bluuebunny/crossref_metadata_2025 huggingface dataset:
The Action of Ergotamine on the Distribution of Carotid Blood Flow ‐ the Migraine Shunt Theory Revisited
Authors: Spierings Egilius L. H. , Saxena Pramod R.
Published: June 2005

SYNOPSIS

Ergotamine alters the distribution of carotid blood flow over the capillaries and the arteriovenous anastomoses in favour of perfusion of the capillaries. This mode of action of ergotamine, which occurred independently of the concomitant reduction in carotid blood flow, indirectly supports the migraine shunt theory in which excessive opening of arteriovenous anastomoses is thought to be the primary hemodynamic derangement underlying the vascular headache of the migraine type.
Cerebral Blood Flow Studies in Patients with Cluster Headache
Authors: Nelson R.F. , Boulay G.H. du , Marshall John , Russell R.W. Ross , Symon Lindsay , Zilkha E.
Published: June 2005

SYNOPSIS

Cerebral blood flow (CBF) has been measured in 26 patients liable to cluster headaches. Of four patients studied during spontaneous attacks CBF fell in three and rose in one. Attacks could not be induced by nitroglycerine, alcohol or histamine except when patients were currently experiencing a bout of cluster headaches. The CBF rose during some induced attacks and fell during others. It is concluded that CBF changes do occur in cluster headache but the pattern is not consistent and does not at present suggest a mechanism for cluster headache.
Treatment of Post‐traumatic Headache with Amitriptyline
Authors: Tyler G. Scott , McNeely Harold E. , Dick M. Lawrence
Published: June 2005

SYNOPSIS

Twenty‐three patients were studied retrospectively for treatment received for post‐head injury. Over 90% of the patients treated made an excellent or good recovery. Prognosis in the post‐head injury victim with headache, irritability, and dizziness and visual problem, can be improved with the judicious use of amitriptyline and a counseling program with concentration on aiding the patient in communicating with significant members of his environment. Additionally, diagnosis and treatment of superimposed specific type of headache must be accomplished.
Intactness of Useful Central Vision During Migraine Scotoma
Authors: Oestreich Alan E.
Published: June 2005

SYNOPSIS

From personal experience the author relates being able to perform venipuncture on a child, using his central vision, during a circumferential phase of migraine scotoma.
Catecholamines and Migraine: Evidence Based on Biofeedback Induced Changes
Authors: Mathew Roy J. , Ho Beng T. , Kralik Patricia , Taylor Dorothy , Claghorn James L.
Published: June 2005

SYNOPSIS

Evidence from several sources indicate an association between arousal and adrenomedullary activation and migraine. Biofeedback therapy is well established as an antimigraine measure. The effect of biofeedback induced relaxation on plasma catecholamines and monoamine oxidase activity was studied; significant decreases were found in both the biochemical values following relaxation therapy. The antimigraine action of biofeedback is explained based on these findings.
Sinus Headache: A Psychophysiological Study
Authors: Hamilton Johnie G. , Haynes Stephen N. , Gannon Linda , Safranek Roma A.
Published: June 2005

SYNOPSIS

A psychophysiological investigation of sinus headache was performed using low frequency headache controls and high frequency muscle‐contraction headache subjects as comparison groups. Two cardiovascular and two electromyograph (EMG) measures were recorded across rest, stress and post‐stress adaptation periods. The results indicated no significant differences between groups on either the cardiovascular or EMG measures, however, trial effects were found on the blood volume pulse (BVP) measure. In addition, an interaction effect of trial by headache type on the BVP cognitive stressor was found. Finally, suggestions are advanced for future sinus headache research.
Preventive Treatment of Migraine with Enzyme Induction by Proxibarbal in a “Double‐Blind” Trial
Authors: Sulman F.G. , Pfeifer D.V.M., Y. , Superstine E.
Published: June 2005

SYNOPSIS

Proxibarbal is a non‐sedative barbiturate with a specific anti‐serotonin and anti‐histamine effect, due to enzyme induction of serotoninase and histaminase. Its lack of unpleasant side‐effects permits its protracted use for the preventive treatment of migraine. Its chemical structure ‐ 5‐allyl‐5‐(beta‐hydroxy‐propyl)barbituric acid ‐ allows enzyme induction within 1–3 months of treatment. Preventive treatment with 1–3 × 100 mg/day proxibarbal for 3 months eliminated migraine attacks in 25 out of 35 cases (71%). In a double‐blind study of 30 female and 5 male patients, treatment with 3 × 100 mg/day produced a drop of from 5–30 attacks to 0–1 attack per month and normalization of high urinary serotonin, 5‐HIAA or histamine levels. The typical side‐effects of anti‐serotonin drugs and antihistaminics, especially sedation or dizziness and hyperorexia, were not observed. The mechanism of this effect was proved by accelerated and increased destruction of serotonin and histamine in vitro by the serum of the patients after treatment.
Endogenous Opioids in Cerebrospinal Fluid and Blood in Idiopathic Headache Sufferers
Authors: Anselmi Bruno , Baldi Elisabetta , Casacci Franco , Salmon Silvia
Published: June 2005

