dealing with pharmacological, and non-pharmacological treatment of primary headaches were selected. Summary of the findings: a total of 104 articles were found; only those reporting results of the case-control studies, or drug vs. placebo, either blind, or open, and that included children, or adolescents were selected. Conclusions: only a few controlled studies about the headache treatment were found in the pediatric age group, although primary headaches are

  7. Persistent primitive trigeminal artery: a review.

    Science.gov (United States)

    Azab, Waleed; Delashaw, Johnny; Mohammed, Mohammed

    2012-01-01

    The trigeminal artery is the largest of the fetal carotid-basilar anastomotic arteries, and it persists for the longest embryonic period. The artery usually involutes after the development of the posterior communicating artery. The exact causes of persistence of this primitive vessel into adulthood are not completely clear. Angiographic and anatomical descriptions of the various persistent trigeminal artery (PTA) configurations and their relation to the remainder of the cerebrovascular tree and the other surrounding structures have been reported. Persistent trigeminal artery can be associated with many other vascular anomalies and disorders including aneurysms, arteriovenous malformations and carotid-cavernous fistulae. A thorough understanding of the anatomical and angiographic features of this persistent embryonic arterial channel is of utmost importance when making therapeutic decisions and embarking on surgical or endovascular intervention for any pertinent pathological condition. We review the embryology, angiographic features, microsurgical anatomy and associated vascular anomalies and disorders of the persistent trigeminal artery. PMID:22843453

  8. Evaluation of patients with headache due to spontaneous intracranial hypotension by RN cisternography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Zy; Park, Chan Hee; Soo, Joo In; Pai, Moon Sun; Yoon, Suk Nam; Kim, Jang Sung [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    Spontaneous intracranial hypotension (SIH) typically occurs without an obvious cause. However, it can be seen following the lumbar puncture, craniotomy, or spinal surgery. Also listed are contributing factors such as sneezing, coughing, intercourse or minor fall. Spontaneous spinal CSF leaks are not common, but are now increasingly recognized as a cause of postural headache associated with intracranial hypotension. The purpose of our study was to evaluate the role of RN cisternography in the diagnosis of SIH cuased by spinal CSF leakage. Four patients with clinical suspicion of SIH (Group I) and six patients as normal control (Group II) underwent RN cisternography. RN cisternography in Group II was done for various reasons, such as hydrocephalus, syringomyelia and memory loss. Group I consisted of the patients who presented with postural headache, as well as additional symptoms, such as nausea, vomiting, dizziness, tinnitus and eyeball pain. The age range of these patients was 27 - 67 years. Lumbar puncture and CSF examinations were performed in Group I more than once and showed typical findings of low CSF pressure and slightly elevated protein level. Brain MRI (4/4), Cervico-thoracic spine MRI (3/4) were also performed. On gadolinium-enhanced brain MRI, enhancement of the meninges which is the most characteristic radiographic finding in intracranial hypotension was found in all patients of Group I. But, cervico-thoracic spin MRI was nonspecific. None of Group I had contrast myelography because of the patient's refusal. Group I and Group II underwent radionuclide cisternography following lumbar subarachnoid injection of 99mTc-DTPA (1-2mCi). The scans were taken in 2, 5, 24 hours later using single head gamma camera equipped with LEAP. Entire spinal region in posterior view and head in frontal and lateral views were obtained. The cisternography of Group I showed the CSF leakage or diverticulum at the level of cervico-thoracic junction(3/4) and mid

  9. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications

    Science.gov (United States)

    Park, Jeong-Wook; Chu, Min Kyung; Kim, Jae-Moon; Park, Sang-Gue; Cho, Soo-Jin

    2016-01-01

    Background Various stimuli can trigger migraines in susceptible individuals. We examined migraine trigger factors by using a smartphone headache diary application. Method Episodic migraineurs who agreed to participate in our study downloaded smartphone headache diary application, which was designed to capture the details regarding headache trigger factors and characteristics for 3 months. The participants were asked to access the smartphone headache diary application daily and to confirm the presence of a headache and input the types of trigger factors. Results Sixty-two participants kept diary entries until the end of the study. The diary data for 4,579 days were analyzed. In this data set, 1,099 headache days (336 migraines, 763 non-migraine headaches) were recorded; of these, 772 headache events had with trigger factors, and 327 events did not have trigger factors. The common trigger factors that were present on headache days included stress, fatigue, sleep deprivation, hormonal changes, and weather changes. The likelihood of a headache trigger was 57.7% for stress, 55.1% for sleep deprivation, 48.5% for fatigue, and 46.5% for any trigger. The headaches with trigger factors were associated with greater pain intensity (p<0.001), headache-related disability (p<0.001), abortive medication use (p = 0.02), and the proportion of migraine (p < 0.001), relative to those without trigger factors. Traveling (odd ratios [OR]: 6.4), hormonal changes (OR: 3.5), noise (OR: 2.8), alcohol (OR: 2.5), overeating (OR: 2.4), and stress (OR:1.8) were significantly associated with migraines compared to non-migraine headaches. The headaches that were associated with hormonal changes or noise were more often migraines, regardless of the preventive medication. The headaches due to stress, overeating, alcohol, and traveling were more often migraines without preventive medication, but it was not evident with preventive medication. Conclusion Smartphone headache diary application is an

  10. Psychometric properties of the Danish versions of headache-specific locus of control scale and headache management self-efficacy scale

    DEFF Research Database (Denmark)

    Hansen, Jacob Sander; Bendtsen, Lars; Jensen, Rigmor

    2009-01-01

    The purpose of the study is to test the cross-cultural adaptation and psychometric properties of a Danish version of the Headache-Specific Locus of Control Scale (HSLC) and the Headache Management Self-Efficacy Scale (HMSE) in a tertiary headache centre. HSLC and HMSE are headache-specific measures...... with other self-report measures concerning general distress, anxiety, depression, and health-related quality of life. Internal stability of the HSLC subscales and the HMSE were analysed using Chronbach's alpha coefficient. The psychometric properties of the Danish version of the HSLC and the HMSE were....... The results are consistent with the earlier findings of the original American versions of HMSE and HSLC. These scales seem to be valid and valuable tools for testing of psychological aspects related to level of functioning and quality of life for headache patients across different cultures of Western...

