bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Dihydroergotamine in Patients with Postconcussion Syndrome
Authors: McBeath Juanita G. , Nanda Anil 
Published: May 2005

SYNOPSISThe experience with 34 patients who came to the Shreveport Headache Clinic for treatment of postconcussion headache is reviewed. All had been suffering from postconcussion (posttraumatic) syndrome for periods ranging from one day to more than three years, and all displayed, in addition to headache, at least three other symptoms characteristic of the syndrome, eg, memory problems, impaired concentration, sleep problems, dizziness, and anxiety. After initial evaluation at the clinic, the patients were admitted to Willis Knighton Medical Center and treated with repetitive administration of intravenous dihydroergotamine (DHE) and metoclopramide. A good to excellent overall response to DHE therapy was achieved by 88% (29) of the patients. The percentages and numbers of patients obtaining good to excellent relief of selected key symptoms were: 85% (28) ‐ headache, 91% (30) ‐ memory problems, 94% (31) ‐ sleep problems, and 88% (29) ‐ dizziness. DHE was well‐tolerated, and no serious or unexpected adverse reactions were reported. The most frequently reported adverse reactions were mild nausea and brief worsening of headache.
1044 Women with Migraine: The Effect of Environmental Stimuli
Authors: Hay K. Michael , Mortimer Marek J , Barker David C. , Debney Lorna M. , Good Peter A 
Published: May 2005

SYNOPSISThis study initiated by a self‐help migraine group investigated disability caused by visual environmental stimuli, e.g. glare, flicker, pattern and color. One thousand forty‐four women with migraine completed the self‐report questionnaire on visual environmental stimuli reported in earlier studies to precipitate or aggravate migraine. One hundred twenty‐one female controls were obtained from general practice and hospital out‐patients. The responses of the classical, common and non‐migraine groups were compared. Women with classical migraine expressed greater disability than those with common migraine or controls both in respect of number of visual sensitivities reported (P < 0.0001 ) and severity of consequences of such stimuli (P < 0.0001). This study indicated differences between classical and common migraine outside of the attack phase apart from aura. Reported range of sensitivities for the migraineurs peaked between the ages of 46–60 years. A high level of unrealized disability caused by visual environmental stimuli was thus identified in hitherto unexplored self‐help groups.
Acute Headache of Recent Onset and Subarachnoid Hemorrhage: A Prospective Study
Authors: Lledo A. , Calandre L. , Martinez‐Menendez B. , Perez‐Sempere A. , Portera‐Sanchez A. 
Published: May 2005

SYNOPSISTwenty‐seven patients with acute severe headache of recent onset were prospectively recruited in the Emergency Room. Mean duration of headache was 61 hours. CT scan disclosed subarachnoid bleeding in 4 patients and spinal tap revealed subarachnoid hemorrhage (SAH) in 5 patients with normal CT scan. In most SAH cases pain was bilateral, very intense and involving the occipital region. Four of these patients had doubtful or no nuchal rigidity and in one, pain improved while in the Emergency Room.In every case with an intense acute severe headache of recent onset CT scan and (if normal) a lumbar puncture are warranted to help rule out a SAH.
Recurrence of Cluster Headache After Carotid Thrombendarterectomy
Authors: Björne Annika , Hindfelt Bengt , Havelius Ulf 
Published: May 2005

SYNOPSISThe pathophysiology of cluster headache is largely unknown. One important contributing factor may be an abnormal intracranial‐extracranial hemodynamic state. A male patient suffered from chronic left‐sided cluster headache for about 15 years. After the institution of lithium therapy the symptoms abated. He was completely free from cluster headache for more than 20 years, until the first postoperative day after a thrombo‐endarterectomy for symptomatic 70% carotid stenosis.This case report indicates the importance of abrupt carotid hemodynamic changes along with dysfunction of the cephalic sympathetic nervous system in the initiation of cluster headache.
Persistent Post‐DuraI‐Puncture Headache Treated With Epidural Infusion of Dextran
Authors: Aldrete J. Antonio 
Published: May 2005

