bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐Administration of Parenteral Ketorolac Tromethamine for Head Pain
Authors: Turkewitz L. Jay , Casaly Joseph S. , Dawson Gregory A. , Wirth Oliver , Hurst Reina J. , Gillette Pamela L. 
Published: May 2005

SYNOPSISSixty‐one separate self‐injections of ketorolac tromethamine (ToradolÒ) by 16 patients diagnosed with episodic migraine with or without aura were evaluated over a 90‐day period for safety, efficacy of painreduction, and the ability of this therapy program to prevent the necessitation of emergency room acute care. Prior to initiation of treatment, patients were formally instructed on intramuscular injection techniques by a member of our nursing staff. Patients were instructed to call upon the onset of a severeheadache interfering with daily functioning and, then, were permitted to proceed with the injection. Headache intensity ratings were collected prior to injection and intermittently for the following twenty‐four hours. The results demonstrate safety and efficacy of this form of therapy. A significant percent of ketorolac usages (64%) resulted in a good response and significant reduction in head pain. Twenty‐three percent of ketorolac usages resulted in a mild response and only 13% of usages provided no relief. Furthermore, 13% of all usages failed to prevent the necessitation for emergency room treatment. The results are discussed in terms of the impact of self‐injection on pain relief and substantial cost‐reduction by decreasing emergency room utilization.
Outpatient Repetitive Intravenous Dihydroergotamine
Authors: Robbins Lawrence , Remmes Anne 
Published: May 2005

SYNOPSISThe efficacy of the repetitive intravenous dihydroergotamine (DHE) inpatient protocol for refractory headache is wellestablished. We conducted a retrospective and prospective study of long‐term headache patients at our clinic toevaluate this regimen in an outpatient setting.Treatment consisted of oral metoclopramide and four doses of DHE, with the total dose equaling 4 mg.,administered over two days. Patients were followed for up to 10 weeks while they continued to receive prophylacticmedication. Responsiveness was rated in terms of decreased frequency or severity of headache: excellent (75% to100%), moderate (50–75%), mild (25–50%), and none (0–25%).In the retrospective study, 69% (43/62) of patients with chronic daily muscle‐contraction‐type headache and severemigraine had an excellent response at two days. An excellent or moderate response was sustained over three weeks in65% (32/49) of the study group (13 patients were dropped from the study for failing to comply with record keepingrequirements). At the 6‐ and 10‐week follow‐up evaluations, the majority of patients (76% and 70%, respectively)reported mild or no relief.Among patients with refractory daily headache or frequent severe migraine studied prospectively, 80% (28/35)reported an excellent response at two days. After six weeks, 66% (23/35) showed excellent or moderate relief. For bothgroups combined, 73% (71/97) of patients showed an excellent response to DHE at two days, with 43% (33/77)sustaining excellent or moderate relief at six weeks. Side effects, including nausea, leg cramps, facial flushing,increased blood pressure, diarrhea, burning at the injection site, and tightness in the throat and/ or chest, were generallymild and transient. Side effects were milder with outpatient DHE versus our experience with inpatient DHE.Outpatient repetitive IV DHE treatment offers flexibility in the management of severe headache. Our studiesdemonstrate the safety and efficacy of this regimen.
Unilateral Headache with Features of Hemicrania Continua and Cervicogenic Headache ‐ A Case Report
Authors: Rothbart Peter 
Published: May 2005

SYNOPSISA case is presented which has features of Cervicogenic Headache and of Hemicrania Continua. A sudden maneuver of the neck and later a greater occipital nerve block, both resulted in relief of the pain. A cervical cause is suggested.
Flunarizine in Migraine: A Double‐blind Placebo‐controlled Study (in a Saudi Population)
Authors: Deeb S. M. AI , Biary N. , Bahou Y. , Jaberi M. AI , Khoja W. 
Published: May 2005

SYNOPSISWe evaluated the effect of flunarizine (Fz) (10 mg/d) on migraine in e double‐blind placebo‐controlled design. The attacks' frequency, duration, severity and associated symptoms were compared before and after treatment. Forty‐two patients completed a three‐month trial period; 21 patients received Fz and 21 placebo, Statistical analysis showed no significant difference between Fz and placebo (p>0.051. In this study Fz was not more efficient than placebo in migraine.
Low Concentrations of Lithium and Cyclooxygenase Inhibitors Enhance Endothelin‐1 (ET‐1)‐Induced Contractions in Human Temporal Artery, but not in Porcine Ophthalmic Artery
Authors: Bakken I. J. , Vincent M. B. , White L. R. , Cappelen J. , Skaanes K. O. , Sjaastad O. 
Published: May 2005