  11. Prevalence and associated factors for episodic and chronic daily headache in the Colombian population.

    Science.gov (United States)

    Rueda-Sánchez, M; Díaz-Martínez, L A

    2008-03-01

    There are multiple risk factors for chronic daily headache (CDH), but they are usually assessed in an isolated form without an adequate control for confounders. CDH is considered a variant of episodic headache, but studies have not gathered enough evidence to evaluate simultaneously CDH and episodic in the same population. We set out to establish simultaneously the factors associated with chronic daily or episodic headache in a population setting, using a cross-sectional survey in a random sample of 1505 adult urban inhabitants (Bucaramanga, Colombia). The survey asked questions about headache, family and personal history of disease, and consumption or abuse of caffeine, alcohol, hypnotics and analgesics. The association among independent variables and CDH or episodic headache was made with multinomial logistic regression. Female gender, arterial hypertension or cranial trauma history, and a high score in the depression scale are associated with episodic headache and CDH. Parents with CDH, the complaint of multiple arousals during sleep and use of hypnotics are associated with CDH, but not with episodic headache. Age <36 years, alcoholism and snoring are factors associated only with episodic headache. Chronic daily headache and episodic headache have several common risk factors, but there are other factors not shared by both conditions. PMID:18254892

  12. Attitudes towards complementary and alternative medicine in chronic pain syndromes: a questionnaire-based comparison between primary headache and low back pain

    Directory of Open Access Journals (Sweden)

    Czaja Eva

    2011-10-01

    Full Text Available Abstract Background Complementary and Alternative Medicine (CAM is widely used and popular among patients with primary headache or low back pain (LBP. Aim of the study was to analyze attitudes of headache and LBP patients towards the use of CAM. Methods Two questionnaire-based surveys were applied comparing 432 primary headache and 194 LBP patients. Results In total, 84.75% of all patients reported use of CAM; with significantly more LBP patients. The most frequently-used CAM therapies in headache were acupuncture (71.4%, massages (56.4%, and thermotherapy (29.2%, in LBP thermotherapy (77.4%, massages (62.7%, and acupuncture (51.4%. The most frequent attitudes towards CAM use in headache vs. LBP: "leave nothing undone" (62.5% vs. 52.1%; p = 0.006, "take action against the disease" (56.8% vs. 43.2%; p = 0.006. Nearly all patients with previous experience with CAM currently use CAM in both conditions (93.6% in headache; 100% in LBP. However, the majority of the patients had no previous experience. Conclusion Understanding motivations for CAM treatment is important, because attitudes derive from wishes for non-pharmacological treatment, to be more involved in treatment and avoid side effects. Despite higher age and more permanent pain in LBP, both groups show high use of CAM with only little specific difference in preferred methods and attitudes towards CAM use. This may reflect deficits and unfulfilled goals in conventional treatment. Maybe CAM can decrease the gap between patients' expectations about pain therapy and treatment reality, considering that both conditions are often chronic diseases, causing high burdens for daily life.

  13. Hair testing in clinical setting: Simultaneous determination of 50 psychoactive drugs and metabolites in headache patients by LC tandem MS.

    Science.gov (United States)

    Licata, Manuela; Rustichelli, Cecilia; Palazzoli, Federica; Ferrari, Anna; Baraldi, Carlo; Vandelli, Daniele; Verri, Patrizia; Marchesi, Filippo; Silingardi, Enrico

    2016-07-15

    Headache patients suffering from recurrent attacks are a population at risk of overuse and abuse of analgesic medications. Associated with triptans, the first-line drugs recommended for the acute treatment, these patients usually take other medications such as opioids analgesics for the attack treatment, antidepressants and antiepileptics for prophylaxis treatment and benzodiazepines, non-benzodiazepine hypnotics and antipsychotics for the treatment of comorbidities. Regular and frequent use of triptans, like of any other symptomatic analgesic, can cause chronic headache and medication-overuse headache (MOH). In these circumstances, a detoxification treatment is necessary and therefore the monitoring and follow-up of the patients are crucial to the success of the treatment. In the present study, a LC tandem MS method has been developed for the identification of 50 psychoactive drugs in human hair, including triptans, benzodiazepines and metabolites, analgesics, antiepileptic, antidepressants and metabolites, a non-benzodiazepine hypnotic (z-drug), antipsychotics and metabolites. Hair samples were decontaminated, pulverized and incubated overnight in methanol; the extracts were then purified by a new and rapid QuEChERS procedure and analyzed by LC-MS/MS under gradient elution with positive ionization MRM mode. The procedure was fully validated in terms of selectivity, linearity, limit of detection and lower limit of quantitation, precision and accuracy, carry-over, matrix effect, recovery and dilution integrity. The validated procedure has been applied to 234 real hair samples collected from headache patients with known type and dosage of the taken drugs; the obtained data could be of interest to evaluate the xenobiotic concentrations in patients with known therapy. PMID:27136283

  14. [Effect of the continuous epidural saline infusion for patients with postdural puncture headache after pulmonary resection].

    Science.gov (United States)

    Katayama, Tatsuya; Hirai, Shinji; Hamanaka, Yoshiharu; Fukui, Takayuki; Itou, Shimon; Hatooka, Shunzou; Mitsudomi, Tetsuya

    2011-11-01

    The dual puncture is one of the diseaseful complications at the induction of the epidural anesthesia, which causes severe symptoms of intracranial hypotension such as headache and nausea. The clinical courses of 3 patients with the dual puncture symptoms after pulmonary resections were retrospectively reviewed, and the effect of the continuous epidural saline infusion treatment (CESI) for the dual puncture was evaluated. Pneumococcal empyema developed in 1 patient who had been treated with conservative management. In contrast, the symptoms of the others who were treated with the CESI were quickly recovered or were effectively prevented. This report strongly suggested that the CESI was convenient and effective treatment for dual punctune symptoms by suppressing the cerebrospinal fluid leakage by elevation of the fluid pressure in the extradural space. PMID:22187867

  15. The effect of nitric oxide synthase inhibition on histamine induced headache and arterial dilatation in migraineurs

    DEFF Research Database (Denmark)

    Lassen, L H; Christiansen, I; Iversen, Helle Klingenberg; Jansen-Olesen, I; Olesen, J

    2003-01-01

    middle cerebral artery (MCA) (transcranial doppler) and diameters of temporal and radial arteries (high resolution ultrasound) were repeatedly measured. Pre-treatment with L-NMMA, had no effect on histamine induced headache or migraine, but also had no effect on the magnitude of histamine induced....... Our results showed for the first time a craniospecificity for the vasodilating effect of histamine and for the arterial effects of NOS inhibition.......We have previously proposed that histamine causes migraine via increased NO production. To test this hypothesis, we here examined if the NOS inhibitor, L-NG methylarginine hydrochloride (L-NMMA:546C88), could block or attenuate histamine induced migraine attacks and responses of the middle cerebral...

  16. Clinical characteristics of patients with persistent postural-perceptual dizziness

    Directory of Open Access Journals (Sweden)

    Roseli Saraiva Moreira Bittar

    2015-06-01

    Full Text Available INTRODUCTION: Persistent postural-perceptual dizziness is the dizziness that lasts for over three months with no clinical explanation for its persistence. The patient's motor response pattern presents changes and most patients manifest significant anxiety. OBJECTIVE: To evaluate the clinical characteristics of patients with persistent postural and perceptual dizziness. METHODS: statistical analysis of clinical aspects of patients with persistent postural-perceptual dizziness. RESULTS: 81 patients, average age: 50.06 ± 12.16 years; female/male ratio: 5.7/1; main reasons for dizziness: visual stimuli (74%, body movements (52%, and sleep deprivation (38%. The most prevalent comorbidities were hypercholesterolemia (31%, migraine headaches (26%, carbohydrate metabolism disorders (22% and cervical syndrome (21%. DHI, State-Trait Anxiety Inventory - Trait, Beck Depression Inventory, and Hospital Anxiety and Depression Scale questionnaires were statistically different (p < 0.05 when compared to controls. 68% demonstrated clinical improvement after treatment with serotonin reuptake inhibitors. CONCLUSION: Persistent postural-perceptual dizziness affects more women than men, with a high associated prevalence of metabolic disorders and migraine. Questionnaires help to identify the predisposition to persistent postural-perceptual dizziness. The prognosis is good with adequate treatment.

