bluuebunny/crossref_metadata_2025 huggingface dataset:
A continuum of attacks between tension-type headache and migraine: elaboration of a diagnostic score based on their clinical characteristics (Abstract)
Authors: Costa Neto Joaquim José de Souza
Published: May 2021

Thesis
The functional anatomy of a headache - "invisible" pain displayed in colors
Authors: Valença Marcelo Moraes , Kowacs Fernando
Published: May 2021

Editorial
Disease progression to chronic migraine: onset of symptoms of headaches, anxiety and mood disorders
Authors: Mercante Juliane P. P. , Peres Mario F. P. , Bernik Marcio A. , Corchs Felipe , Guendler Vera Z. , Zukerman Eliova
Published: May 2021

Background: Psychiatric conditions, mostly anxiety and mood disorders, are common in patients with chronic migraine. There has recently been extensive debate on migraine progression, but little is known about the role of psychiatric disorders in this respect. Objective: In order to evaluate the role of psychiatric disorders in migraine progression, we analyzed the temporal profile of migraine, mood and anxiety disorders, and years since onset of symptoms in chronic migraine (CM) patients. Methods: Fifty CM patients diagnosed according to the International Headache Society (2004) criteria were interviewed and diagnosed for mental disorders using the Structured Clinical Interview for DSM-IV (SCID-I/P). Results: Anxiety disorders preceded the onset of episodic migraine, which was followed by depression and daily headaches. Conclusions: Psychiatric comorbidity evaluation in chronic migraine may lead to better patient management and clinical outcomes. Patients with a history of anxiety, episodic migraine, and depression may be at risk of developing CM. Early treatment of anxiety, mood disorders, and episodic migraine may prevent disease progression to CM.
XXV Congresso Brasileiro de Cefaleia
Authors: Medicine Headache
Published: May 2021

IHS Masters School1º Brazilian-North American Synposium (BRANAS)VI Congresso do Comitê de Dor Orofacial
XXV Congresso Brasileiro de Cefaleia
Authors: Medicine Headache
Published: May 2021

Resumos
Headache Medicine is now indexed in Latindex and Index Scholar
Authors: Kowacs Fernando , Valença Marcelo Moraes
Published: May 2021

Editorial
Functional anatomy of headache: hypothalamus
Authors: Valença Marcelo Moraes , Andrade-Valença Luciana P. A. , Martins Carolina
Published: May 2021

There is now compelling evidence that the hypothalamus exerts a major role in the mechanism of headache triggering. Pain and concomitant changes in the hormonal secretory pattern occur during an attack of headache when hypothalamic structures are involved. During spontaneous migraine or cluster headache attacks activation of the hypothalamus is shown by positron emission tomography. Over the past 10 years a number of patients with refractory chronic cluster headache have received neurostimulation of the posteroinferior hypothalamus as a form of treatment. The clinical use of deep brain stimulation (DBS) is based on the theory of posterior hypothalamic nucleus dysfunction as the cause of cluster headache attacks. In this article the authors review the functional anatomy of the hypothalamic region and its neighborhood, using silicone-injected cadaveric head and MRI. In conclusion, a better understanding of the functional anatomy of the hypothalamus and its neighborhood is imperative for understanding the pathophysiology of several of the primary headaches, particularly migraine and the trigemino-autonomic headaches. Direct stimulation of the posterior hypothalamic region using DBS devices is now the "state of the art" form of treatment indicated for refractory chronic cluster headache. The exact mechanism and the actual region where the DBS may act are still unknown, and studies on the functional anatomy of the hypothalamus are crucial to the progress in this marvelous field of functional neurosurgery.
Hospital management of intractable headaches. The Instituto de Neurologia de Curitiba approach
Authors: Rowe Adriel , Iachinski Renato , Rizelio Vanessa , Sato Henry Koiti , Nascimento Maria Tereza de Moraes Souza , Souza Ricardo Krause Martinez de , Kowacs Pedro André
Published: May 2021

Intractable headaches, also called refractory headaches, are usually unresponsive to standard therapies and comprise clinical conditions that represent a clinical management problem regarding therapy. Thereby, many approaches to manage "intractable headaches" have been proposed; meanwhile many aspects remain unclear and open to debate. Accordingly, these patients often require special care and customized management, such as inpatient treatment. Hospitalization aims to enhance management of the patients as a whole and thus improve their quality of life. This paper summarizes the Instituto de Neurologia de Curitiba (INC) approach, which comprises withdrawal of the overused medication, management of abstinence symptoms, management of rebound headache, introduction of effective prophylactic therapy, general counseling and education of the patient, and other aspects of management. The inpatient approach used at the INC is presented and a small sample of patients treated according to this approach is described and discussed.
Prevalence of headaches in individuals referred from primary care to secondary care
Authors: Rodrigues Joismar Manuel , Caires Vanessa Vilela , Fontoura Kátia Beatriz Costa , Silva Teresa Cristina Santos , Goulart Simone Fonseca , Rocha Cláudia Marcucci , Teixeira Antônio Lúcio , Silva Junior Ariovaldo Alberto da
Published: May 2021

Background: Improve the quality of public health is a growing necessity today. Identifying reasons for medical referral (from general to specialized care) is a prelude for developing educational initiatives that have this goal. Objective: To estimate the prevalence of headaches as a cause of referral from the primary to the secondary level of public medical care. Methods: First-time referrals from four primary care units to neurology care were assessed. Results: Sample consisted of 587 individuals referred to neurology consultation. Headache was the cause of referral in 31.2% of the individuals; 79.2% of the headache cases were in women. Rates for other diseases were lower and are presented for benchmarking. Conclusion: Headache represented an important cause of demand for neurological care. Education initiatives on principles of headache management are necessary and may translate into decreased referral rates to neurologists.
Cerebrovascular reactivity in migraineurs
Authors: Sousa Arthur de Carvalho Jatobá e , Gomes Ciro Martins , Coelho Rodolfo de Souza , Teixeira Ricardo Afonso
Published: May 2021