SYNOPSISEndothelins are a recently discovered group of potent vasoconstrictor peptides synthesized by endothelial cells and other tissues in various species, which seem to participate in the regulation of vascular tonus. Abnormalities in vasoactivity in the head may be an important event in headache pathophysiology, although the mechanisms responsible for such constrictions and/or dilations are not known. The endothelium and its constrictor peptide, endothelin, may play a key role in such mechanisms. Of the various drugs used in the treatment of headache, lithium is an accepted treatment for cluster headache, and indomethacin is the drug of choice for the associated condition chronic paroxysmal hemicrania. The mechanism of action of these drugs in these headaches is not known. Due to the possible involvement of endothelin in headache disorders, the objective of this study was to verify the effects of lithium and cyclooxygenase inhibitors (indomethacin, acetylsalicylic acid and naproxen) on endothelin‐1 (ET‐1)‐induced contractions in isolated human temporal arteries and porcine ophthalmic arteries. It was found that all drugs increased the (ET‐1)‐induced contractions in human temporal arteries. Conversely, there were no significant changes induced by the drugs in porcine ophthalmic arteries. These results are consistent with the variation of activity often seen in different vascular beds and between species. The potential importance of such reactions for the understanding of vascular changes putatively involved in headache development and treatment is discussed.
MRI of Intracranial Arteries in Nitroglycerin Induced Cluster Headache Attacks
Authors: Hannerz Jan , Greitz Dan 
Published: May 2005

SYNOPSISEight patients with episodic cluster headache, five in active episode, three out of episode, were investigated as to diameters of intracranial arteries before and after nitroglycerin (NG) administration. The diameter of all intracranial carotids were increased about 10 minutes after NG, although more in the patients in episode than in patients out of episode. The dilatation remained for the next 60 minutes in the patients who did not get a cluster headache attack. There was a normalization of the diameters of the internal carotid arteries compared to the initial values, at maximum pain in all patients who got a cluster headache attack. Similar changes were also found in the basilar arteries. The findings support the hypothesis of a constriction of intracranial arteries at maximum pain in cluster headache attacks to stop the pain.
SUNCT Syndrome: VII. Ocular and Related Variables.
Authors: Sjaastad O. , Kruszewski P. , Fostad K. , Elsås T. , Qvigstad G. 
Published: May 2005

SYNOPSISSUNCT is a unilateral headache syndrome with shortlasting attacks, accompanied by e.g. conjunctival injection and lacrimation on the painful side. Intraocular pressure (lOP), corneal indentation pulse (CIP) amplitudes, episcleral venous pressure, and corneal, tympanic, and facial temperature have been studied in 6 SUNCT patients. IOP and CIP amplitudes increased on the painful side during headache paroxysms, while episcleral venous pressure remained unchanged. Corneal temperature seemed to increase during attack on both sides. However, the number of observations during attacks is scanty. Outside of attacks, the corneal temperature on the symptomatic side seemed to be higher when compared with the non‐symptomatic side (generally ³0.5°C), provided that the attack frequency was high. The facial temperature seemed to be even on both sides or slightly higher on the symptomatic than on the non‐symptomatic side in the periocular area. This pattern seems to be different from the one in trigeminal neuralgia, in which the temperature has been reported to be lowest on the painful side of the face. During attacks, there seemed to be a tendency for the temperature to increase in the periocular area, but not over the mandible or in the neck. The results obtained could be caused by increased blood supply to the eye (and the surrounding skin) on the symptomatic side because of vasodilatation during repeated pain attacks. As far as the ocular changes are concerned, probably the arteriolar side of the vascular bed is involved.
Posttraumatic Headache: Permanency and Relationship to Legal Settlement
Authors: Packard Russell C. 
Published: May 2005