SYNOPSIS

Endogenous opioids and 5‐hydroxytryptamine are the main neurotransmitters that regulate nociception, hedonia and autonomia. These functions are simultaneously impaired in idiopathic headaches. Enkephalins, beta‐endorphin, and tryptophan (5‐HT precursor) were evaluated in CSF and plasma of migraine and cluster headache sufferers. The following results were obtained:(a) decreased levels of CSF enkephalins in migraine attack and cluster headache,(b) increased CSF Tryptophan (TP) in migraine,(c) increased free plasma TP in migraine attack,(d) increased serum beta‐endorphin‐like‐immunore‐activity at the end of attack.A possible link between these findings and the impairment of nociception, hedonia and vegetative balance in headache sufferers is here discussed.
Ophthalmoplegic Migraine: Ischemic or Compressive Neuropathy?
Authors: Vijayan N.
Published: June 2005

SYNOPSIS

It is currently believed that the ophthalmoplegia in ophthalmoplegic migraine (O.M.) is due to compression of the cranial nerves by dilated and swollen carotid or basilar arteries. One of our patients seen recently did not fit the pattern of a compressive neuropathy because the pupil was spared during three episodes of O.M. A review of the literature revealed that contrary to common belief, the pupils are involved completely in only 33% of patients with O.M. Analysis of the clinical features and the relevant anatomy of the vascular supply of the third cranial nerve suggest that the ophthalmoplegia is due to a delayed ischemic neuropathy leading to border zone infarction of the nerve rather than direct compression due to an enlarged vessel.
Hemicranial Disorder of Vasomotor Adrenoceptors in Migraine and Cluster Headache
Authors: Yamamoto Masahiro , Meyer John Stirling
Published: June 2005

SYNOPSIS

Regional cerebral blood flow (rCBF) and cerebral vasomotor responses to 5% CO2 inhalation were measured before and after pharmacologic μ‐ or β‐adrenoceptor manipulation in Migraine (M) and Cluster headaches (C). Responses of 77 vascular headache patients (M =66 and C = 11) were compared to those of 15 Muscle contraction headache (MCH) and 64 normal volunteers. Oral drugs were: Peripheral μ‐adrenoceptor stimulator:isometheptene (Midrin(r)), peripheral μ‐blocker:dihydroergotoxin (Hydergine(r)), centrally acting μ‐blocker:clonidine (Catapres(r)), peripheral β‐blocker:propranolol (Inderal(r)), peripheral β‐stimulator:isoproterenol (Isuprel(r)). Peripheral μ stimulation markedly reduced rCBF during headache but effect lessened after headache subsided in M and C. Peripheral μ‐blockade and β‐stimulation increased CBF in M and C. Peripheral β‐blockade markedly decreased CBF during headache in M but caused only small CBF reductions when headache‐free. Peripheral adrenoceptor effects on rCBF in M and C were greatest on most recent headache side. Central effects of clonidine were opposite (greatest on non‐headache side). Excessive CO2 responses were greatest on side of headache. After peripheral μ‐stimulation, peripheral μ‐blockade, peripheral β‐stimulation or blockade, CO2 responses were restored toward normal but not after central μ‐blockade. In MCH. contrary to M and C, μ‐stimulation had no effect on CBF or CO2 responses. There appears to be an asymmetrical adrenoceptor disorder in M and C possibly due to sympathetic denervation‐hypersensitivity.
Interval Therapy of Migraine: Long‐term Results
Authors: Raskin Neil Hugh , Schwartz Robert K.
Published: June 2005

SYNOPSIS

Recrudescence of migraine headaches some time after the initiation of drug prophylaxis and the responsiveness of many patients to one or more vasoactive agents but not others are factors that have not hitherto been incorporated into a systematic appraisal of the putative long‐term benefits of migraine therapy. In this study, followup information was obtained upon 146 treated migraineurs who were initially evaluated within the last 9 years and were drawn randomly from coded files; the major component of their treatment was the sequential use of the following drugs: propranolol, amitriptyline, ergonovine, methysergide, ergotamine, phenelzine, papaverine and cyproheptadine. Data was also collected upon 85 age‐matched patients who chose a variety of treatment modes other than drugs in an attempt to lessen headache problems that were comparable to the drug‐treated group. The mean followup period for both groups was 35 months. Of the drug‐treated patients, 55% evidenced substantial improvement of at least one year‘s duration compared to 26% of the control group (p<.01); improvement of at least 2 years’ duration was apparent among 31% of the drug‐treated patients whereas 12% of the controls did as well (p<.01). Prophylactic migraine therapy proffers substantial long‐term benefits to some patients.
Barometric Pressure and Other Factors in Migraine
Authors: Cull R.E.
Published: June 2005

SYNOPSIS

Forty‐four adult patients suffering from either classical or common migraine recorded the dates of their attacks over periods of six months. Barometric pressure on the day of attacks, changes in pressure before attacks, days of the week and months of the year were correlated to the frequency of migraine attacks. The frequency of migraine attacks was significantly less when barometric pressure at 06.00 hrs was less than 1005 mb compared with pressures between 1016–1025 mb. A rise in barometric pressures of more than 15 mb over the preceding 24 hours was also associated with a significantly reduced migraine frequency. Attacks of migraine were more common on Fridays and Saturdays and during Autumn.
Vestibular Function in Migraine
Authors: Kuritzky Arieh , Toglia U.J. , Thomas D.
Published: June 2005

SYNOPSIS

In order to evaluate vestibular function in migraine, electronystagmography (ENG) was used. Twenty migrainous patients in the headache free phase and free of drugs for at least one week prior to study, were studied. The ENG examination included spontaneous eye movements, bithermal caloric tests and rotatory tests.