Cerebrovascular reactivity (CR) assessed by transcranial Doppler (TCD) has been evaluated among migraineurs with conflicting results. We assessed the CR using the breath holding index (BHI) among 228 migraineurs during ictal or interictal phase and 56 controls. Migraineurs exhibited increased BHI values in the interictal phase and reduced BHI in the ictal phase when compared to controls.
Exploding head syndrome – the early steps
Authors: Piovesan Elcio Juliato , Kowacs Pedro André , Campos Helder Granhold , Augusto Lucas Pires , Coluni Lucas , Werneck Lineu Cesar
Published: May 2021

Exploding head syndrome is a rare entity associated with migraine that occurs during sleep onset. A male migraine with aura patient presented with episodes of abrupt awakening following perceptions of sounds resembling a speeding up motorcycle engine interspersed with bursts of exhaust explosions like noises, accompanied by an exploding sensation in the head. The patient presented in the evolution of self-limited period of headache chronicity. This syndrome has been associated with an atypical form of acoustic aura that often leads to migraine chronification.
Oculo-nasal autonomic symptoms in migraine and cluster headache (Abstract)
Authors: Sampaio Maria da Conceição Filgueira
Published: May 2021

Thesis
Migraine and academic performance among medical students
Authors: Diniz Barbara Silva , Alves Flavia Oliveira , Dias Julia Rocha , Vasconcelos Laura Toledo de , Esteves Vanessa Tavares , Rezende Dilermando Fazito de , Jurno Mauro Eduardo
Published: May 2021

Objective: To estimate the frequency of migraine and analyze its influence on the academic performance of students between 2nd and 9th period of the Barbacena Medicine College. Methods: From a cross-sectional study, samples of 336 students were examined. They answered a questionnaire constructed specially for the occasion, in which migraine was diagnosed and its repercussions were analyzed. Results: Among 336 analyzed students, 43 (12.8%) had migraine, while 293 (87.2%) didn't evidence it. Absences from school activities are more frequent in the migraine group (85.0%) than (69.0%) in non-migraine. 49.0% of those who had migraine were absent from physical activities and 29.0% missed social gatherings. In contrast, in the group without migraine 50.0% missed physical activities and 15.0% weren't at social gatherings. In the evaluation of school performance through additional or special tests, the study showed that 26.0% of migraine did the tests in the first period while this rate was 12.0% in those without migraine. Conclusions: The frequency of migraine is approximately 13.0%. We conclude that there is a strong relationship between migraine and academic performance; it's evident that students with migraine seem prone to low yield, shown by the number of additional tests and school absence and loss of social activities.
Allodynia in cluster headache: a review
Authors: Leite Elder Machado , Martins Hugo André de Lima , Valença Marcelo Moraes
Published: May 2021

Allodynia is defined as the experience of pain due to nonpainful stimuli, and occurs in several clinical contexts, including primary headaches. Cluster headache is a primary cephalalgia which is more common in males, characterized by excruciating pain, and autonomic trigeminal dysfunction. The prevalence of allodynia in cluster headache patients is a relevant matter with few studies devoted to. Thus, the need formore information demanded a review of most important studies to value the amount of data and its relevance. To bring light to this yet blurry matter, it was made a review using the terms "allodynia" and "cluster headache" through the CAPES periodics, accessing the most relevant studies regarding to this association.
The highly instructive Headache Toolboxes are now also available in Portuguese for the benefit of our patients
Authors: Valença Marcelo Moraes , Kowacs Fernando
Published: May 2021

Editorial
Migraine, tension-type headache, and attention-deficit/Hyperactivity disorder in childhood: A population-based study
Authors: Arruda Marco Antônio , Arruda Renato , Guidetti Vincenzo , Bigal Marcelo Eduardo
Published: May 2021

Short Communication
Clinical and polysomnographic characteristics in patients with morning headache
Authors: Fraga Thalyta Porto , Jalali Paulo Samandar , Santos Paulo Sergio Faro , Jesus Alan Chester Feitosa de
Published: May 2021

Background: The relation between headaches and sleep disorders are complex and heavily questioned. However, there is still controversy about this interrelationship. Objective: To describe the clinical and polysomnographic characteristics of patients with morning headache, and to compare them with patients without morning headaches. Methods: Prospective study between April and August 2009. One hundred and eight patients were included consecutively and by convenience. All patients were submitted to polysomnography and were distributed in the group with headache (group 1) or the group without headache (group 2). Results: Morning headache was reported by 33 (30.6%) patients, 17 (51.5%, p = 0.02) women. The clinical characteristics in the group of morning headache were 42.4% with disease in upper respiratory system, 72.7% with anxiety, 45% with headache in general, 54% with neurocognitive symptoms, 81.2% reported non restorative sleep and 60.6% had insomnia (all p< 0.05). Among the polysomnographic features surveyed, the only variable that showed statistical significance was wake after sleep onset. Almost 43% (vs. 20%) of patients with morning headaches were in normal range. Conclusions: It was not possible to conclude that the presence of the increase apnea/hypopnea indices, desaturation relevant and intermittent and disruption of sleep patterns are sufficient to modulate, by itself, the occurrence of morning headaches. Sleep disorders can act as a trigger for morning headaches in susceptible individuals with specific clinical profile
A influência do período menstrual nos índices de cefaleia, incapacidade e modulação da dor em mulheres jovens
Authors: Silva Pablo Augusto Silveira da , Santos Luiz Henrique Gomes
Published: May 2021