  17. Placebo and other psychological interactions in headache treatment.

    Science.gov (United States)

    Autret, A; Valade, D; Debiais, S

    2012-04-01

    We present a theory according which a headache treatment acts through a specific biological effect (when it exists), a placebo effect linked to both expectancy and repetition of its administration (conditioning), and a non-specific psychological effect. The respective part of these components varies with the treatments and the clinical situations. During antiquity, suggestions and beliefs were the mainstays of headache treatment. The word placebo appeared at the beginning of the eighteenth century. Controversies about its effect came from an excessive interpretation due to methodological bias, inadequate consideration of the variation of the measure (regression to the mean) and of the natural course of the disease. Several powerful studies on placebo effect showed that the nature of the treatment, the associated announce, the patients' expectancy, and the repetition of the procedures are of paramount importance. The placebo expectancy is associated with an activation of pre-frontal, anterior cingular, accumbens, and periacqueducal grey opioidergic neurons possibly triggered by the dopaminergic meso-limbic system. In randomized control trials, several arms design could theoretically give information concerning the respective part of the different component of the outcome and control the natural course of the disease. However, for migraine and tension type headache attacks treatment, no three arm (verum, placebo, and natural course) trial is available in the literature. Indirect evidence of a placebo effect in migraine attack treatment, comes from the high amplitude of the improvement observed in the placebo arms (28% of the patients). This figure is lower (6%) when using the harder criterium of pain free at 2 h. But these data disregard the effect of the natural course. For prophylactic treatment with oral medication, the trials performed in the last decades report an improvement in 21% of the patients in the placebo arms. However, in these studies the duration of

  18. A consecutive series of 22 cases of hypnic headache in France.

    Science.gov (United States)

    Donnet, A; Lantéri-Minet, M

    2009-09-01

    A series of 22 patients was consecutively diagnosed with hypnic headache (HH) from June 2007 to June 2008 in two headache specialty centres participating in the French Observatory of Migraine and Headaches. Patients and headache characteristics were compared with the 2004 International Classification of Headache Disorders, 2nd edn (ICHD-II) criteria for HH and published series of HH patients. One-third of HH patients reported migraine-like headaches (pulsating/unilateral/stabbing) and > 20% were aged eating/drinking especially a cup of coffee, reading/watching television) that differentiate HH from migraine and suggest relationships between HH and trigeminal autonomic cephalalgias. The functional and emotional impact of HH appears low and similar to that of migraine in patients consulting in primary care practice. Improvements in ICHD-II criteria are suggested, especially to introduce the typical motor behaviour acted out by HH patients. PMID:19250282

  19. Treating tension-type headache -- an expert opinion

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Jensen, Rigmor

    2011-01-01

    INTRODUCTION: Tension-type headache (TTH) is a highly prevalent disorder with enormous costs for the individual and the society. AREAS COVERED: Nonpharmacological and pharmacological treatments are reviewed. Electromyographic (EMG) biofeedback has a documented effect in TTH, while cognitive-behavioral...... therapy and relaxation training are most likely to be effective. Physical therapy and acupuncture may be valuable options for patients with frequent TTH. Simple analgesics and nonsteroidal anti-inflammatory drugs are recommended for treatment of episodic TTH. Combination analgesics containing caffeine are...

  20. Effects of the Kampo Formula Tokishakuyakusan on Headaches and Concomitant Depression in Middle-Aged Women

    OpenAIRE

    Masakazu Terauchi; Shiro Hiramitsu; Mihoko Akiyoshi; Yoko Owa; Kiyoko Kato; Satoshi Obayashi; Eisuke Matsushima; Toshiro Kubota

    2014-01-01

    Objectives. To identify the correlates of headaches in middle-aged women and investigate the effects of Tokishakuyakusan (TJ-23), a formula of traditional Japanese herbal therapy Kampo, on headache and concomitant depression. Methods. We examined cross-sectionally the baseline records of 345 women aged 40–59 years who visited our menopause clinic. Among them, 37 women with headaches were treated with either hormone therapy (HT) or TJ-23; the data of these women were retrospectively analyzed t...

  1. Parent–Teen Interactions as Predictors of Depressive Symptoms in Adolescents with Headache

    OpenAIRE

    Lewandowski, Amy S; Palermo, Tonya M.

    2009-01-01

    This study investigated parent–adolescent conflict, family functioning, and adolescent autonomy as predictors of depressive symptoms in adolescents with primary headache. Frequent headaches during adolescence can have a negative impact on activity levels and psychological functioning. Depression is particularly prevalent in adolescents with headache but little research has examined the role of parent–teen interactions in predicting depressive symptoms. Thirty adolescents diagnosed with migrai...

  2. Air Pollution and Daily Clinic Visits for Headache in a Subtropical City: Taipei, Taiwan

    OpenAIRE

    Hui-Fen Chiu; Yi-Hao Weng; Ya-Wen Chiu; Chun-Yuh Yang

    2015-01-01

    This study was undertaken to determine whether there was an association between air pollutant levels and daily clinic visits for headache in Taipei, Taiwan. Daily clinic visits for headache and ambient air pollution data for Taipei were obtained for the period from 2006–2011. The odds ratio of clinic visits for headache was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single pollutant models, on w...

  3. Jane Austen's (1775-1817) references to headache: fact and fiction.

    Science.gov (United States)

    Larner, A J

    2010-11-01

    References to headache in Jane Austen's works, both fictional and non-fictional, and in biographical works undertaken by Austen family members have been collated. These multiple references suggest that Jane Austen used headache as a narrative device to reflect not only physiological bodily processes but also psychological states, possibly based on her own experience of headache and that of female relations and acquaintances. PMID:21079258

  4. Headache in Behçet’s disease: case reports and literature review

    OpenAIRE

    Govoni, M; Trotta, F; La Corte, R; A. Lo Monaco; Capone, J. G.; C. Monaldini; S. Volpinari

    2011-01-01

    Objective: To evaluate the prevalence of headache and its different patterns in patients with Behçet’s disease (BD) with and without neurological involvement and to investigate clinical correlations. Methods: Patients fulfilling the International Study Group criteria for Behçet disease (ISGc) were studied. Patients were invited to fill a “headache questionnaire”, which consisted of two sections: the first one included demographic and anamnestic data, family history for both headache and BD, d...

  5. Etiopathophysiological assessment of cases with chronic daily headache: A functional magnetic resonance imaging included investigation

    OpenAIRE

    Akram Hashemi; Mohammad Torabi Nami; Mohammad Ali Oghabian; Habib Ganjgahi; Zahra Vahabi; Hajir Sikaroodi

    2012-01-01

    BACKGROUND: Chronic daily headache (CDH) has gained little attention in functional neuro-imaging. When no structural abnormality is found in CDH, defining functional correlates between activated brain regions during headache bouts may provide unique insights towards understanding the pathophysiology of this type of headache.METHODS: We recruited four CDH cases for comprehensive assessments, including history taking, physical examinations and neuropsychological evaluations (The Addenbrooke’s C...