The results showed vestibular abnormalities in sixteen patients (80%). Spontaneous nystagmus was found in nine patients (45%). Sixteen patients (80%) had adnormal caloric tests and fifteen (75%) had adnormal rotatory tests.

These findings suggest impairment in vestibular function in a large proportion of migrainous patients. The significance and a possible mechanism are discussed.
Lithium for Cluster Headache: Review of the Literature and Preliminary Results of Long‐term Treatment
Authors: Ekbom Karl
Published: June 2005

SYNOPSIS

Nineteen male patients aged 26 to 67 years have been treated with lithium sulphate in the form of slow release tablets (Lithionit(r) Durules(r)) to prevent attacks of cluster headache. Treatment was given to a serum concentration between 0.7 and 1.2 mmolI. Eight of the patients had chronic symptoms and in all of them the treatment resulted in immediate partial remission of their headaches. The average headache index improved within 2 weeks by 85.3 per cent (75–100%). Three patients were treated for between 18 and 36 months. In one of them the treatment was still effective after 2 years, while the other two appeared in due course to become tolerant to the effects of the drug. Both of them, however, had long periods of remission after interruption of treatment, which may indicate that lithium alters the natural course of the disease in chronic cases.

In 7 patients with periodic symptoms lithium had only a slight or no effect on the headaches. In four other cases lithium was given for, on average, 19.7 months (6‐31), principally owing to psychiatric symptoms. This long‐term prophylactic treatment resulted in an almost complete suppression of cluster periods. Two of these patients tried to discontinue the drug after one year. This produced extremely severe rebound headaches after 3 weeks.

It is concluded that lithium is efficacious in chronic cluster headache. Lithium has only slight effects in acute periods of cluster headache but may prevent them in some patients when the drug is given in a free interval between two periods. In view of its potential serious side‐effects, lithium should be given with caution to strictly selected patients.

The mechanisms of actions of lithium are discussed.
Exacerbation of Migraine by Treatment With Lithium
Authors: Peatfield R.C. , Clifford Rose F.
Published: June 2005

SYNOPSIS

The administration of lithium carbonate (Priadel) to five patients with classical or common migraine caused the attacks in all of them to become much more frequent and severe. This outcome contrasts with the drug's established role in cluster headache, and suggests that the Pathogeneses of these two types of pain may be different.
Indomethacin Responsive Headache Syndromes
Authors: Mathew Ninan T.
Published: June 2005

SYNOPSIS

Three headache syndromes which respond clinically to Indomethacin therapy are described. These include l) Indomethacin responsive cluster headache (chronic paroxysmal hemicrania). Four patients who were unresponsive to Sansert, Prednisone and Lithium responded significantly to Indomethacin and not to placebo. Distinguishing features were (a) numerous attacks a day, (b) headaches are sudden in onset, severe and last on an average of 15–20 minutes, (c) long history of headaches without remission. 2) Sharp, short lived head pain syndrome (SSHP). Synonyms are ice pick like headache, “jabs and jolts”, and “needle in the eye syndrome”. Five cases are described. These head pains are variable in location, sudden, sharp and last only for seconds to a few minutes. They are common in a migraine population, but may occur as a primary manifestation in some, especially those above the age of 60. Etiology is uncertain. Response to Indomethacin is dramatic. 3) Exertional headache. Two cases of benign cough headache resistant to many other antimigraine agents responded to Indomethacin in a double blind cross over evaluation.

Headache syndromes which respond to Indomethacin, as a general rule, are of sudden onset, with severe short lived head pains. Specific action of Indomethacin in this syndrome is not clear. The possible role of prostaglandins and prostacyclins in the production of head pains and the effect of Indomethacin on the prostaglandin system is discussed.
An Inquiry into the Genesis of Migraine Headache
Authors: Botney Mitchell
Published: June 2005

SYNOPSIS

Headache is one symptom of migraine; nausea and vomiting, abdominal distress, vertigo and fever are others. Perceptual alterations are also associated with migraine: photophobia, phonophobia, heightened sensitivity to olfactory stimuli and increased general irritability are often noted. Headache, however, is most debilitating.

A hypothesis is proposed describing one mechanism whereby genesis of migraine headache may occur. This mechanism is consistent with clinical and experimental observations taken from human and animal studies. Briefly, various agents or activities induce vasoconstriction of the cranial arteries in susceptible populations. Oxygenation of the brain is decreased with consequent decrease in the synthesis of serotonin, a neurotransmitter implicated in pain perception. Stimuli not normally painful, such as vasodilatation, thus become painful.
Self‐help Treatment for Migraine Headaches: A Controlled Outcome Study
Authors: Kohlenberg Robert J. , Cahn Timothy
Published: June 2005

SYNOPSIS

A self‐help approach for the control of migraine headaches was evaluated. Self‐help refers to a self‐directed effort, without therapist contact aimed at reducing the symptoms of migraine. The experimental plan involved giving migraine headache patients one of two experimental books and then evaluating the effect.

Subjects were recruited through newspaper announcements and were required to have had at least two vascular headaches per month. During the first six weeks of the study, the baseline period, all subjects recorded headache frequency, intensity and duration. Subjects were then matched for headache frequency and then randomly assigned to receive either the treatment or control book.

The treatment book contained instructions for thermal biofeedback, relaxation and cognitive behavior therapy. A liquid crystal device for measuring fingertip temperature was also included. Instructions in the treatment book were written such that a self‐help, no‐therapist treatment could be followed by the subject. The control book was a popularly available paperback in which a series of case studies on headache treatment and diagnosis were discussed. It was selected because it was easy to read and contained information about headaches but did not necessarily direct the reader to start a self‐help program.