Introdução: A menstruação é um acontecimento que marca a vida das mulheres, e seu primeiro episódio, a menarca, representa o início da fase reprodutiva. Alterações pré-menstruais físicas e mentais acometem as mulheres durante sua vida reprodutiva, a fase lútea e os sintomas pré-menstruais estão correlacionados, incluindo cefaleias, cólicas, irritabilidade, diminuição de concentração, depressão e ansiedade. Objetivo: Relacionar os sintomas de dor e cefaleia e alterações na mobilidade cervical com o período menstrual em universitárias jovens. Método: Trata-se de um estudo quantitativo experimental prospectivo que utilizou a Escala Visual Analógica de Dor (VAS) para avaliar a intensidade de dor; Questionário Midas para avaliar a incapacidade devido à cefaleia; Algometria para avaliar o limiar de dor à pressão; Modulação Condicionada da Dor para avaliar as vias inibitórias de dor; Os questionários Start Back Screening Tool para avaliar a presença de fatores psicossociais na dor e o Dizziness Handicap Inventory para avaliar presença de tontura; Escala Tampa para avaliar Cinesiofobia; Questionário Neck Disability Index para avaliar a incapacidade cervical nas AVD's e o Flexion Rotation Test para avaliar a ADM da cervical alta. Resultados: O questionário Midas apresentou um dado crescente de incapacidade leve a moderada, junto com a escala Tampa para Cinesiofobia. Apesar destes resultados, as entrevistadas não apresentaram sinais de tontura, fatores psicossociais, restrição de ADM cervical e nem nociceptivos. Conclusão: Até o momento as jovens avaliadas não demonstraram influência significativa do período menstrual na amplificação do quadro de dor, cefaleia e a possível incapacidade ocasionada pelas mesmas.
Management of psychiatric comorbidities in migraine
Authors: Peres Mario Fernando Prieto , Valença Marcelo Moraes , Silva-Neto Raimundo Pereira
Published: May 2021

Psychiatric commorbidities are one of the main issues in migraine management. Diagnosis and treatment strategies are deeply affected by mental health diagnosis and symptoms. Depression and anxiety has been the most studied topics, anxiety aspects such as excessive worry, inability to control worries, inability to relax are highligheted. It is also reviewed in this paper data on the relation of psychiatric symptoms and migraine; the rationale for using a symptom-based approach; how migraine overlaps with anxiety, ADHD, and bipolar symptoms. Screening tools addressing specific mental health topics are discussed, as a comprehensive approach for frequent acute medication intake considering psychiatric comorbidity. An algorythm is proposed for the general management of psychiatric comorbidity in migraine.
Syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL)
Authors: Almeida Laryssa Crystinne Azevedo , Valença Marcelo Moraes
Published: May 2021

The authors make a narrative review on "headache syndrome and transient neurological deficits with cerebrospinal fluid lymphocytosis (CRL)," a rare, underdiagnosed disorder of little knowledge by physicians specializing in care in the emergency room. Aspects of the clinical picture, diagnosis, prognosis, and treatment are discussed
Cefaleia em trovoada secundária à síndrome da vasoconstricção cerebral reversível
Authors: Santos Paulo Sergio Faro , Rizelio Vanessa , Telles Bruno Augusto
Published: May 2021

Neuroimaging in Headache
Cefaleias, Médicos e Mídias
Authors: Jesus Alan Chester Feitosa de
Published: May 2021

Opinião Pessoal
XXXII CONGRESSO BRASILEIRO DE CEFALEIA / XIII CONGRESSO DE DOR OROFACIAL
Authors: Medicine Headache
Published: May 2021

XXXII CONGRESSO BRASILEIRO DE CEFALEIA / XIII CONGRESSO DE DOR OROFACIAL
XXXII CONGRESSO BRASILEIRO DE CEFALEIA / XIII CONGRESSO DE DOR OROFACIAL
Authors: Medicine Headache
Published: May 2021

Temas Livres - Sessão de PôsteresCefaleia e Dor Orofacial
ICF categories compromised in Migraine
Authors: Silva Suellen Freitas da , Feitosa Hugo , Santos Alyne Karine de Lima , Barros Manuella Moraes Monteiro Barbosa , Ferro Karinne Josepha Oliveira , Souza Ana Izabela Sobral de Oliveira , Coutinho Neta Tamara Cavalcanti de Morais , Barboza Paulo José Moté , Rocha Filho Pedro Augusto Sampaio , Wanderley Débora , Oliveira Daniella Araújo de
Published: May 2021

Objective: To identify which categories of the International Classification of Functioning, Disability, and Health (ICF) are compromised in patients with migraine from the perspective of health professionals. Methods: This is a cross-sectional study conducted at the headache outpatient clinic of the Clinical Hospital of Pernambuco, Oswaldo Cruz University Hospital and at the Motor Learning and Control Laboratory of the Federal University of Pernambuco. A five-section printed and online questionnaire based on ICF checkList 2.1 was used. Health professionals from different specialities who had experience in treating patients with migraine were invited. Professionals were instructed to complete the questionnaire and to choose, based on their clinical experience, which categories had the highest degree of impairment or the highest relationship with the clinical condition of migraine patients. A cut-off point of 70% for approval of categories was considered. Results: Sixteen professionals were enrolled in the survey. The questionnaire was compost by 106 categories, of which 32 reached the cutoff point of 70% to be considered approved. Among these categories, seven (21.8%) are part of the body functions component, five (15.6%) body structures, thirteen (40.6%) activities, and participation and seven (21.8%). of environmental factors. Conclusion: In the perception of health professionals, individuals with migraine present impairment in all domains of the ICF and the activity and participation domains presented the highest number of compromised categories.
Functionality changes of migraine women
Authors: Santos Alyne Karine Lima , Feitosa Hugo , Silva Suellen F , Barros Manuella Moraes Monteiro Barbosa , Ferro Josepha Karinne de Oliveira , Souza Ana Izabela Sobral de Oliveira , Coutinho Neta Tamara Cavalcanti de Morais , Barboza Paulo José Moté , Rocha Filho Pedro Augusto Sampaio , Wanderley Débora , Oliveira Daniella Araújo de
Published: May 2021