  6. Cluster headache as a first manifestation of multiple sclerosis: case report and literature review

    Directory of Open Access Journals (Sweden)

    Mijajlović MD

    2014-11-01

    Full Text Available Milija D Mijajlović,* Vuk M Aleksić,* Nadežda M Čovičković Šternić Department for Cerebrovascular Disorders and Headaches, Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia *These authors contributed equally to this work Abstract: Cluster headache (CH is estimated to be the most common primary trigeminal autonomic headache, although it is a rare disabling medical condition. Dominant symptoms of CH include severe unilateral orbital, supraorbital, and/or temporal pain, lasting from 15 to 180 minutes if untreated, associated with at least one of various autonomic symptoms during the headache, such as conjunctival injection, lacrimation, nasal congestion and rhinorrhea, facial sweating, miosis, ptosis, and eyelid edema. Headache is not frequently a symptom of multiple sclerosis (MS. The most commonly reported primary headaches are migraine without aura and a tension-type headache. Several described cases involved complicated migraine, ophthalmoplegic migraine-like headache, and finally cluster-like headache. We present a case of a 45-year-old male patient who had typical CH attacks as the initial and only clinical manifestation of MS, which was diagnosed after cerebrospinal fluid (CSF isoelectric focusing and brain magnetic resonance imaging (MRI investigation. He presented as a typical cluster-like headache patient since in the background of the CH symptoms and signs, were MS demyelinating lesions. In a patient with CH symptoms one should always think about the possibility of cluster-like-headache, which presents the CH patient with different underlying diseases, so we proposed a protocol to evaluate such patients and exclude diseases that could be in the background of CH symptoms. Keywords: demyelinating disease, headache, trigeminal autonomic cephalalgia, diagnosis

  7. Propofol and Alfentanil in Treatment of a Patient With Episodic Cluster Headache

    OpenAIRE

    Razavi, Sajjad; Gharaei, Babak; Jafari, Alireza; Aghamohammadi, Homayoun; Mirkheshti, Alireza

    2014-01-01

    Introduction: Cluster headache is a severe hemifacial pain with concomitant symptoms such as lacrimation, conjunctival congestion, and nasal discharge. Peripheral (to be a spectrum of trigeminal autonomic cephalgia) and central (hypothalamus) disorders have been suggested to be involved. Several modalities have been recommended to prevent or alleviate this devastating headache. Case Presentation: In this case report, we presented a young man with an acute cluster headache who responded dramat...

  8. The impact of headache severity on quality of life of patients with migraine

    Directory of Open Access Journals (Sweden)

    Simić Svetlana

    2006-01-01

    Full Text Available Migraine is a chronic disease characterized by episodic headache attacks, most often on one side of the head with pulsating, moderate to severe pain. We conducted an assessment of headache severity by using the M1GSEV questionnaire, and the quality of life assessment by using the QVM questionnaire, on a sample of 30 patients suffering from migraine. Afterwards, the research results were compared. The research results indicate that the majority of patients suffer from severe and moderate headaches. The quality of life is poorer in patients suffering from severe headaches.

  9. Prevalence of headache and its interference in the activities of daily living in female adolescent students

    Directory of Open Access Journals (Sweden)

    Alaine Souza Lima

    2014-06-01

    Full Text Available OBJECTIVE: To describe the prevalence of headache and its interference in the activities of daily living (ADL in female adolescent students.METHODS: This descriptive cross-sectional study enrolled 228 female adolescents from a public school in the city of Petrolina, Pernambuco, Northeast Brazil, aged ten to 19 years. A self-administered structured questionnaire about socio-demographic characteristics, occurrence of headache and its characteristics was employed. Headaches were classified according to the International Headache Society criteria. The chi-square test was used to verify possible associations, being significant p<0.05.RESULTS: After the exclusion of 24 questionnaires that did not met the inclusion criteria, 204 questionnaires were analyzed. The mean age of the adolescents was 14.0±1.4 years. The prevalence of headache was 87.7%. Of the adolescents with headache, 0.5% presented migraine without pure menstrual aura; 6.7%, migraine without aura related to menstruation; 1.6%, non-menstrual migraine without aura; 11.7%, tension-type headache and 79.3%, other headaches. Significant associations were found between pain intensity and the following variables: absenteeism (p=0.001; interference in ADL (p<0.001; medication use (p<0.001; age (p=0.045 and seek for medical care (p<0.022.CONCLUSIONS: The prevalence of headache in female adolescents observed in this study was high, with a negative impact in ADL and school attendance.

  10. Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

    Directory of Open Access Journals (Sweden)

    Laureys Steven

    2011-02-01

    Full Text Available Abstract Background Occipital nerve stimulation (ONS has raised new hope for drug-resistant chronic cluster headache (drCCH, a devastating condition. However its mode of action remains elusive. Since the long delay to meaningful effect suggests that ONS induces slow neuromodulation, we have searched for changes in central pain-control areas using metabolic neuroimaging. Methods Ten drCCH patients underwent an 18FDG-PET scan after ONS, at delays varying between 0 and 30 months. All were scanned with ongoing ONS (ON and with the stimulator switched OFF. Results After 6-30 months of ONS, 3 patients were pain free and 4 had a ≥ 90% reduction of attack frequency (responders. In all patients compared to controls, several areas of the pain matrix showed hypermetabolism: ipsilateral hypothalamus, midbrain and ipsilateral lower pons. All normalized after ONS, except for the hypothalamus. Switching the stimulator ON or OFF had little influence on brain glucose metabolism. The perigenual anterior cingulate cortex (PACC was hyperactive in ONS responders compared to non-responders. Conclusions Metabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation might support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes. Selective activation in responders of PACC, a pivotal structure in the endogenous opioid system, suggests that ONS could restore balance within dysfunctioning pain control centres. That ONS is nothing but a symptomatic treatment might be illustrated by the persistent hypothalamic hypermetabolism, which could explain why autonomic attacks may persist despite pain relief and why cluster attacks recur shortly after stimulator arrest. PET studies on larger samples are warranted to confirm these first results.