SYNOPSISIn our increasingly litigious society there is persistence of an attitude that posttraumatic headache (or other injuries) will either improve or disappear following resolution of a claim. In some states (Florida) in order for a person to initiate a claim, an injury must be considered permanent. This is often a difficult task with a subjective symptom. This retrospective study was performed to evaluate the reliability of criteria used to diagnose a “permanent” posttraumatic headache and whether these headaches stay “permanent” after legal settlement. Data was obtained by a structured telephone interview of fifty adult outpatients diagnosed as having permanent posttraumatic headache and their litigation settled at least one year previously. Patients with previous headaches, other accidents or head injuries were excluded. The average length of time from settlement to interview was 23 months. Forty‐six had been in automobile accidents and four either had falls or blunt trauma to the head. (Eight cases involved Workman's Compensation).Criteria used at this clinic for determining permanency were either posttraumatic headache persisting for longer than one year with no evidence of further improvement (43 patients) or patients with headaches persisting longer than 6 months with a plateau (no change) in their pattern for three months or more with an adequate trial of treatment (in our judgment). These criteria did seem reliable. All fifty patients interviewed continued to report persistent headache symptoms one year or more following legal settlement. Improvement in headache pattern after legal settlement was only reported by four patients.
MRI in Migraineurs
Authors: Robbins Lawrence , Friedman Harold 
Published: May 2005

SYNOPSISForty‐six migraineurs and 69 age‐ and sex‐matched controls referred for MRI scans of the brain were evaluated for the incidence of intracranial pathology. Axial long TR/short TE and long TR/Iong TE and sagittal short TR/short TE scans were performed in all patients. Enhancement with Gd‐DTPA was performed in all controls and in nine migraineurs. Six of 46 (13%) of the migraineurs had white matter lesions versus three of 69 (4.3%) of the controls. The white matter lesions in migraineurs were seen in a younger age group than in the controls. These findings agree with recent MRI studies. Ischemia or an immune‐based white matter demyelination are possible mechanisms for the white matter lesions.
Tizanidine in Chronic Tension‐Type Headache: A placebo controlled double‐blind cross‐over study
Authors: Fogelholm Rainer , Murros Karl 
Published: May 2005

SYNOPSISThe efficacy of tizanidine in chronic tension‐type headache was compared with placebo in a randomized, double‐blind and cross‐over study in 37 women aged 20 to 59 years with a history of headache for 7 months to 30 years (median 5 years). The treatment periods were 6 weeks with an intervening 2 week wash‐out period. The treatment was started with 6 mg/ day divided into three doses, and the daily dose could be increased to 18 rag/day depending on the treatment response. The effect of the treatment was measured by visual analogue scale, verbal rating scale, number of days free of headache, number of analgesics needed, and the dose of trial medication needed. In all these measurements, tizanidine was statistically significantly more effective than placebo. The pre‐trial Beck Depression Inventory score did not predict the response to treatment, neither did the level of electromyographic activity of the trapezius muscle. Side‐effects, drowsiness and dry mouth were significantly more common during tizanidine treatment but they were usually mild. The results of the present trial suggest that tizanidine is effective in the treatment of chronic tension‐type headache in women.
Management of Acute Intractable Headaches Using IV Therapy in an Office Setting
Authors: Stiller John 
Published: May 2005

SYNOPSISTwenty‐seven consecutive patients with acute intractable headaches were treated in an office setting with an intravenous protocol of an antiemetic, hydrocortisone sodium succinate, and dihydroergotamine (DHE). All patients had significant pain relief within 45 minutes. Patients who were not pain‐free post‐treatment uniformly reported decreasing pain at the time of departure from the office. No patients required further treatment (including narcotic medication) for acute headache. All patients were followed for at least 24 hours. Adverse reactions were transient and mild. Akathisia was not uncommon and has probably been underestimated in previous studies.
Headaches During Intracranial Endovascular Procedures: A Possible Model of Vascular Headache
Authors: Martins Isabel P. , Baeta Élia , Paiva Teresa , Campos Jorge , Gomes Leonor 
Published: May 2005

SYNOPSISWe report a series of 11 patients who developed headaches during intracranial endovascular procedures performed for the treatment of arteriovenous malformations (10 cases) or aneurysms (1 case).Headache was precipitated either by balloon inflation (3 cases) or by embolization (8 cases), and had a very constant pattern. In all cases the pain started suddenly, reaching maximum intensity at once. Headache was focal, unilateral, ipsilateral to the occluded artery, nonthrobbing and short‐lasting (usually less than 10 minutes). It was not associated with gastrointestinal, autonomic, or aura‐like symptoms. Headache localization depended upon the catheterized artery, being constant for each of the major vascular territories. Yet, in all patients pain was felt in the cutaneous territory of the ophthalmic division of the trigeminal nerve.The occurrence of headache was not associated with cortical deficit nor cortical irritation (assessed both clinically and by the EEG) and therefore seems to be directly related to the stimulation of the arterial wall. This type of pain can be used as a model of pure vascular headache. Its study can contribute not only to understand the pattern of intracranial vascular innervation but also to understand or to refute the vascular components of migraine.
MRI Findings in a Case of Ophthalmoplegic Migraine
Authors: Stommel Elijah W. , Ward Thomas N. , Harris Robert D. 
Published: May 2005