Objective: Identification of changes in functionality of women with migraine according to the International Classification of Functioning, Disability, and Health (ICF). Method: This is a qualitative study conducted in the format of focus group interviews, which included women between 18 and 55 years old diagnosed with migraine based on the criteria of the International Headache Society. The women were divided into groups with averages of two to four people and, guided by a moderator, they were encouraged to talk about the influence of migraine on performing the tasks to which they are exposed daily, taking into account the environment in which they are inserted. The categories that reached the 30% agreement cutoff point in the groups were approved. Results: There were 10 rounds of interviews, each with a focus group with an average of two to four people, totaling 29 women with a mean age of 35 years old (95% CI: 18 - 51). Eighteen categories were approved, four in the Body Function domain, four in the Body Structure domain, six categories in the Activity and Participation domain and four categories in the Environmental Factors domain. Conclusion: Women with migraine perceive lteration in functionality in all ICF domains, with the Activities and Participation domain presenting the most mentioned categories.
The dark side of the migraine: an analysis of the semiotic of headache of the Pink Floyd's album
Authors: Santos Patrick Emanuell Mesquita Sousa , Coelho Iara Alves , Silva-Néto Raimundo Pereira
Published: May 2021

The dark side of moon é um álbum do grupo inglês Pink Foyd, considerado um dos mais influentes discos do século XX. Neste artigo, realizamos uma análise cefaliátrica do álbum. As faixas são correlacionadas com a crise migranosa, desde os critérios diagnósticos (fotofobia, fonofobia, piora com exercício e aura) até a relação com o trabalho, gatilhos e síndromes raras como "Alice no País das Maravilhas".
Interactive between headache, systemic arterial hypertension and stoke: a integrative review
Authors: Lima Gizele da Silva , Laurentino Iris Milleyde da Silva , Silva Vânia Nazaré da Costa , Leite Antonio Flaudiano Bem , Valença Marcelo Moraes , Santos Erlene Roberta Ribeiro dos
Published: May 2021

Introduction: Several studies present evidence that headache is a symptom often associated with systemic arterial hypertension (SAH) and it may contribute to a greater potential for the development of these diseases, including the risks of more serious damages, such as stroke). Objective: To identify in the existing scientific publications the relation between migraine, systemic arterial hypertension and secondary outcome of cerebrovascular accident. Methodological procedures: This is an integrative literature review from 2014 to 2018, in the bibliographic databases of Latin Literature (LILACS) and the Medical Literature Analysis and Retrieval System Online (MEDLINE /PUBMED) conducted in April 2019. From 50 identified records, considering the selected descriptors, through selection and eligibility procedures according to the proposed inclusion and exclusion criteria, 04 articles were selected. The PRISMA tool (Preferred Reporting Items for Systematic Reviews and Meta-analyzes) was used as a guideline in the writing of the integrated review. Results: 50% of the analyzed studies directed the objectives for the investigation of the association between migraine and cardiovascular disease. The others, prioritized as objective the evaluation of migraine as a risk factor for stroke. The findings of the studies analyzed in full confirm the presence of the association of migraine with systemic arterial hypertension and stroke. Of these, only one presented no significance in the statistical model, when migraine was generally included for the risk of stroke, but when migraine with aura was inserted, it showed positive results. Conclusion: Migraine is directly associated with cardiovascular diseases and can have a significant impact, both for the patients' disability and for the public health policy, which needs to improve strategies for monitoring and preventing negative outcomes in the long term.
Osmophobia and primary headaches in children and adolescents
Authors: Bernardo Albérico Albanês Oliveira , Medeiros Fabíola Lys de , Rocha-Filho Pedro Augusto Sampaio
Published: May 2021

Headache is one of the most frequent complaints in children and adolescents and there are difficulties to specify the diagnostic in the pediatric population, mainly due to the fact of biological and psychic immaturity. There is an important relationship between odors and primary headaches. Osmophobia can occur during headaches and odors can trigger headache attacks. The prevalence of osmophobia in pediatric patients with migraine varies from 25% to 35%, being a symptom of low sensitivity, but high specificity in the differential diagnosis between migraine and tension-type headache. Odor intolerance, when present, does not appear to be difficult to report and characterized by adults or children.
Hipotireoidismo subclínico e cefaleias
Authors: Carvalho Marise de Farias Lima , Santo Pedro Henrique Muniz Falcão do Espírito , Lima Raphaella Von Sohsten Calabria , Donato Helena Mello de Godoy
Published: May 2021