  11. SUNCT syndrome: The materialization of a headache syndrome

    Directory of Open Access Journals (Sweden)

    Ottar Sjaastad

    2008-10-01

    Full Text Available Ottar SjaastadDepartment of Neurology, St. Olav´s Hospital, 7006 Trondheim University Hospitals, Trondheim, NorwayAbstract: Shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome is a rare headache, described by our group in 1989. This overview presents our early studies of SUNCT pathogenesis. Due to the conspicuous ictal, ocular phenomena, ie, conjunctival injection and tearing, our studies started out with ocular parameters: intraocular pressure and corneal indentation pulse amplitudes, both of which showed clear ictal increments, symptomatic side. Beat-to-beat, noninvasive blood pressure measurements during attack showed instant, systolic blood pressure rise and corresponding pulse rate decrease. Carotid body, the principal peripheral chemoreceptor, seemed to function normally. The middle cerebral artery was dilated during attacks, particularly on the symptomatic side. Finally, some viewpoints are added regarding terminology. SUNCT is a workable and accepted term. There does not seem to be any need for another, fictitious term to describe the same clinical picture.Keywords: SUNCT syndrome, intraocular blood flow, intraocular pressure, median artery blood flow, carotid body function, hypothalamic stimulation

  12. Diagnostic Accuracy Comparison of Artificial Immune Algorithms for Primary Headaches

    Science.gov (United States)

    Çelik, Ufuk; Yurtay, Nilüfer; Koç, Emine Rabia; Tepe, Nermin; Güllüoğlu, Halil; Ertaş, Mustafa

    2015-01-01

    The present study evaluated the diagnostic accuracy of immune system algorithms with the aim of classifying the primary types of headache that are not related to any organic etiology. They are divided into four types: migraine, tension, cluster, and other primary headaches. After we took this main objective into consideration, three different neurologists were required to fill in the medical records of 850 patients into our web-based expert system hosted on our project web site. In the evaluation process, Artificial Immune Systems (AIS) were used as the classification algorithms. The AIS are classification algorithms that are inspired by the biological immune system mechanism that involves significant and distinct capabilities. These algorithms simulate the specialties of the immune system such as discrimination, learning, and the memorizing process in order to be used for classification, optimization, or pattern recognition. According to the results, the accuracy level of the classifier used in this study reached a success continuum ranging from 95% to 99%, except for the inconvenient one that yielded 71% accuracy. PMID:26075014

  13. Diagnostic Accuracy Comparison of Artificial Immune Algorithms for Primary Headaches

    Directory of Open Access Journals (Sweden)

    Ufuk Çelik

    2015-01-01

    Full Text Available The present study evaluated the diagnostic accuracy of immune system algorithms with the aim of classifying the primary types of headache that are not related to any organic etiology. They are divided into four types: migraine, tension, cluster, and other primary headaches. After we took this main objective into consideration, three different neurologists were required to fill in the medical records of 850 patients into our web-based expert system hosted on our project web site. In the evaluation process, Artificial Immune Systems (AIS were used as the classification algorithms. The AIS are classification algorithms that are inspired by the biological immune system mechanism that involves significant and distinct capabilities. These algorithms simulate the specialties of the immune system such as discrimination, learning, and the memorizing process in order to be used for classification, optimization, or pattern recognition. According to the results, the accuracy level of the classifier used in this study reached a success continuum ranging from 95% to 99%, except for the inconvenient one that yielded 71% accuracy.

  14. Headache in the paediatrics patients, clinical-EEG Correlation.

    Directory of Open Access Journals (Sweden)

    Marcelino Lizano Rabelo

    2011-12-01

    Full Text Available A descriptive study was made, with the objective to describe to a clinical group of variables epidemiologists and of laboratory of 108 patients to whom it was made to them and EEG and whose fundamental symptom was the headache; in the period January to December of 2009. The data was taken from the registry of patients of the neurophysiology department of Paediatric Hospital. The variables of the study were: age, sex, type of headache, results of the EEG, and characteristics of pathological EEG activity. The results were expressed in graphical and analyzed tables and of percentage form. The patients of 14 to 16 years predominated (40,7%, female patient (53,7%, clinically the observed recurrent acute migraine in 60 cases was the one that prevailed, as well as normality in the EEG (81,5%, the pathological cases we observed focal paroxysms in 15 patients (75% and focal alterations in 80% of the pathological EEG. Conclusions: In our environment the migraine in the paediatric patient is a frequent pathology that motivates the accomplishment of diverse studies among them the EEG, being this normal one in most of the cases and the non-specific alterations, the recurrent acute migraine and female patients prevailed.

  15. Primary intracranial angiomatoid fibrous histiocytoma presenting with anaemia and migraine-like headaches and aura as early clinical features

    DEFF Research Database (Denmark)

    Hansen, Jakob Møller; Larsen, Vibeke Andrée; Scheie, David;

    2015-01-01

    A 17-year-old female with migraine with aura complained of fatigue and was diagnosed with anemia. Three years later, changes in her headache pattern prompted hospital referral. Brain MRI showed a bi-lobed extra-axial intracerebral tumor encroaching both parieto-occipital regions. The resection...... specimen yielded a rare diagnosis of primary intracranial angiomatoid fibrous histiocytoma (AFH). Tumor removal resulted in cessation of her migraine and anemia. AFH may cause systemic symptoms--in this case fatigue and anemia--long before focal neurological symptoms are present. This is the first report...... of an intracranial AFH presenting as migraine with visual aura and anemia....

  16. Personality traits in chronic daily headache patients with and without psychiatric comorbidity: an observational study in a tertiary care headache center

    OpenAIRE

    Rausa, Marialuisa; Cevoli, Sabina; Sancisi, Elisa; Grimaldi, Daniela; Pollutri, Gabriella; Casoria, Michela; Grieco, Daniela; Bisi, Alberto; Cortelli, Pietro; Pozzi, Euro; Pierangeli, Giulia

    2013-01-01

    Background Previous studies suggest that patients with Chronic Daily Headache (CDH) have higher levels of anxiety and depressive disorders than patients with episodic migraine or tension-type headache. However, no study has considered the presence of psychiatric comorbidity in the analysis of personality traits. The aim of this study is to investigate the prevalence of psychiatric comorbidity and specific personality traits in CDH patients, exploring if specific personality traits are associa...

  17. Low omega-6 vs. low omega-6 plus high omega-3 dietary intervention for Chronic Daily Headache: Protocol for a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Smith Sunyata

    2011-04-01

    Full Text Available Abstract Background Targeted analgesic dietary interventions are a promising strategy for alleviating pain and improving quality of life in patients with persistent pain syndromes, such as chronic daily headache (CDH. High intakes of the omega-6 (n-6 polyunsaturated fatty acids (PUFAs, linoleic acid (LA and arachidonic acid (AA may promote physical pain by increasing the abundance, and subsequent metabolism, of LA and AA in immune and nervous system tissues. Here we describe methodology for an ongoing randomized clinical trial comparing the metabolic and clinical effects of a low n-6, average n-3 PUFA diet, to the effects of a low n-6 plus high n-3 PUFA diet, in patients with CDH. Our primary aim is to determine if: A both diets reduce n-6 PUFAs in plasma and erythrocyte lipid pools, compared to baseline; and B the low n-6 plus high n-3 diet produces a greater decline in n-6 PUFAs, compared to the low n-6 diet alone. Secondary clinical outcomes include headache-specific quality-of-life, and headache frequency and intensity. Methods Adults meeting the International Classification of Headache Disorders criteria for CDH are included. After a 6-week baseline phase, participants are randomized to a low n-6 diet, or a low n-6 plus high n-3 diet, for 12 weeks. Foods meeting nutrient intake targets are provided for 2 meals and 2 snacks per day. A research dietitian provides intensive dietary counseling at 2-week intervals. Web-based intervention materials complement dietitian advice. Blood and clinical outcome data are collected every 4 weeks. Results Subject recruitment and retention has been excellent; 35 of 40 randomized participants completed the 12-week intervention. Preliminary blinded analysis of composite data from the first 20 participants found significant reductions in erythrocyte n-6 LA, AA and %n-6 in HUFA, and increases in n-3 EPA, DHA and the omega-3 index, indicating adherence. Trial Registration ClinicalTrials.gov (NCT01157208

  18. Trigeminal neuralgia and persistent trigeminal artery

    OpenAIRE

    Conforti, Renata; Parlato, Raffaele Stefano; De Paulis, Danilo; Cirillo, Mario; Marrone, Valeria; Cirillo, Sossio; Moraci, Aldo; Parlato, Ciro

    2012-01-01

    We report a case of trigeminal neuralgia caused by persistent trigeminal artery (PTA) associated with asymptomatic left temporal cavernoma. Our patient presented unstable blood hypertension and the pain of typical trigeminal neuralgia over the second and third divisions of the nerve in the right side of the face. The attacks were often precipitated during physical exertion. MRI and Angio-MRI revealed the persistent carotid basilar anastomosis and occasionally left parietal cavernoma. After dr...