Data was obtained for 51 subjects who completed a three‐ and six‐month followup data collection period (treatment N = 22, control N = 29). There was a 62% decrease in headache frequency at six months for subjects who received the treatment book and a 14% drop for those who received the control book. Corresponding findings were also obtained for duration and pain levels of the headache as well as for prescribed medication use. Although the results indicated that this type of self‐help treatment could be effective for many migraine patients, limitations and cautions in interpretation of these results were discussed.
An Epidemiological Study of Headache in a Hospital Staff
Authors: Manzoni G.C. , Campari M. , Terzano M.G. , Moretti G. , Fanti E.
Published: June 2005

SYNOPSIS

An epidemiological study of headache has been carried‐out in a hospital staff with the purpose: (a) to check out the prevalence of headache (migraine and muscle‐contraction headache in particular) in an occupational group representative of the working population at large; (b) to verify the existence of clinical aspects generally held peculiar to migraine in different types of headache; (c) to evaluate comparatively the reliability of self‐administered questionnaire and direct clinical interview in order to quantify epidemiologically the various headaches sub‐types.

Initially a simple questionnaire was administered to 1331 employees of Parma Regional Hospital; subsequently sufferers from headache were individually submitted to a complete clinical and laboratory examination.

On the basis of the questionnaire, 361 subjects (27.12%) resulted to suffer frequently from headache attacks. The subsequent individual examination indicated that 37.1% suffered from common migraine, 27.3% from muscle tension headache, 7.6% from mixed headache, 3.8% from classic migraine, 3% from post‐traumatic headache.

The findings which were obtained by self‐administered questionnaire and by individual direct examination are comparatively discussed.
Angiotensin and Aldosterone Elevation in Salt‐induced Migraine
Authors: Brainard John B.
Published: June 2005

SYNOPSIS

This study was designed to document the clinical observation that oral salt load triggers migraine, and to evaluate angiotensin and aldosterone changes during the headache response.

One gram capsules of sodium chloride or identical gelatin placebos given by mouth to 25 migraine patients and 24 non‐migrainous controls resulted in statistically significant elevation of plasma angiotensin levels in those receiving salt compared to those receiving gelatin. Fourteen out of fifteen migraine patients who received salt developed typical migraine headache. Headache occurred in one out of ten migraineurs ingesting gelatin capsules. This difference in induced headache was also statistically significant.
Cross‐validation of the Kudrow‐Sutkus MMPI Classification System for Diagnosing Headache Type
Authors: Andrasik Frank , Blanchard Edward B. , Arena John G. , Teders Steven J. , Rodichok Lawrence D.
Published: June 2005

SYNOPSIS

In order to determine the generality of the Kudrow‐Sutkus (1979) MMPI classification system for diagnosing headache type, a cross‐validation analysis was performed on 99 headache subjects. Results indicated a high level of support for Kudrow‐Sutkus' Group A (migraine and cluster) classification criteria (65.4% and 75.0% correct assignments for female and male subjects, respectively) but a low level of support for Kudrow‐Sutkus' Group B (combined and chronic scalp muscle tension) classification criteria (5.9% and 25.2% correct assignments for female and male subjects, respectively). Possible reasons accounting for these differences are discussed.
The McGilI‐Melzack Pain Questionnaire in the Diagnosis of Headache
Authors: Allen Robert A. , Weinmann Robert L.
Published: June 2005

SYNOPSISThe McGilI‐Melzack Pain Questionnaire (MMPQ), comprised primarily of adjectives descriptive of pain, was administered to 100 patients seeking treatment for headache. Diagnostic classification of patients into migraine or muscle contraction headache groups was conducted by a screening neurologist using information other than pain description. Reliability determinations were made following independent diagnosis by two other neurologists using a headache pain history and symptom form (HPHSF) devoid of pain adjectives. Comparison of 30 subjects HPHSF's revealed that the screening neurologist's diagnosis and that of two other neurologists, (t = .87, p<.01) and (t = .48, p<.05), indicate high agreement between three physicians in headache diagnosis devoid of pain description. Results show that migraine headache patients report significantly more affective words (t99 = 3.89, p<.001) than do muscle contraction headache sufferers; however, no significant differences existed between the groups' use of sensory or evaluative works. Migraine sufferers, while not reporting their headache as more severe “generally,” did report more intense pain when recalling headache at its “worst” (t99 = 2.69, p<.01) and at its “least” (t99 = 1.74, p<.05) compared to the muscle contraction headache 'group. Discriminant analyses were conducted on one‐half of the sample to determine diagnostic group membership on the basis of pain description alone. Findings revealed that group membership could be predicted at a 90% rate (x21.45 = 33.06, p<.001). A cross validation on the second half of the sample confirmed these findings (x21.48 = 13.08, p<.05) suggesting that the MMPQ is of value in headache diagnosis. Differences between electromyographic studies and headache pain report are discussed as well as suggestions concerning modification of the MMPQ for headache assessment.
Neuroendocrine Data in Chronic Post‐traumatic Headache
Authors: Savoldi F. , Murialdo G. , Bono G. , Testa E. , Martignoni E. , Polleri A. , Nappi G.
Published: June 2005