Introdução: Nos últimos anos, diversas disfunções hormonais têm sido investigadas como causa de cefaleia, dentre elas o hipotireoidismo. A cefaleia atribuída ao hipotireoidismo é uma das cefaleias secundárias aos distúrbios da homeostase, em torno de um terço dos hipotireoideos podem referir cefaleia, mas poucos trabalhos avaliaram a prevalência de cefaleia nos pacientes com hipotireoidismo subclínico, uma condição classicamente referida como mais leve e de importância questionável. Objetivo: O objetivo de nosso trabalho foi revisar a literatura acerca do tema hipotireoidismo subclínico e cefaleia. Material e Métodos: Realizou-se uma pesquisa nos sites de busca da Pubmed e Scielo por artigos relacionados ao tema utilizando os descritores Hypothyroidism, subclinical hypothyroidism, headache and migraine. Resultados: Estudos recentes ajudaram a clarear a relação cefaleia e hipotireoidismo como real e impactante. Considerando especificamente o hipotireoidismo subclínico, é possível que o impacto do sintoma seja igualmente relevante neste grupo. A frequência de migrânea parece ser maior entre os pacientes com hipotireoidismo subclínico ao compará-los com indivíduos eutireoideos; os resultados são, entretanto, conflitantes para a população pediátrica. Pode haver um efeito benéfico do tratamento do hipotireoidismo subclínico sobre o sintoma. Conclusão: Cefaleia é um sintoma comum e relevante entre pacientes com hipotireoidismo. Essa relação parece também presente nos pacientes com hipotireoidismo subclínico, e mais estudos são necessários para entender os mecanismos e a importância do tratamento da disfunção hormonal nestes casos.
Cefaleias ocupacionais: quando suspeitar?
Authors: Santos Patrick Emanuell Mesquita Sousa , Campelo Alanny Gabrielly Diogenes , Costa Ezequiel Gonçalves da , Lima Guilherme Antonio Morais , Rosado Matheus Saraiva Valente , Silva-Néto Raimundo Pereira
Published: May 2021

As doenças ocupacionais estão diretamente ligadas à profissão do trabalhador, enquanto que as do trabalho estão ligadas ao ambiente de trabalho. No Brasil, estas entidades mórbidas são regidas pela Lei nº 8.213 de 24 de julho de 1991. As cefaleias ocupacionais foram, primeiramente, descritas por Bernardino Ramazzini, em 1700, em seu livro De morbis artificum diatriba. No entanto, até o momento, não foram inseridas na lista de doenças relacionadas ao trabalho, publicada pelo Ministério da Saúde, e adotada pelo Ministério da Previdência Social. A classificação de Schilling utilizada nas doenças ocupacionais em geral pode ser adaptada aos diagnósticos de cefaleia ocupacional. Para se chegar a esse diagnóstico, são necessários três elementos essenciais: anamnese ocupacional, diário de atividades e nexo causal.
Cuidado com a cefaleia crônica diária!
Authors: Santos Paulo Sergio Faro
Published: May 2021

Opinião Pessoal
Treating headache with a needle in the anatomic spots Tratar cefaleia com uma agulha nos pontos anatômicos corretos
Authors: Valença Marcelo Moraes
Published: May 2021

Editorial
Tenth year of Headache Medicine Journal, 25 years of Brazilian publications in the headache field
Authors: Peres Mario Fernando Prieto , Valença Marcelo Moraes
Published: May 2021

Editorial
Alice in Wonderland Syndrome
Authors: Sanvito Wilson Luiz
Published: May 2021

Case Report
Histomorphometric analysis of mast cells in different regions of human intracranial dura mater
Authors: Rosas Emanuela Paz , Paz Silvania Tavares , Souza Neta Ana Clara de , Costa Raisa Ferreira , Silva Ana Paula Fernandes da , Freitas Manuela Figueiroa Lyra de , Valença Marcelo Moraes
Published: May 2021

Objective: To analyze mast cell histomorphometry in three different regions of the human intracranial dura mater. Method: Three specimens of dura mater were collected after approval by the Ethics Committee (CAAE No. 57692216.5.0000.5208). Each dura mater was obtained from human cadavers between 7 and 24 hours after death. After collection, the samples were fixed, cut into two fragments and longitudinally placed in the following way: external (periosteum) and internal (meningeal) sides. The fragments (1.5 cm2) were taken from three different regions: proximity of the right middle meningeal artery, the proximity of the left middle meningeal artery and superior sagittal sinus. These fragments were submitted to microtomy (10 μm), stained with 0.1% toluidineblue and analyzed by optical microscopy. The histomorphometric parameters adopted were: the distance from the mast cells to the vessels, the number and if the mast cells were degranulated. Five fields from each case were analyzed. For this analysis, the Image J 1.52a 2019 software was used. Results: A higher number of mast cells was observed in the periosteal layer when compared withthe meningeal layer (p=0.026). When the distribution of the mast cells was evaluated, we observed that the cells were localized in the proximity of the middle meningeal artery (p<0.05). Conclusion: In human dura mater, the mast cells are localized in the proximity of dural arteries.
Migraine stigma
Authors: Valença Marcelo Moraes , Peres Mario F P
Published: May 2021

Editorial
Frequency of diagnoses in a specialized headache clinic in Buenos Aires
Authors: Nagel Vanessa , Cavanagh Sol , Olivier Marina , Larripa Natalia , Gutierrez Maria T , Grandinetti Mariela , Calvo Daniela , Salvat Fernando , Bonamico Lucas , Goicochea Maria Teresa
Published: May 2021