  19. Demystifying the persistent pneumothorax: role of imaging.

    Science.gov (United States)

    Chaturvedi, Apeksha; Lee, Steven; Klionsky, Nina; Chaturvedi, Abhishek

    2016-06-01

    Evaluation for pneumothorax is an important indication for obtaining chest radiographs in patients who have had trauma, recent cardiothoracic surgery or are on ventilator support. By definition, a persistent pneumothorax constitutes ongoing bubbling of air from an in situ chest drain, 48 h after its insertion. Persistent pneumothorax remains a diagnostic dilemma and identification of potentially treatable aetiologies is important. These may be chest tube related (kinks or malposition), lung parenchymal disease, bronchopleural fistula, or rarely, oesophageal-pleural fistula. Although radiographs remain the mainstay for diagnosis and follow up of pneumothorax, computed tomography (CT) is increasingly being used for problem solving. Aetiology of persistent air leak determines the optimal treatment. For some, a simple repositioning of the chest tube/drain may suffice; others may require surgery. In this pictorial review, we will briefly describe the physiology of pneumothorax, discuss imaging features of identifiable causes for persistent pneumothorax and provide a brief overview of treatment options. Specific aetiology of a persistent air leak may often not be immediately discernible, and will need to be carefully sought. Accurate interpretation of imaging studies can expedite diagnosis and facilitate prompt treatment. Key points • Persistent pneumothorax is defined as a leak persisting for more than 2 days.• Radiographs can identify chest-tube-related causes of pneumothorax.• CT is the most useful test to identify other causes.• Penetrating thoracic injury can cause fistulous communication resulting in a persistent pneumothorax.• Discontinuity of visceral pleura identified by CT may indicate a bronchopleural fistula. PMID:27100907

  20. Bilateral SUNCT-like headache in a patient with prolactinoma responsive to lamotrigine

    OpenAIRE

    Zidverc-Trajkovic, Jasna; Vujovic, Svetlana; Sundic, Ana; Radojicic, Aleksandra; Sternic, Nadezda

    2009-01-01

    Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is a rare trigeminal autonomic cephalalgia. The cases of SUNCT with attacks that affected both sides simultaneously have only rarely been reported and some of them had underlying pathology. We have reported a case of bilateral SUNCT-like headache secondary to a prolactinoma and responsive to lamotrigine treatment.

  1. Impaired Mood in Headache Clinic Patients : Associations With the Perceived Hindrance and Attainability of Personal Goals

    NARCIS (Netherlands)

    Ciere, Yvette; Visser, Annemieke; Lebbink, John; Sanderman, Robbert; Fleer, Joke

    2016-01-01

    BACKGROUND: Headache disorders are often accompanied by impaired mood, especially in the headache clinic population. There is a large body of literature demonstrating that an illness or disability may affect the way in which patients perceive their personal goals and that the perception that the att

  2. Impaired Mood in Headache Clinic Patients : Associations With the Perceived Hindrance and Attainability of Personal Goals

    NARCIS (Netherlands)

    Ciere, Yvette; Visser, Annemieke; Lebbink, John; Sanderman, Robbert; Fleer, Joke

    2016-01-01

    BackgroundHeadache disorders are often accompanied by impaired mood, especially in the headache clinic population. There is a large body of literature demonstrating that an illness or disability may affect the way in which patients perceive their personal goals and that the perception that the attai

  3. Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache

    Directory of Open Access Journals (Sweden)

    Md Rabiul Alam

    2012-01-01

    Conclusions: Very short-term use of IV hydrocortisone was found effective in reducing headache following spinal anesthesia. However, its clear mechanism of action is yet to be determined. Large-scale studies are recommended to consider the steroid therapy as a standard treatment for postdural puncture headache.

  4. Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

    Directory of Open Access Journals (Sweden)

    S. Mhamdi

    2015-07-01

    We present a case of severe headache occurring after a TEVAR with intentional coverage of the origin of the left SCA. This headache was the only symptom from which the patient complained, and which disappeared immediately after carotid-SCA bypass. Other devastating complications can happen, which gave as a concern about the management of SCA when decision to practice a TEVAR is taken.

  5. Cognitive-Behavioral Therapy versus Temporal Pulse Amplitude Biofeedback Training for Recurrent Headache

    Science.gov (United States)

    Martin, Paul R.; Forsyth, Michael R.; Reece, John

    2007-01-01

    Sixty-four headache sufferers were allocated randomly to cognitive-behavioral therapy (CBT), temporal pulse amplitude (TPA) biofeedback training, or waiting-list control. Fifty-one participants (14M/37F) completed the study, 30 with migraine and 21 with tension-type headache. Treatment consisted of 8, 1-hour sessions. CBT was highly effective,…

  6. Change Mechanisms in EMG Biofeedback Training: Cognitive Changes Underlying Improvements in Tension Headache.

    Science.gov (United States)

    Holroyd, Kenneth A.; And Others

    1984-01-01

    Subjects (N=43) suffering from tension headache were assigned to one of four electromyograph (EMG) biofeedback conditions and were led to believe they were achieving high or moderate success in decreasing EMG activity. Regardless of actual EMG changes, subjects receiving high-success feedback showed greater improvement for headaches than…

  7. Application of ICHD-II criteria in a headache clinic of China.

    Directory of Open Access Journals (Sweden)

    Zhao Dong

    Full Text Available BACKGROUND: China has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II. METHODS AND RESULTS: Personal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9-80 years and the female/male ratio of 1.67/1. The primary headaches (78.4% were classified as the following: migraine (39.1%, tension-type headache (32.5%, trigeminal autonomic cephalalgias (5.3% and other primary headache (1.5%. Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843 were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%, chronic tension-type headache (CTTH, 32.7% and chronic migraine (CM, 13.5%. The visual analogue scale (VAS score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, P<0.001. The similar result was also observed in VAS score between migraine with MOH and CM (8.0±1.5 vs 7.0±1.5, P = 0.004. The peak age at onset of TTH for male and female were both in the 3(rd decade of life. However, the age distribution at onset of migraine shows an obvious sex difference, i.e. the 2(nd decade for females and the 1(st decade for males. CONCLUSIONS/SIGNIFICANCE: This study revealed the characteristics of the headache clinic

  8. Ibuprofen for acute treatment of episodic tension-type headache in adults

    DEFF Research Database (Denmark)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew;

    2015-01-01

    BACKGROUND: Tension-type headache (TTH) affects about one person in five worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (1 to 14 headaches per month), and chronic TTH (15 headaches a month or more). Ibuprofen is one of a number of...... analgesics suggested for acute treatment of headaches in frequent episodic TTH. OBJECTIVES: To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. SEARCH METHODS: We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January...... 2015. We sought unpublished studies by asking personal contacts and searching on-line clinical trial registers and manufacturers' websites. SELECTION CRITERIA: We included randomised, placebo-controlled studies (parallel-group or cross-over) using oral ibuprofen for symptomatic relief of an acute...