SYNOPSISA retrospective review was done on medical records of 13 patients with persistent post‐dural‐puncture headaches after one or more epidural blood patches. Headache occurred in nine patients with post‐laminectomy syndrome after “wet taps” while performing epidural blocks. In two patients post‐dural‐puncture headache appeared after long term implanted intrathecal catheters were removed. In two other cases headache developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three patients were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran‐40 was given followed by an infusion of 3 mL/hr, until 12 hours after the head pain and any other related symptoms subsided. In all patients the headache disappeared within 20 hours after initiating therapy (9.55 mean hours, SD ± 0.79). In five patients headache ceased in less than five hours. Nausea and photo‐phobia subsided earlier. Patients with post‐dural‐puncture headache resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural infusion of dextran‐40.
An Update on the Epidemiology of Migraine
Authors: Lipton Richard B. , Silberstein Stephen D. , Stewart Walter F. 
Published: May 2005

SYNOPSISEpidemiologic studies provide estimates of the scope and distribution of the public health problems posed by migraine. These studies have been facilitated by the development of the International Headache Society criteria for migraine, which have now been used in separate prevalence studies in several countries. In this article, we review some of the methodological challenges in studying migraine epidemiology, report recent results from studies using IHS criteria, and suggest directions for future research.
Diagnosing Recurring Headaches: IHS Criteria and Beyond
Authors: Marcus Dawn A. , Nash Justin M. , Turk Dennis C. 
Published: May 2005

SYNOPSISCurrent classification systems for diagnosing recurring headaches utilize sets of specific criteria. To determine the usefulness of these criteria in the practical application of diagnosing headache patients, 698 headache specialists were asked to review four case vignettes of headache patients and assign a diagnosis. They also ranked International Headache Society (IHS) criteria along with other features commonly used in the diagnosis of headaches in order of importance. There was no difference in ranked importance for the specific criteria posed by the IHS compared with commonly used criteria not included within the IHS system. A large majority of the respondents combined IHS features with other associated features not used in the IHS system as the basis of diagnostic assignment. These results raise a question about the acceptance and utilization of the IHS system as a basis for diagnoses. They also suggest that there is a need to educate health care providers about the appropriate use of the current IHS criteria to increase reliability of headache diagnosis.
A Population‐Based Survey of the Social and Personal Impact of Headache
Authors: Kryst S. , Scherl E. 
Published: May 2005

SYNOPSISTo explore the social and personal impact of headache, we contributed questions on serious headache to a population‐based telephone survey on health in Kentucky. A total of 647 persons aged 20 and older was assessed for serious headache. Migraine without aura was distinguished from non‐migraine headache using a modification of the 1988 IHS criteria. The 12‐month period prevalence for all serious headaches was 13.4%; for migraine, it was 8.5%. Demographically, there was a higher proportion of headache sufferers in the low income bracket (<$10,000/year) and a higher proportion of women reporting migraines. Of those with serious headaches, 73.6% stated that headaches adversely affected their lifestyle in at least one way. Migraineurs reported significantly more interference in family relations, work attendance, and work efficiency than non‐migraineurs. Women said their family relationships and work productivity were impacted significantly more often than men. Of those reporting disability, 46.8% said they take only non‐prescription medications. We conclude there is a significant number of serious headache sufferers in Kentucky who experience social as well as vocational impairment as a result of their illness. Further research is recommended to evaluate the extent of interpersonal and personal disability and to identify barriers to adequate health care for headache sufferers.
Chronic Tension‐Type Headache: An Investigation of the Appraisal Process
Authors: Kearney Jeffrey M. , Holm Jeffrey E. , Kearney Maria L. 
Published: May 2005