Objective: Headache is one of the most frequent reason for consultations in neurology. The global prevalence among adults with migraine is approximately 10% with migraine, 40% for tension-type headache (TTH) and 3% for chronic daily headache. The purpose of this study is to analyze the prevalence of the diagnoses of headache and craniofacial pain among patients evaluated in a specialized headache clinic of Buenos Aires during 2017. Methods: Retrospective, descriptive study. We reviewed the electronic medical records of patients who consulted for headaches or craniofacial pain from January 1st to December 31st, 2017. Diagnoses were made according to the criteria of the International Classification of Headache Disorders (ICHD-3). Results: We reviewed 3254 electronic medical records and documented 3941 diagnoses: headache (93.03%), craniofacial pain (3.62%) and unclassifiable (3.35%). The average age was 43.14 years. 80.7% were women. Primary headaches were the most frequent diagnoses (78.54%). Migraine represented the main diagnosis (87.42%). Episodic migraine without aura was the most prevalent diagnosis (48%). Tension- type headache (TTH) was found in 8.74% of cases of primary headaches and Trigeminal autonomic cephalalgias (TACs) in 2.89%. Medication-overuse headache (MOH) represented 77.93% of the secondary headaches, and most of them also met chronic migraine criteria fulfilled criteria of chronic migraine. Primary trigeminal neuralgia represented 50% of craniofacial pain and 27% were secondary trigeminal neuralgia, mostly postherpetic or posterior to dental procedures. Regardin to the frecuency, 33.58% of the patients had chronic headache. Conclusion: In our section, migraine is the most frequent diagnosis followed by medication-overuse headache. The percentage of chronic headache is higher than the prevalence in the general population, probably because it is a tertiary center.
XXXIII CONGRESSO BRASILEIRO DE CEFALEIA
Authors: Medicine Headache
Published: May 2021

Poster
Application of thermal microcautery in migraine management
Authors: Papageorgiou Eleni , Kovas Konstantine , Power Camillus , Kostopoulos Nikolaos
Published: May 2021

Thermal microcautery is a novel minimally invasive intervention for migraine. We present a case series of twenty-one patients who underwent this technique. Nineteen patients reported improvement in migraine management. Of these four patients went on to complete remission and a further eleven patients reported over 50% improvement. In addition, the majority of patients noted reductions in intensity and duration of headache with a better response to medication. The efficacy of thermal microcautery generates a new hypothesis that attempts to explain how a neuromodulation technique may be helpful in the management of migraine.
Dialysis Headache Associated with Caffeine-Withdrawal Headache in Patients Undergoing Hemodialysis
Authors: Dos-Santos Edarlan Barbosa , Brito Kattiucy Gabrielle da Silva , Pinto Bernardo Afonso Ribeiro , Gaban Tatiane Fernandes da Fonseca , Catharino Antonio Marcos da Silva
Published: May 2021

Headaches are particularly relevant as a complication of hemodialysis, given that this condition increases the discomfort felt by patients undergoing this therapy. The objective of the present study was to evaluate the prevalence of headache in patients undergoing hemodialysis sessions, particularly considering dialysis headaches due to caffeine-withdrawal. This was a crosssectional, observational, quantitative and qualitative study with questionnaires and interviews. The questionnaire addressed biopsychosocial aspects, clinical aspects and criteria for the classification of headaches according to the International Headache Society. A hundred and sixty patients with stage-V chronic kidney disease responded to the questionnaire during hemodialysis sessions. Headache prevalence was 90% and over the period studied 53.1% of patients presented the symptom. Among these patients with headaches, over half (55.3%) presented criteria for concomitant caffeine-withdrawal headaches and dialysis headaches. The beginning of headaches varied between one month and more than five years, with most occurring for more than five years. Frequency varied from sporadic crises to more than one crisis a day, though more than one crisis a day predominated. The interval between crises was of a few days, with mean duration of less than one hour, which ceased with the use of self-medicated analgesics, with no worsening factor. This condition is a challenge for neurologists and headache experts. More studies are needed to decrease this prevalence, to decrease the abusive use of analgesics and improve the quality of life of these patients.
Prevalence of thunderclap headache in patients with ruptured intracranial aneurysms: series of 60 cases
Authors: Esmanhotto Bruno Bertoli , Piovesan Elcio Juliato , Lange Marcos Christiano
Published: May 2021

Thunderclap headache (TCH) is a head pain that begins suddenly and is severe at onset. TCH might be the first sign of subarachnoid hemorrhage. This study was conducted to evaluate the presence of thunderclap headache (TCH) in patients with ruptured intracranial aneurysm (RIA) and endovascular treatment (EVT). We evaluated the pattern of headache in 60 patients who suffered a RIA and EVT at time of admission and prospectively evaluated the characteristics of previous headache within one year before the rupture. Thirty-one patients (51,7 %) had TCH related to the rupture. Aneurysm size does not affect the occurrence of thunderclap headache (p=0,08). The vascular aneurysm territory is not related to presence of TCH (p=0,527). The prevalence of TCH in this cohort was similar to previous studies. All patients with acute thunderclap headache should be evaluated for subarachnoid hemorrhage.
Clinical characteristics of headaches attributed to diagnostic and therapeutic procedures
Authors: Silva-Néto Raimundo Pereira
Published: May 2021

Headaches may appear after performing diagnostic and / or therapeutic procedures with close temporal relationship to these events. The objective of this research was to know the clinical characteristics of headache secondary to diagnostic and / or therapeutic procedures. We reviewed secondary headaches according to ICHD-3, and searched for those that arose after performing a diagnostic and / or therapeutic procedure. A total of 11 different diagnoses of headache attributed to diagnostic and / or therapeutic procedures were found. Some secondary headaches are due to diagnostic and / or therapeutic procedures.
Intracranial lipoma manifesting with change in preexisting headache characteristics
Authors: Santos Patrick Emanuell Mesquita Sousa , Silva Ivan Rodrigues , Peres Mário Fernando Prieto , Silva-Néto Raimundo Pereira
Published: May 2021