SYNOPSIS

Twenty chronic post‐traumatic headache subjects (16 men and 4 women) were considered, together with age and sex matched normal controls. Pituitary function was challenged by means of luteinising hormone releasing hormone (100 mg,iv), thyrotropin (TSH) releasing hormone (200 mg,iv) and regular insulin (.1 U/kg,iv). The responses of gonadotropins, TSH, somatotropin (STH) and prolactin (PRL) were studied in the group as a whole and in clinical subgroups. No differences were found in the baseline levels of the hormones. No significant changes were observed in the responses of gonadotropins and STH. A decreased response was found for TSH and, in the female series, an enhanced response of PRL was observed. Patients complaining for a decreased libido showed a larger PRL response. The smaller response of TSH exhibits a straight inverse relationship to the clinical severity. The periodicity of PRL secretion studied in male patients with a harmonic analysis according to the Fourier's theorem showed the preservation of the physiological sleep‐entrained night surge. The per cent incidence of the harmonics with a period shorter than 24 hours decreases according to the clinical severity, at variance to the finding in normal controls. The only persisting harmonic is the one with a 24 hour period. In the absence of major post‐traumatic endocrine syndromes, post‐traumatic headache subjects show changes of the neuroendocrine regulation of pituitary secretion. The findings are consistent with the hypothesis of an hyperactivity of serotoninergic neurotransmission.
The Headache and Pain of Spontaneous Carotid Dissection
Authors: Fisher C. M.
Published: June 2005

SYNOPSIS

The clinical features of the headache and neck pain in 21 cases of spontaneous carotid dissection are described. Twenty of 21 patients had head pain or headache and of the 20, 12 had neck pain as well. One patient had neck pain only. Typically, the headache involved the ipsilateral forequarter of the head and neck pain was of local origin in the region of the upper few inches (10 cm.) of the internal carotid artery. Recognition of the headache as a prodromal manifestation may lead to prevention of a stroke through the use of anticoagulation.
Cocaine as an Abortive Agent in Cluster Headache
Authors: Barre' Felix
Published: June 2005

SYNOPSIS

A systematic trial of Cocaine hydrochloride as an abortive therapeutic agent in cluster headache is presented. Headache induction was performed with sublingual Nitroglycerin (1.0 mg) and cocaine was employed for abortive purposes. Subjects were then instructed in a mode of self‐application of cocaine solution to their Sphenopalatine Foramen regions for abortion. Most patients can learn to abort most of their cluster headaches by application of cocaine solution to their Sphenopalatine Foramen region in from 15 seconds to three minutes. The risk of addiction is slight when employing 5 to 10% solution for the period of time that the typical cluster persists (4–12 weeks), and the benefits are great in cessation of the agonizing pain that accompanies this headache. Cocaine may be a valuable adjunctive abortive therapeutic measure in cluster headache when combined with a patient educational program. The rapidity of its effectiveness in some circumstances might suggest that the origin of much of the pain of cluster headache may be found in the Pterygomaxillary Fossa region.
Effort Headache in Runners
Authors: Massey E. Wayne
Published: June 2005

SYNOPSIS

Effort Headache may be produced by many sports activities and three cases are presented which occurred in runners. The clinical characteristics are similar to vascular headaches aggrevated by altitude, heat, high humidity and sexual intercourse. Although exertional headache should cause vigilance in evaluation, a benign type is usually seen in runners.
Further Observations on the Mast Cells Over the Painful Region in Cluster Headache Patients
Authors: Liberski P.P. , Prusinski A.
Published: June 2005

SYNOPSIS

23 patients and 6 healthy controls were requested to participate in this study. Examination of skin samples consisted of light microscopic estimation as well as, transmission electron microscopic techniques (TEM) and immunohistochemical techniques. The total number of mast cells (MCs) was significantly higher in cluster headache (CH) patients than in controls, but differences between painful region and opposite temporal site were inconclusive. TEM search revealed presence of MCs around nerve fibres. There were no plasma cells containing polyclonal Ig, IgA, IgG and IgM according to horseradish peroxidase techniques. These observations suggest the role of MCs in CH pathogenesis, which support author's previous findings and results of others as well. The lack of PCs may indicate no involvement of B‐cell mediated phenomena but of T‐cell one, of which MCs are special part.
Superficial Temporal Arterial Dilation Without Headache in Extracranial‐Intracranial Bypass Patients
Authors: Myers Daniel E. , Boone Stephen C. , Gregg John M.
Published: June 2005

SYNOPSIS

Superficial temporal arterial (STA) dilation has long been associated with migraine pain, but it is still not clear if vasodilation alone is sufficient to produce pain. Extracranial‐intracranial bypass (EC‐IC) patients are known to exhibit STA dilation post‐operatively. A group of 56 E.C.‐I.C. patients was questioned about headache, during scheduled post‐operative examinations. Routine pre‐operative and post operative arteriograms of the STA were compared to verify vasodilation. Doppler sonograms were performed on eight of these patients to demonstrate systolic flow velocity changes and to evaluate velocity pulse curve profiles. Despite significant and sometimes marked arterial dilation, as well as pulsatile changes consistent with migraine, none of the subjects complained of post‐operative headache. Implications of the results with regard to migraine, hypertensive and toxic headaches are discussed.
The Psychophysiological Etiology of Muscle‐Contraction Headache
Authors: Haynes Stephen N. , Cuevas Jacqueline , Gannon Linda R.
Published: June 2005