SYNOPSISThe few existing studies that have explicitly examined appraisal of stress in tension‐type headache sufferers have found that these individuals perceive events in a more negative manner than headache‐free controls. However, can it necessarily be assumed that they perceive events in a less accurate manner than headache‐free controls? To answer this question, sixty chronic tension‐type headache sufferers and 60 controls engaged in a 40‐trial contingency learning task in which they had to estimate the amount of control they could exert. Results provide little support for the notion that the cognitive appraisal of tension‐type headache sufferers is more accurate than that of headache‐free individuals. However, differences were found in perceived control when behavioral involvement was considered. This result is discussed in terms of learned helplessness theory.
Headache and Depression: Confounding Effects of Transdiagnostic Symptoms
Authors: Hol Jeffrey E. , Penzie Donald B. , Holroy Kenneth A. , Brow Timothy A. 
Published: May 2005

SYNOPSISA link between headache and depression has been noted in the literature for over 30 years. To date, however, studies investigating this relationship have ignored the potential impact transdiagnostic symptoms (i.e., symptoms indicative of both depression and headache) may have on correlations between measures of depression and measures of headache activity. The present study examined this issue using the Beck Depression Inventory in a large sample of recurrent headache sufferers who had presented for treatment at one of two university‐based clinics. Factor analysis identified two distinct, albeit correlated, factors reflecting cognitive/affective symptoms and somatic symptoms. Correlational analyses found consistent relationships between the somatic symptom factor and measures of headache activity, but not between the cognitive/affective factor and headache activity. We suggest that the BDI items comprising the somatic factor identified in this study may not be appropriate indicators of depression in recurrent headache samples.
Tension Headache: Botulinum Toxin Paralysis of Temporal Muscles
Authors: Zwart John‐Anker , Bovim Gunnar , Sand Trond , Sjaastad Ottar 
Published: May 2005

SYNOPSISThe pathogenetic mechanism of tension headache (TH) is still unknown. The role of pericranial muscle tension in TH is also enigmatic. To evaluate this factor in chronic TH, pericranial muscles were paralysed in 6 chronic TH patients, using botulinum toxin. All patients fulfilled the IHS criteria of chronic TH associated with involvement of the pericranial muscles, but not the current criteria for cervicogenic headache. The patients were followed‐up regularly with evaluation of the paralysis, changes in pain intensity, and pressure pain threshold measurements. We primarily only injected the temporal muscle on the one side, using the other side as a control. Contralateral muscles were in some cases injected at a later stage. In our study, we did not find any significant reduction in pain intensity, as measured by the visual analogue scale, nor any changes in pressure pain threshold, as measured by an algometer. On the basis of our observations, we conclude that muscle tension in these muscles possibly plays a minor role in the genesis of chronic TH. In our study, however, we have only treated a limited number of patients, and only one pericranial muscle has been injected systematically. Further studies of various neck/posterior head muscles ought to be performed in order to further evaluate a possible effect of tension in the pericranial musculature in producing this type of pain.
Double‐Blind Trial of Fluoxetine: Chronic Daily Headache and Migraine
Authors: Saper Joel R. , Silberstein Stephen D. , Lake Alvin E. , Winters Marjorie E. 
Published: May 2005

SYNOPSISThis study is the first double‐blind placebo‐controlled trial of fluoxetine for chronic daily headache (CDH) and migraine. After a one month single‐blind baseline on placebo, subjects with CDH (n=64) and migraine (n=58) were randomly assigned to a three month trial of fluoxetine (20 mg) or an identical placebo. Fluoxetine and placebo were increased to 40 mg in the second month, depending on patient response. Patients kept daily headache records, and completed 100 mm visual analogue scales (VAS) of headache and mood each month.For the group of CDH patients on fluoxetine, overall headache status (VAS) after three months compared to the end of the single‐blind placebo baseline improved a mean of 50% vs. 11% for those receiving the double‐blind placebo ( P =.029), with 47% vs. 23% improving at least 50% ( P =.097, n.s.). Fluoxetine patients showed significant improvement in monthly mood ratings compared to placebo (.001 by the end of the study), and modest but significant improvement in daily records of headache frequency ( P =.019) but not pain severity. Significant mood improvements preceded improvement in headache, reaching significance by the end of the second month on fluoxetine ( P =.013), while headache improvement emerged only during the third month ( P =.001). Double‐blind investigator judgement identified more headache improvement in fluoxetine than placebo recipients (40% vs. 22%, P =.032).Fluoxetine was not effective on any measure for migraine, with the exception of modest mood improvement at the end of the third month ( P =.043). Adverse effects were more frequent but not more severe for fluoxetine, including sleep disturbance (28% vs. 8%, P =.008), tremors (20% vs. 5%, P =.025), and minor stomach pain (13% vs. 0%, P =.008).Fluoxetine appears moderately effective for CDH but not migraine, with a generally tolerable side effect profile. The influence on headache may be linked to its effect on mood. In general, study subjects were not clinically depressed. Future research might focus on subjects with comorbid depression and headache.
Chronic Paroxysmal Hemicrania in a Child
Authors: Gladstein J. , Holden E.W. , Peralta L. 
Published: May 2005