Intracranial lipomas represent 0.1% to 0.5% of all intracranial tumors. Approximately half of the patients are asymptomatic. In symptomatic patients, headache is the most common symptom. We describe the case of a 71-year-old woman with history of generalized seizures and episodic migraine for about 30 years. In recent months, there has been a change in the characteristics of headache. She was admitted to the emergency room with muscle weakness in left hemibody and intense headache onset approximately four hours ago. Neuroimaging exams revealed a median frontal expansive lesion suggestive of intracranial lipoma.
The neurologist’s hammer
Authors: Nogueira Eduardo , Fragoso Yara Dadalti
Published: May 2021

From the obscurity of 18th century wineries to the hands of the greatest neurologists in history, the percussion hammer has a fascinating history. The first famous percussion hammer was created in 1841 by the German physician Max Wintrich and was initially used for thoracic percussion. In 1875, Erb and Westphal both published simultaneous articles with the results from research that they had conducted separately, from which they confirmed that percussive objects were useful for stimulating deep tendon reflexes, especially patellar reflexes. The percussion hammer, however, was not yet ideal. It was designed to strike the thorax rather than the tendons, so it did not have the right weight or ideal length, and even its shape was not practical. New modified versions of the instrument subsequently emerged, and the hammer became the characteristic symbol of the neurologist.
Aerobic exercise training for migraine prevention: A trigger-based analysis
Authors: Oliveira Arão Belitardo , Swerts Diego Belandrino , Peres Mario Fernando Prieto
Published: May 2021

Background: Although aerobic exercise has been recommended for migraine management, no study has yet explored the effects of regular aerobic exercise on migraine triggers profile. Objective: To evaluate the effects of a 12-week aerobic exercise intervention on migraine triggers profile. Methods: We conducted a secondary, post hoc analysis of a randomized, controlled clinical trial. Triggers were recorded in a paper-based headache diary with a formal list including 8 common migraine triggers. Results: Twenty-five patients concluded the protocol and were analysed (exercise: n = 12; waitlist: n = 13). In the whole cohort, the most common triggers were stress/irritability (60 %), sleep deprivation (60 %), fasting (28 %), and foods (28 %). Most patients (52 %) had ≥ 3 triggers. The exercise group showed a higher baseline proportion of patients with ≥ 3 triggers (69 %) compared to waitlist group (25 %) (p = 0.041). After intervention period, there was no difference in the proportion of patients with ≥ 3 triggers between waitlist (16.6 %) and exercise (30 %) groups (p = 0.502). The exercise group showed greater numeric reductions (from group’s sum) than waitlist group for triggers stress/irritability (-14 vs -9), fatigue (-12 vs -6), and menstruation (-9 vs -5). This seemed to reflect the reduced number of attacks in the exercise group [mean (CI95 %): -2.5 (-3.7, -1), p = 0.002] vs waitlist [0.9 (2.4, -0.8), p = 0.341]. Conclusion: Tracking migraine triggers during exercise interventions may help to unravel specific clinical effects of regular exercise. Trial registration: #NCT01972607.
Coexistence of Sunct Syndrome and pituitary tumor: A possible association to be recognized
Authors: Vieira Julia Vescovi , Cintra Amanda dos Santos , Fonseca Ana Paula Alves , Rocha Antônio José da , Domingues Renan Barros
Published: May 2021

Case Report
Migraine surgery
Authors: Piovesan Élcio Juliato
Published: May 2021

Editorial
Headache in patients with coronavirus disease (Covid-19): An integrative literature review
Authors: Bastos Sarah Nilkece Mesquita Araújo Nogueira , Sousa Diego Afonso Cardoso Macedo de , Melo Simone Santos e Silva , Barbosa Bárbara Louise Freire , Cruz Larisse Giselle Barbosa , Silva-Néto Raimundo Pereira
Published: May 2021

IntroductionThe disease caused by the new coronavirus was named by the acronym COVID-19 which means “COrona VIrus Disease”, while “19” refers to the year 2019, when the first cases in Wuhan, China, were identified.ObjectiveOur objective was to identify the prevalence of headache and to know its clinical characteristics in COVID-19 patients, available in the literature.MethodsBased on a literature search in the major medical databases and using the descriptors “headache and coronavirus”, “headache and 2019-nCoV”, “headache and SARS-CoV-2”, “headache and coronavirus and 2019-nCoV” and “headache and coronavirus and SARS-CoV-2” we include articles published between January 2019 and April 2020. We found 94 articles, but only 13 met the inclusion criteria.ResultsIn 13 articles analyzed in this review, a total of 3,105 Chinese patients (51.6% men and 48.4% women) had laboratory diagnoses of COVID-19. In 240 (7.7%) patients, headache was an associated symptom of COVID-19, but in only 52 (21.7%) of them there was some information about the characteristics of this headache.ConclusionsCOVID-19 patients have several clinical manifestations, including headache that is nonspecific with a prevalence of 7.7%.
Main symptoms associated to the catastrophizing in women with fibromyalgia and migraine
Authors: Barros Amanda de Oliveira Freire , Barros Manuella Moraes Monteiro Barbosa , Santana Reydiane Rodrigues , Wanderley Débora , Tenório Angélica da Silva , Oliveira Daniella Araújo de
Published: May 2021