  9. Simultaneous occurrence of ipsilateral cluster headache and chronic paroxysmal hemicrania: a case report.

    Science.gov (United States)

    Centonze, V; Bassi, A; Causarano, V; Dalfino, L; Centonze, A; Albano, O

    2000-01-01

    A 42-year-old man came to our headache unit in October 1995 complaining of recurrent attacks of headache, which had begun in February 1991. Chronic cluster headache was diagnosed, and he was given verapamil, 360 mg per day. The attacks ceased in the following months and verapamil was stopped in March 1996. In May 1997, a recurrence of the attacks required the readministration of verapamil, 360 mg per day. The attacks decreased (one to three per week), but after 2 months the patient reported a worsening in his condition due to the appearance of shorter attacks, which were diagnosed as chronic paroxysmal hemicrania. The administration of indomethacin, 225 mg per day, resulted in the disappearance of the short attacks. The concomitant occurrence of attacks of cluster headache and chronic paroxysmal hemicrania suggests the presence of shared factors in the pathophysiology of the two forms of headache. This hypothesis is supported by previous reports in the literature. PMID:10759906

  10. Case report Atypical clinic of foreign objects in the Maxillary Sinus ; Cluster-Type Headache

    Directory of Open Access Journals (Sweden)

    Zahide Mine Yazici

    2015-12-01

    Full Text Available Cluster-type headaches often seen in men, which might be a different intensity, around the eyes and in the temporal region, a type of primary headache that may continue approximately between 15 and 180 minutes. In the literature, a lot of reasons of cluster- type headache had been defined . Many systemic diseases may carry this symptom . Besides, belong the interest field of ear, nose and throat physician, it can bee seen in the paranasal sinus pathology. In the literature, Headache by the foreign bodies of maxillary sinus is considered extremely rare. İn this article, in the light of the literature, we present a patient refer to our clinic with symptoms of cluster headache, at paranazal sinüs CT scanning, in the maxillary sinus fungus ball was thought, that’s why caldwell-luc operation was performed and we extracted 11 pieces of glass from maxillary sinus.

  11. Clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation

    Directory of Open Access Journals (Sweden)

    Dmitry ePinchuk

    2013-03-01

    Full Text Available The clinical effectiveness of headache treatment by transcranial direct current stimulation with various locations of stimulating electrodes on the scalp was analyzed retrospectively. The results of the treatment were analyzed in 90 patients aged from 19 to 54 years (48 patients had migraine without aura, 32 – frequent episodic tension-type headaches, 10 – chronic tension-type headaches and in 44 adolescents aged 11 – 16 years with chronic posttraumatic headaches after a mild head injury. Clinical effectiveness of tDCS with 70 – 150 µA current for 30 – 45 minutes via 6.25 cm2 stimulating electrodes is comparable to that of modern pharmacological drugs, with no negative side effects. The obtained result has been maintained on average from 5 to 9 months. It has been demonstrated that effectiveness depends on localization of stimulating electrodes used for different types of headaches.

  12. Cognitive behavioural treatment for the chronic post-traumatic headache patient

    DEFF Research Database (Denmark)

    Kjeldgaard, Dorte; Forchhammer, Hysse B; Teasdale, Thomas William;

    2014-01-01

    BACKGROUND: Chronic post-traumatic headache (CPTH) after mild head injury can be difficult to manage. Research is scarce and successful interventions are lacking.To evaluate the effect of a group-based Cognitive Behavioural Therapy (CBT) intervention in relation to headache, pain perception......, psychological symptoms and quality of life in patients with CPTH. METHODS: Ninety patients with CPTH according to ICHD-2 criteria were enrolled from the Danish Headache Center into a randomized, controlled trial. Patients were randomly assigned to either a waiting list group or to a nine-week CBT group...... intervention. At baseline and after 26 weeks all patients completed the Rivermead Post Concussion Symptoms Questionnaire, SF-36, SCL-90-R and a headache diary. RESULTS: The CBT had no effect on headache and pressure pain thresholds and only a minor impact on the CPTH patients' quality of life, psychological...

  13. Reduction of Medication Costs After Detoxification for Medication-Overuse Headache

    DEFF Research Database (Denmark)

    Shah, Asif M; Bendtsen, Lars; Zeeberg, Peter;

    2013-01-01

    OBJECTIVE: To examine whether detoxifying patients with medication-overuse headache can reduce long-term medication costs. BACKGROUND: Direct costs of medications in medication-overuse headache have been reported to be very high but have never been calculated on the basis of exact register data....... Long-term economic savings obtained by detoxification have never been investigated. METHODS: We conducted a registry-based observational retrospective follow-up study on 336 medication-overuse headache patients treated and discharged from the Danish Headache Center over a 2-year period. By means of the...... Danish Register of Medicinal Product Statistics, we collected information on the costs and use of prescription-only medication 1 year before admission and 1 year after discharge from Danish Headache Center. RESULTS: The average medication costs per patient per year decreased with 24%, from US$971 before...

  14. [Botulinum toxin type A in headache treatment : Established and experimental indications].

    Science.gov (United States)

    Gaul, C; Holle-Lee, D; Straube, A

    2016-08-01

    In recent years botulinum toxin type A has been used increasingly more in the treatment of specific headache disorders. Especially regarding chronic migraine with and without combined medication overuse, convincing randomized studies have proven the efficacy of this treatment option and have led to approval for this indication. Regarding other headache entities, such as episodic migraine, tension-type headache, trigeminal autonomic cephalalgia (TAC), neuralgic, neuropathic and myofascial pain, currently available scientific data on the efficacy of botulinum toxin type A are scarce and often ambiguous. The exact underlying mechanisms of the influence of botulinum toxin type A on the pathophysiology of headache are not completely clear but an influence on the release of calcitonin gene-related peptide (CGRP) seems to play a crucial role. This article summarizes the most important studies as well as experiences of treatment with botulinum toxin type A regarding different headache entities. PMID:27300190

  15. Unexpected death after headache due to a colloid cyst of the third ventricle

    Directory of Open Access Journals (Sweden)