SYNOPSIS

Although numerous pharmacological and behavioral treatments of muscle‐contraction headache have been introduced, the psychophysiological mechanisms underlying this pain disorder have not been identified. This paper reviews and critiques laboratory and treatment studies which add to our understanding of the psychophysiological factors involved in muscle‐contraction headache. The results of a number of studies are consistent with a hypothesized muscle‐contraction or vasomotor etiology. However, other studies have reported results inconsistent with these traditional etiological hypotheses. Interpretation of results is hindered by numerous methodological problems, particularly inconsistent and unreliable diagnostic procedures and insufficient controls for alternative etiological explanations. Although causal inferences are difficult to draw, it is evident that significant individual differences exist in the degree to which muscle‐contraction headaches are associated with elevated cephalic muscle tension and that muscle tension alone is insufficient to account for the occurrence of muscle‐contraction headache. The role of additional possible causative factors is discussed.
Tension Headache Patients Versus Controls: A Study of EMG Parameters
Authors: Sutton Elyse P. , Belar Cynthia D.
Published: June 2005

SYNOPSIS

Tursky's (1976) set of pain descriptors for the intensity and reactivity dimensions were psychophysically scaled by patients with either tension, migraine, combined migraine and tension or cluster headaches and by a group of non‐headache sufferers. The reactivity descriptors consistently discriminated headache from non‐headache subjects and tended to be aligned consistent with the severity of the pain experienced in the various kinds of headaches.
Cardiac Arrhythmia in Basilar Migraine
Authors: Gilroy John , Lerman Victor J.
Published: June 2005

SYNOPSIS

Basilar migraine may produce temporary change in brainstem function resulting in impairment of activity of medullary autonomic nuclei. A case of basilar migraine with transient cardiac arrhythmia is described and it is suggested that abnormalities in cardiac rhythm may be detected by cardiographic monitoring in some cases of basilar migraine. This report emphasizes the occasional occurrence of serious complications during a migraine attack.
Lateral Medullary Syndrome After Basilar Migraine
Authors: Solomon Glen D. , Spaccavento Leo J.
Published: June 2005

SYNOPSIS

Brainstem strokes have been reported following neck trauma and manipulation, but never previously reported following basilar artery migraine. We describe a 21‐year‐old man who suffered a lateral medullary syndrome associated with basilar artery migraines. Angiography revealed complete occlusion of the left vertebral artery.
Chronic Muscle Contraction Headache and the Pain‐Prone Disorder
Authors: Blumer Dietrich , Heilbronn Mary
Published: June 2005

SYNOPSIS

It has long been recognized that depressive traits are commonly associated with muscle contraction headache. Our studies of patients with chronic pain afflicting various body parts led to the delineation of a psycho‐biological profile consisting of typical depressive features, in addition to a set of characteristic clinical, premorbid and historical features. We term this syndrome the pain‐prone disorder and consider it a variant of depressive disease. This study compared psychobiological profiles of patients whose pain was localized to the head with that of patients whose pain was localized to single and multiple areas elsewhere. Of a total 627 chronic pain patients referred to the Henry Ford Hospital Pain Clinic after no somatic cause for their pain was substantiated, 32 patients complained of headaches only, and 53 complained of pain with single localization elsewhere; we randomly selected an additional 53 patients who complained of pain in multiple locations. The headache patients differed from all other pain patients in only three respects: their pain was less continuous; there was greater denial of emotional problems, though a larger number reported suicidal gestures. All groups were likewise depressed. The results support the concept of chronic pain as a variant of depressive disease, regardless of location.
Evaluation of Oculocephalic Sympathetic Function in Vascular Headache Syndromes
Authors: Vijayan N. , Watson Craig
Published: June 2005

SYNOPSIS

The pathogenesis of cluster accompaniments remains unknown. Generally these manifestations are considered to be the result of sympathetic paralysis and parasympathetic overactivity. However, no definitive studies have so far been done to support this idea.

These accompaniments were studied clinically in 44 patients. Detailed autonomic function testing was undertaken in 7 of them utilizing the techniques described in the accompanying paper. We conclude from this study that the accompaniments can be explained on the basis of (1) sympathetic paralysis alone, and (2) that the site of lesion in the sympathetic pathway is located in the third neuron, most likely in the pericarotid region.
Natural History of Cluster Headache‐ Part 1 Outcome of Drop‐out Patients
Authors: Kudrow Lee
Published: June 2005

SYNOPSIS

Cluster patients lost to follow‐up for a period of from three to eight years were the subject of this study. One hundred and forty‐nine/169 drop‐outs or their relatives were contacted via mailings, telephone calls, or professional missing‐person searchers; and questioned regarding headache status and serious illness.

Of the 149 drop‐out patients, 75 (50.3%) reported no change in headache. Eleven (7.4%) had experienced a shift in headache type, that is, from chronic to episodic or episodic to chronic, equally. Fifty‐one (34.2%) had experienced a prolonged (permanent ?) remission, and twelve (8.1%) had died. Thus, the major determinants of drop‐out status included prolonged remission (longer than usual remission duration) and death (42.3%). Remission and mortality rates increased with duration of cluster disorder.

Prolonged (permanent ?) remission rates were highest among patients who had previously experienced usual remission period durations of one year or longer.

Mortality increased with age. Cancer mortality, however, was found to be twice that of coronary artery disease and stroke combined. There was a proportionately higher representation of women and chronic types in the cancer mortality group. Although all patients in this group had smoked cigarettes and drank alcohol, no correlation could be made between extent of these habits and site of cancer.
Platelet Activity in Migraine
Authors: Andrea Giovanni D' , Toldo Moreno , Cortelazzo Sergio , Milone Francesco Ferro
Published: June 2005

SYNOPSIS

Migraine is a disease associated with increased platelet activity.