SYNOPSISChronic paroxysmal hemicrania (CPH) is a relatively new condition first described in 1973. Since its first description, over 80 cases have been reported worldwide. Very few cases have been reported in children. We report the presentation of an 8‐year‐old boy to illustrate the problems in diagnosis and treatment of this rare disease in childhood.
Side‐Locked Unilaterality and Pain Localization in Long‐Lasting Headaches: Migraine, Tension‐Type Headache, and Cervicogenic Headache
Authors: D'Amico Domenico , Leone Massimo , Bussone Gennaro 
Published: May 2005

SYNOPSISSide‐locked unilaterality and specific localization of pain are not as well‐defined clinical characteristics in long‐lasting headaches (duration more than 4 hours) as they are in short‐lasting forms. We examined side‐locked unilaterality and pain distribution at onset and at peak headache in 74 patients with different forms of long‐lasting headache: migraine and tension‐type headache (IHS) and cervicogenic headache (according to Sjaastad et al). Side‐locked unilaterality of pain was found in all forms, but to differing extents‐20.8% in migraine, 12.5% in tension‐type headache, while it was a mandatory criterion for cervicogenic headache. The pain tended to localize anteriorly, particularly at onset, in migraine; was more diffuse in tension‐type headache; and always began in the occipitonuchal region in cervicogenic headache. Our results may contribute to a better clinical definition of long‐lasting headaches.
Plasma Monoamines in Tension‐Type Headache
Authors: Castillo J. , Martínez F. , Leira R , Lema M. , Noya M. 
Published: May 2005

SYNOPSISClinical and pharmacological data suggest a derangement of central monoaminergic systems in tension‐type headache. Biochemical evidence has been rarely recognized. These findings may relate with pathophysiological mechanisms of headache or with underlying depression. We measured platelet‐rich plasma serotonin and plasma catecholamines (norepinephrine, epinephrine, and dopamine) in 30 patients with tension‐type headache and in 20 healthy controls, using High‐Pressure Liquid Chromatography. We studied differences between groups and the relation between biochemical parameters and clinical indices evaluating duration and severity of headache and depression. Platelet serotonin levels in tension headache patients were higher than in controls ( P <0.001). Plasma catecholamine levels were lower in patients than in controls ( P <O.001 for epinephrine and dopamine, and P <0.05 for norepinephrine). There was a positive correlation between dopamine levels and duration of history of headache (r=0.55, P <0.05). A negative correlation between epinephrine levels and severity of headache was observed (r=‐51, P <0.01). No correlations were found between monoamine levels and severity of depression. Our results add to the evidence of alterations of monoaminergic central systems in tension‐type headache patients. These alterations seem to be independent from the underlying depression and related to the pathophysiologic mechanisms of headache.
Paroxetine in the Treatment of Chronic Daily Headache
Authors: Foster Carol A. , Bafaloukos Jacklyn 
Published: May 2005

SYNOPSISForty‐eight patients with chronic daily headache, unresponsive to several combinations of pharmacological treatments, were selected for an open‐label study using paroxetine. Patients were given 10 mg to 50 mg of paroxetine for a period of 3 to 9 months. Ninety‐two percent of the patients improved significantly, based on the patients' percent of the reduction in number of headache days per month. The common side effects were fatigue, insomnia, and urogenital disturbances. The possible mechanism of action of paroxetine in the treatment of chronic daily headache is discussed. Paroxetine appears to be effective in the treatment of chronic daily headache; however, double blind studies are needed to confirm these preliminary findings.
Migraine and Concomitant Symptoms Among 8167 Adult Twin Pairs
Authors: Honkasalo M‐L. , Kaprio J. , Winter T. , Heikkilä K. , Sillanpää M. , Koskenvuo M. 
Published: May 2005