ObjectiveTo evaluate the main symptoms associated catastrophizing in women with fibromyalgia and migraine.MethodologyWe conducted an observational study with 26 women diagnosed with both fibromyalgia and migraine, aged between 30 and 60 years (46±8 years). The Pain Catastrophizing Scale was applied as a cut-of point =30, dividing the volunteers in groups with (n=18) and without catastrophizing (n=8). We assessed the quality of sleep (Pittsburgh sleep quality index), the presence of depression and anxiety (Becks depression and anxiety inventories), the quality of life perception (Fibromyalgia impact questionnaire-revised), the disability due to migraine (Migraine disability assessment) and the level of physical activity (International physical activity questionnaire).ResultsThe time of fibromyalgia did not difer (p=0.80) between the group with (8.54±4.88) and without catastrophizing (10.04±3.47). The Fibromyalgia impact questionnaire-revised scores were significantly higher (p=0.01) among women with catastrophizing (78±12.6) than those without (56.6±22.3). There was no diference between the groups (p>0.05) in relation to the other outcomes evaluated.ConclusionThe presence of catastrophizing in women with fibromyalgia and migraine are associated with a worse perception of quality of life. a worse perception of quality of life.
Headache triggered by sleep deprivation: an observational study
Authors: Rosado Matheus Saraiva Valente , Silva-Néto Raimundo
Published: May 2021

IntroductionSleep deprivation is one of the main triggers of primary headaches, especially in migraine patients.ObjectiveTo determine the prevalence of headache triggered by sleep deprivation in night workers.MethodsThe study was cross-sectional, observational, non-random and convenience. We interviewed 71 night workers of a public hospital with diagnosis of primary headaches and presence of headache the day after night shift.ResultsThe 71 night workers (50 women and 21 men) had a mean age of 36.7±7.7 years, ranging from 22 to 50 years. Of these workers, 83.2% were diagnosed with migraine and 16.9% with tension-type headache (TTH). The number of monthly night shifts was greater than 10, in 50.8% of migraine patients and in 58.3% of those with TTH. It was observed that 91.5% of migraine patients and 83.3% of patients with TTH slept ≥ 6 hours a night when they were at home, but when they were at work, they all slept ≤ 4 hours a night. Headache occurred the following day of night work in 83.1% of migraine patients and in 41.7% of those with TTH (p=0.005).ConclusionHeadache triggered by sleep deprivation was highly prevalent, predominating in migraine patients.
Recommendations for the management of headaches during the COVID-19 pandemic
Authors: Fragoso Yara Dadalti , Calderaro Marcelo , Souza Marcio Nattan Portes , Santos Patrick Emanuell Mesquita Sousa , Nogueira Eduardo , Wang Shuu-Jiun , Ashina Messoud , Silberstein Stephen D , Peres Mario F P
Published: May 2021

BackgroundDuring the novel coronavirus - COVID-19 pandemic, health care systems are facing one of its greatest challenges.ResultsSecondary headaches may need urgent care at an emergency department. Primary headaches exacerbations may require intravenous infusion. Treatment optimization is key for a better outpatient management.ConclusionWe give recommendations on when a headache patient should go to the hospital despite the current limited resources, and primary headache management aspects during the outbreak.
Food avoidance among patients with headache
Authors: Machado Stella Boreggio , Ares Nayara Cavalcanti , Scorcine Claudio , Fragoso Yara Dadalti
Published: May 2021

ObjectiveTo assess food and drink avoidance among patients with headache by means of an online survey.MethodsIndividuals with frequent headaches were invited to answer a Google Form questionnaire [https://form.jotformz.com/200233754863656]. The survey included sex, age and characteristics of headache. Dietary habits were assessed as the number of times the individual consumed certain foods, on a daily, weekly, or monthly basis. The participants could state up to three foods that they avoided for fear of headache attacks.Results120 complete forms were received. Alcoholic beverages were the most frequent trigger factor, reported by 26.7% of the patients. 95.5% of the participants did not consume alcohol regularly. Cheese, caffeine and fat were also recognized as potential triggers of headaches. There was no standard profile of dietary triggers and, therefore, everyone has to be personally approached in this subject.ConclusionThe online survey confirmed that individual characteristics of headache were dietary triggers in half the participants. Alcohol was the most frequently mentioned trigger, followed by cheese, fat and caffeine.
Sociodemographic characteristics of patients with chronic headache
Authors: Sampaio Patrick Giordanni Gomes , Maracajá Hiago Diniz , Figueiredo Sara Raquel Nóbrega , Figueiredo Virgínia Gabriela Nóbrega , Temoteo Túlio Carneiro Monteiro , Melo Nátalia Meg Adijuto de
Published: May 2021

Introduction: Headache is an entity characterized by a painful process in the cephalic segment and may originate from cranial or facial structures, being considered a common medical complaint. The chronification process of the pain can present a decrease in quality, the functional capacity and the patient’s and labor environment, and also as well as affect their interpersonal relationships, since the chronic cephalalgic process can lead the patient to moments of social isolation, mood swings, depression. Methods: The research was conducted through a retrospective cross-sectional study, performing the analysis of medical records of patients seen at the Unifacisa’s outpatient neurology School Clinic complaining of chronic headache, from February 1st to August 31, 2019. Results: With the analysis of the medical records, 684 attendances were obtained, where 30 of the patients treated had the diagnosis of chronic headache, 29 women and 01 man. These patients received the following diagnoses: 18 (60%) patients with chronic migraine without aura, 4 (13.3%) patients with chronic migraine with aura, 12 (40%) patients with chronic daily medication overuse headache, 9 (30%) patients with chronic tensiontype headache (CTTH), 1 (3.3%) patient with basilar migraine, 2 (6.6%) patients with secondary headache. Conclusion: Although a small number of chronic headache patients were obtained, yet we realize that it is the migraine that leads to a greater demand for specialized medical care. In addition, as expected due to the latest research, a significant number of patients with headache due to excessive use of common painkillers.