The aim of this paper was to study "in vivo" platelet activation by assessing platelet serotonin (5HT) content and beta‐thromboglobulin (B‐TG) and platelet factor four (PF4) plasma levels, in headache‐free‐periods and during migraine attacks.

In headache‐free‐periods, there was no differences in platelet 5HT values between migraine patients and control subjects. On the other hand, there were significant differences in B‐TG and PF4 plasma levels. Furthermore, two groups of migraine patients were observed, one with normal B‐TG plasma levels and the other with high B‐TG plasma levels. PF4 plasma levels behave similarly.

During migraine attacks, platelet 5‐HT fell, while B‐TG and PF4 plasma levels rose, if compared to the values recorded immediately before attacks.

We suggest that migraine patients, particularly those ones with high basal values of B‐TG and PF4 plasma levels, form a high risk group to cerebrovascular ischaemic diseases. For these patients a prophylaxis with antiplatelet drugs is indicated.
Ancillary Symptoms in the Biofeedback Treatment of Headaches
Authors: Cox Daniel J. , Lefebvre R. Craig , Hobbs William R.
Published: June 2005

SYNOPSIS

26 consecutive headache patients treated with biofeedback completed the Hopkins Symptom Checklist before and two months following treatment. Contrary to psychoanalytic and systems theories, successfully treated patients demonstrated significant reduction in both somatic and general psychological symptomatology, compared to nonsuccessfully treated patients. Additionally, pretreatment headache diagnosis and measures of depression and anxiety predicted treatment outcome.
Evidence for Sympathetic Deactivation by Temporal Vasoconstriction‐ and Digital Vasodilation‐Biofeedback in Migraine Patients: A Reply to Elmore and Tursky and a New Hypothesis
Authors: Knapp Theodor W.
Published: June 2005

SYNOPSIS

The aim of this contribution is twofold: first, a reply is given to Elmore and Tursky.1 who hypothesized that temporal pulse amplitude biofeedback (TPA) works on the basis of sympathetic activation. Contrary to this point of view, some data are reported supporting the opposite tendency: i.e. sympathetic deactivation. Secondly, based on the first part of this article, a new hypothesis is formulated with the intention of explaining temporal vasoconstriction simultaneously found with digital vasodilation and handtemperature increase during handwarming biofeedback (HTB) resp. during volitional handwarming/relaxation.1,11 This new hypothesis postulates that temporal vasoconstriction occurs during handwarming/relaxation due to the fact that peripheral extracranial scalp and face arterioles dilate. As a result, blood and oxygen supply as well as carbon dioxide release is increased, which leads in turn to a reduction in arteriolar ischemia, hypoxia and acidosis. The improved blood delivery from the temporal arteries to the extracranial arterioles and tissue provokes a relative degree of vasoconstriction of the temporal arteries.
Cerebrovascular Changes in Patients With Headache During Antiserotoninergic Treatment
Authors: Amano Takahiro , Meyer John S.
Published: June 2005

SYNOPSISCBF and cerebral vasomotor responses to 5% CO2 and 100%O2 inhalation were evaluated in 88 patients with headache (56 migraineurs, 17 cluster, 15 non‐vascular) before and during acute versus chronic administration of (1) methysergide (single dose 0.047 mg/kg for acute and 0.071 mg/kg/day for chronic) or (2) cyproheptadine (single dose 0.092 mg/kg for acute and 0.139 mg/kg/day for chronic). Acute treatment with methysergide produced decreases [−4.5%] in F1 values (fast or gray matter flow). Chronic treatment (3–12 weeks) produced increases (%7.9%). These CBF changes only occurred among migraineurs and were not seen in cluster and non‐vascular headache patients. In migraineurs methysergide induced F1 increases were asymmetric between hemispheres. This asymmetry was not seen in patients with non‐vascular headache. Methysergide induced biphasic F1 changes specific for migraineurs, implies rapid and excessive stimulation of cerebrovascular serotoninergic receptors, followed by excessive and asymmetric blockade. Acute treatment with cyproheptadine produced increases (+3.9%) in F1 values. Chronic treatment (3–12 weeks) produced decreases (−8.6%) Since cyproheptadine is Known to alter cholinergic, histaminergic and serotonergic receptors, it is concluded that acute cyproheptadine treatment may stimulate and chronic treatment may block both cholinergic and histaminergic receptors so that any serotonergic effects in the opposite direction are masked. Vasomotor responses were not altered in any of the headache groups by either methysergide or cyproheptadine, so that serotoninergic receptors do not appear to participate in excessive cerebral vasodilator CO2 responses seen in migraineurs.
Platelet Lipid Composition in Human Migraine
Authors: Bottomley J.M. , Hanington Edda , Jones R.J. , Chapman D.
Published: June 2005

SYNOPSIS

Fatty acid profiles were determined in platelets of 21 patients suffering from Classical Migraine and these results were compared with those obtained in a control group of 24 healthy individuals. Cholesterol levels and the cholesterol/phospholipid ratios of 4 of the migraine patients were investigated and compared with values obtained from 4 age‐matched control persons.

No significant differences could be detected between the fatty acid profiles of the migraine and control groups, Analysis of the cholesterol content and the cholesterol/phospholipid ratio of the platelets revealed no significant differences between the two groups.