We studied the inheritance of migraine and concomitant symptoms among 2690 monozygotic (1524 female and 1166 male) pairs and 5497 dizygotic (2951 female and 2546 male) twin pairs. Our material consists of a population‐based questionnaire study among Finnish twins in 1981. The definition of migraine is based on a questionnaire method.Concordance was assessed using probandwise concordance rates and tetrachoric correlations for monozygotic (MZ) and dizygotic (DZ) twin pairs. For estimating the contribution of genetic factors to the susceptibility of migraine, a polygenic multifactorial model was used. Structural equation models were applied for estimating variance components and to compare different genetic models.Nearly one‐half (40% to 50%) of the liability to migraine is attributable to genetic factors. In all structural analyses, the model with both additive genetic and unshared environmental component had the best goodness‐of‐fit value. The genetic component varied between 34% to 51% in different migraine types. There were no remarkable differences between sexes except in the effects due to dominance, where the proportion was 26% for men and 14% for women. Concomitant symptoms among subjects within pairs concordant for headache had genetic effects varying from 56% (subjects with unilaterality) and 56% (subjects with visual symptoms) to 45% (persons with nausea and vomiting). The two threshold model of headache points to the continuum model of headache, and the thresholds represent different levels of severity of the pain.Our results emphasize a multifactorial and higher than previously reported genetic pattern in the etiology of migraine. Also unshared environmental factors play an important role.
Quantification of Headache Disability: A Diagnostic‐Based Approach
Authors: Micieli Giuseppe , Frediani Fabio , Cavallini Anna , Rossi Francesco , Bussone Gennaro , Merli Silvio , Nappi Giuseppe 
Published: May 2005

The quantification of the social and economic handicaps caused by headache is a complex problem, especially given the great variability of headache patients' clinical pictures. In the present study, 400 patients, consecutively admitted to Headache Centers in Pavia and Milan, were interviewed on the relationship between headache and their work and social activities, in order to evaluate their socioeconomic handicap due to headache. The analysis of the data primarily focused on attack‐type headaches (migraine, cluster headache, and episodic tension‐type headache) and chronic or daily headaches (chronic tension‐type headache and migraine combined with tension‐type headache). These latter types were often characterized by the daily use or abuse of analgesics.The overall profile which emerged from the study reveals relatively low levels of handicap or disability in work and social activities. These low levels can be mainly attributed to timely, and at times excessive, use of analgesics.
Improvement of Decreased Critical Flicker Frequency (CFF) in Headache Patients With Drug Abuse After Successful Withdrawal
Authors: Schnider Peter , Maly Joachim , Grünberger Josef , Aull Susanne , Zeiler Karl , Wessely Peter 
Published: May 2005

A considerable proportion of headache patients fulfill the criteria of “drug abuse” (definition according to the International Headache Society [IHS] criteria). These patients exhibit markedly reduced vigilance and continuous performance, as shown by the results of critical flicker frequency (CFF) analysis.The present study deals with the question whether this impairment of vigilance and continuous performance is reversible. Forty‐eight headache patients with drug abuse were investigated three times by means of CFF analysis: immediately before (A), immediately after (B), and 3 weeks after having finished (C) inpatient drug withdrawal.Immediately after withdrawal, a significant decrease of headache intensity was observed. The CFF values, however, remained unchanged at a depressed level, probably due to withdrawal medication and the initial sedative side effects of thymoleptic agents (given as prophylaxis).Three weeks after withdrawal, however, the CFF values were significantly improved, and were now within a range not far from the normal values known from a healthy general population. Thus, even after many years of drug abuse, headache patients have a good chance to improve their vigilance and continuous performance and to reach normal or close to normal levels.