    Twaij Zuhair

    2006-07-01

    Full Text Available Abstract Background Colloid cysts of the third ventricle are rare benign intracranial non-neoplastic cysts. Headache is the most common symptom. We present a case of sudden death due to colloid cyst in a 17 year old female who had symptoms of intermittent headaches. Case presentation A 17 year old female presented with intermittent mild headaches for a period of two years. She complained of severe headache in the night and was found unresponsive the next morning. Resuscitation team was called on site but the patient was already dead. At post mortem examination a dilated ventricular system was found with a colloid cyst of the third ventricle. Conclusion This report highlights the difficulty in the diagnosis and importance of recognizing colloid cyst of the third ventricle which should be in the differential diagnosis of headaches in children and young adults and of hydrocephalus at autopsy

  16. Disabling Orthostatic Headache after Penetrating Stonemason Pencil Injury to the Sacral Region

    Directory of Open Access Journals (Sweden)

    Carlo Brembilla

    2015-01-01

    Full Text Available Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described. The current case concerns a 42-year-old man with an accidental penetrating stonemason pencil injury into the vertebral canal without neurological deficit. After the self-removal of the foreign object the patient complained of a disabling orthostatic headache. The early identification and treatment of the intracranial hypotension due to the posttraumatic cerebrospinal fluid (CSF sacral fistulae were mandatory to avoid further neurological complications. In the current literature acute pattern of intracranial hypotension immediately after a penetrating injury of the vertebral column has never been reported.

  17. CO2 measurements during transcranial Doppler examinations in headache patients

    DEFF Research Database (Denmark)

    Thomsen, L L; Iversen, Helle Klingenberg

    1994-01-01

    Transcranial Doppler (TCD) examinations are increasingly being used in studies of headache pathophysiology. Because blood velocity is highly dependent on PCO2, these parameters should be measured simultaneously. The most common way of performing measurements during TCD examinations is as end......-tidal pCO2 with a capnograph. When patients are nauseated and vomit, as in migraine, the mask or mouthpiece connected to the capnograph represents a problem. We therefore evaluated whether a transcutaneous pCO2 electrode was as useful as the capnograph for pCO2 measurements in TCD examinations. We...... conclude that this is not the case, and recommend capnographic end-tidal pCO2 measurements during TCD examinations. However, transcutaneous pCO2 measurements may represent a supplement to spot measurements of end-tidal pCO2 in stable conditions when long-term monitoring is needed, and the mask or...

  18. Is oral contraceptive-induced headache dependent on patent foramen ovale? Clinical dynamics, evidence-based hypothesis and possible patient-oriented management.

    Science.gov (United States)

    Chiofalo, Benito; Laganà, Antonio Simone; Imbesi, Giovanna; Vitale, Salvatore Giovanni; Catena, Ursula; Campolo, Federica; Lanzo, Gabriele; Centini, Gabriele; Triolo, Onofrio

    2016-09-01

    Secondary headache is one of the most common side effect during oral contraceptive (OC) treatment and it leads many patients to stop the therapy. Patent foramen ovale (PFO) is an interatrial communication that spontaneously closes at birth in about 75% of the population. However, in the rest of adults PFO maintains a direct communication between the right and left side of circulation. In these patients PFO is a tunnel-like structure that could allow a blood clot to pass from the right to the left side of circulation, thus can cause paradoxical embolization. Although an increased frequency of PFO in patients with migraine was already reported, the relationship between PFO and migraine remains uncertain. In patients with migraine, the prevalence of moderate or large PFO is 35% and seems not associated with the presence of aura or the frequency of headache. Basing on these assumptions, we hypothesize that asymptomatic PFO could play a role in secondary headache due to OC. The procoagulant effect of OC improves the production of microemboli that through the POF could pass from the right to the left atrium and than to the brain, where they could be responsible of secondary headache. If our hypothesis would be confirmed in future studies, it would be possible to identify high-risk patients for developing OC-induced headache and other cerebrovascular major diseases through transcranial Doppler and transesophageal echocardiography. This scenario may radically change the management of reproductive-age woman who have to undergo OC therapy for contraception or other medical conditions. PMID:27515209

  19. [Autoantibodies to glutamate receptors in children with chronic posttraumatic headache].

    Science.gov (United States)

    Goriunova, A V; Bazarnaia, N A; Sorokina, E G; Semenova, N Iu; Globa, O V; Semenova, Zh B; Pinelis, V G; Roshal', L M; Maslova, O I

    2006-01-01

    Autoantibodies (aAB) to AMPA (Glu R1 subunit) and NMDA (NR 2A subunit) glutamate receptors were studied in blood serum of 60 children, aged 7-16 years, with chronic posttraumatic headache after mild skull injury. All the children were divided into 2 groups: group 1 included 48 children with concussion of the brain, group 2--12 children with brain contusion. Group 1 was divided into 2 subgroups: subgroup 1a comprised 34 children with single concussion and subgroup 1b--14 children with repeated concussion. The aAB level was determined 6 months and 1 year after skull injury. The aAB concentration was expressed in percents to the control level being considered significant if the increase was higher than 120%. The increased NMDA aAB level was observed during the first year after skull injury. In the la subgroup, the NR2 aAB level in blood serum was 145 +/- 12,6%, in the 1b one--108 +/- 12,4%, in group 2--165 +/- 34%. The content of aAB to AMPA receptors was elevated only in children of lb subgroup and group 2 (150 +/- 16,8% and 167 +/- 31,3%, respectively). The EEG examination of this group revealed the nonspecific paroxysmal discharges in 18% of cases and epileptiform activity in 6% of children. The results obtained suggest that children with posttraumatic headache have elevated levels of aAB to glutamate receptors, hyperstimulation of which reflects hypoxic processes in the brain, and are in need of metabolic therapy. PMID:16972597

  20. Case Series Report on the Effect of Hand Acupuncture - Focusing on 29 Patients with Headache -

    Directory of Open Access Journals (Sweden)

    Seung-Ho Sun

    2011-09-01

    Full Text Available Objectives: The purpose of 29 case series is to report the possibility that a hand acupuncture is effective in relieving headache. Methods: After approval from the Institutional Review Board (IRB, I analyzed 29 cases medical records of outpatients with headache, who visited OO oriental medical hospital from December 2008 to December 2010, who have taken a hand acupuncture's treatment without other intervention, and who were diagnosed with one disease of international classification of headache disease second version (ICHD-2. The data was analyzed with Wilcoxon signed rank test to determine whether a hand acupuncture's treatment differed between before and after treatment's Visual Analogue Scale(VAS according to types of headache and syndrome differentiation. Statistics program was used SPSS 18.0. Differences were considered significant at P<0.05. Results: The VAS of patients with headache was reduced after treatment of hand acupuncture from 6.57±2.04 to 2.90±2.04 for overall headache, from 6.32±2.05 to 2.47±2.03 for tension-type headache(P<0.001, from 7.10±2.18 to 3.70±1.77 for migraine(P<0.001, and from 6.00±1.41 to 2.50±3.54 for headache unspecified. A hand acupuncture produced a decrease in VAS of both ascendant hyperactivity of liver yang(P<0.001 and phlegm turbidity according to syndrome differentiation(P=0.002. No adverse event were encountered in any of the patients. Conclusions: It is suggested that a hand acupuncture may be effective in relieving headache, and could be applicable to first choice of acupuncture treatment for headache.