Freeze‐fracture electron microscopy of the platelet membranes of the two groups revealed no striking differences in the protein distribution and environment in the migraine condition.

We conclude that the membranes of platelets of migraine‐suffering and control individuals have a similar composition, the symptoms of this disorder thus being mediated by other differences between the platelets.
Plasma Opioid Levels in Post‐traumatic Chronic Headache and Trigeminal Neuralgia: Maintained Response to Acupuncture
Authors: Nappi G. , Facchinetti F. , Bono G. , Micieli G. , Parrini D. , Martignoni E. , Petraglia F. , Genazzani A.R.
Published: June 2005

SYNOPSIS

Six patients affected by post traumatic chronic headache (PTCH), six affected by typical idiopathic trigeminal neuralgia (TN) and 8 healthy volunteers were submitted to Traditional Chinese Acupuncture (TCA). Heparinized blood samples were obtained in basal conditions, and 1, 5, 20 and 60 minutes after withdrawal of the needles. In all plasma samples, ACTH was measured by RIA after glass powder extraction while both βLPH and βEP RIAs were performed after plasma silicic acid extraction and Sephadex G‐75 column chromatography.

In PTCH patients, βLPH and βEP plasma levels (pg/ml: M ± SE) increased at the 5th minute (from 72.6 ± 10.9 to 111.6 ± 23.9 and from 22.2 ± 3.9 to 30.4 ± 3.8; p <0.01, respectively), decreasing to basal values at the end of the observation period.

The same response was observed in TN patients (βLPH from 51.0 ± 0.91 to 93.8 ± 1.6; EP from 15.0 ± 1.4 to 30.0 ± 3.9); the basal values in this group were slightly lower than those found in PTCH patients.

ACTH plasma concentrations were not modified by TCA in either group, while modifications were observed in normal healthy volunteers.

In conclusion, both PTCH and TN patients respond to TCA in terms of plasma βLPH and βEP release, in a manner similar to that of healthy controls; this observation can be used to discriminate these patients from primary headache sufferers in whom impaired basal levels and stimulated plasma endorphin levels have been previously demonstrated.
Post‐lumbar Puncture Headache
Authors: Spielman Fred J.
Published: June 2005

SYNOPSIS

Headache is a frequent complication of dural puncture. Cerebrospinal fluid leakage from the subarachnoid space decreases the cushioning effect the fluid has on the brain, producing traction on nerves and blood vessels. The headache, worse when the patient's head is elevated, and usually located in the frontal and occipital regions, is often associated with neck stiffness and nausea. The symptoms typically occur the day after dural puncture and are normally limited to 5 or 6 days. The post‐lumbar puncture headache's incidence and severity are directly related to needle size. The mainstays of treatment are hydration and bedrest. Analgesics and tranquilizers can be used to relieve anxiety and muscle spasm. Severe symptoms unresponsive to conservative measures have been treated with an epidural blood patch. The success rate of this therapy is over 90 per cent.
Prostaglandin ‐ E 2 Levels in the Saliva of Common Migrainous Women
Authors: Vardi J. , Flechter S. , Alguati A. , Regev I. , Ayalon D.
Published: June 2005

SYNOPSIS

Prostaglandin E2 (PG‐E2) levels were measured in the saliva of 6 women suffering from common migraine, during an attack, and in the interval between attacks; the results obtained were compared to the levels found in a matched control group of healthy women. There was a significant increase in the levels of PG‐E2 during migraine attack P<0.05. These results may suggest that PG‐E2 takes an important role in the mechanism of migraine.
Flunarizine, a Calcium Channel Blocker: a New Prophylactic Drug in Migraine
Authors: Amery W.K.
Published: June 2005

SYNOPSIS

The postulated pivotal role of focal brain hypoxia in the genesis of the migraine attack and the anti‐hypoxic properties of flunarizine, have led to the use of the selective calcium‐entry blocker in the treatment of migraine. Clinical experience is reviewed. Open findings, confirmed by double‐blind placebo‐controlled studies and comparisons with pizotifen and cinnarizine, have shown that flunarizine, given at 10 mg daily, is a safe and effective prophylactic drug for both common and classical migraine. Factors determining the efficacy of flunarizine are discussed.
A Comparison of MMPI Personality Data and Frontalis Electromyographic Readings in Migraine and Combination Headache Patients
Authors: Weeks Randall , Baskin Steven , Rapoport Alan , Sheftell Fred , Arrowsmith Fran
Published: June 2005

SYNOPSIS

Three headache specialists independently evaluated one hundred and fifty patient headache histories and classified them into separate diagnostic categories. Personality data from selected scales of the MMPI and frontalis electromyographic readings during three stimulus conditions were compared between migraine patients and combination headache patients. Patients were also asked to rate the perceived level of stress elicited by the three conditions (sitting comfortably at rest, performing mental arithmetic, and imagining a severe headache).

Results indicated that raters could reliably classify patients into the migraine or combination headache group, as well as differentiate either of those groups from other headache diagnoses. Subjects in the combination group had higher MMPI scores on scale one (hypochondriasis), scale two (depression), scale three (hysteria), and scale seven (psychasthenia). There was no significant difference in frontalis muscle tension between the two groups although both showed a significant amount of muscular reactivity to the stress induction conditions. Subjects were accurate in their perception of this reactivity. Methodological suggestions were made regarding future phychophysiological research with headache patients.