SYNOPSISMRI using gadolinium contrast material can demonstrate lesions in cranial nerves. Tumors and Inflammatory lesions have been described.1,2 There is little published information on MRI of cranial nerve in patients with migraine headache with ophthalmoplegia.3 We present a case of ophthalmoplegic migraine with a cranial nerve abnormality which was subsequently shown to improve as the patient clinically improved. Implications from this finding are discussed in relation to the pathophysiology of ophthalmoplegic migraine.
Headache as a Presentation of Angina: Reproduction of Symptoms During Angioplasty
Authors: Bowen James , Oppenheim Gary 
Published: May 2005

SYNOPSISWe report a case of angina presenting as headache in a 59‐year‐old man. Headaches were relieved by nitroglycerin and were reproduced by occlusion of the first obtuse marginal artery during angioplasty. Headaches resolved after successful angioplasty. The temporal relationship between coronary artery occlusion and the headache suggests that headache angina is due to referred pain rather than a generalized vaso‐spastic disorder.
Cough Headache Presenting as a Toothache: A Case Report
Authors: Moncada Elizabeth , Graff‐Radford Steven B. 
Published: May 2005

SYNOPSISBenign cough headache (BCH) presents as an intermittent, usually bilateral, severe bursting or explosive pain brought on by coughing. Some of the known conditions which can mimic the pain experienced in BCH are subarachnoid hemorrhage, increased intracranial pressure, intracranial tumors, and even toothache. Careful evaluation must be carried out in order to differentiate between these conditions. A case of BCH which presented as a toothache is reported. The evaluation for exertional headaches, and for headaches brought on by coughing, is discussed.
Cervicogenic Headache: Responses to Nitroglycerin, Oxygen, Ergotamine and Morphine
Authors: Bovim G. , Sjaastad O. 
Published: May 2005

SYNOPSISThe responses in cervicogenic headache to four different agents have been studied. Nitroglycerin was given sublingually to 27 patients. Eighteen patients got more than 20% increase of their headache. Of those with any headache increase at all, 12 got bilateral and 12 unilateral pain. The typical late cluster headache response to nitroglycerin was not seen in cervicogenic headache. The provocative effect of nitroglycerin seemed less marked in cervicogenic than in cluster headache. Oxygen inhalation, a frequently used treatment for cluster headache, was given to 14 patients with cervicogenic headache. In general, the effect seemed uncertain and probably clearly inferior to the effect in cluster headache. Ergotamine treatment (given to 13 patients) also seemed to be of little avail in cervicogenic headache. Morphine injections given to 11 cervicogenic headache patients resulted in “marked” improvement in 4, but complete pain freedom was only seen in 2 cases. In our opinion, the present results add further evidence to the view that different etiologic and pathogenetic factors underlie cervicogenic headache and cluster headache.
Natural History of Cluster Headache
Authors: Pearce JMS 
Published: May 2005

SYNOPSISA follow‐up study of 123 patients with episodic cluster headaches and of 9 patients with chronic cluster headaches was undertaken after 10–25 years, (mean 14.7 and 13.9 years respectively). This shows a significant but low remission rate for both episodic and chronic cluster headache. It confirms the observation that some patients change from episodic to chronic pattern, and that occasionally chronic clusters may become episodic.
Idiopathic Stabbing Headaches Lasting a Few Seconds
Authors: Dangond Fernando , Spierings Egilius L.H. 
Published: May 2005

SYNOPSISFour cases of idiopathic stabbing headache subjectively perceived as lasting several seconds are reported. The classification of the International Headache Society suggests that these headaches typically last “a fraction of a second”. The perception of such brief pains may be difficult to quantitate and, therefore, the duration of the headache should not be used as a strict diagnostic criteria.
Effectiveness of a Piroxicam Fast Dissolving Formulation Sublingually Administered in the Symptomatic Treatment of Migraine Without Aura
Authors: Nappi Giuseppe , Micieli Giuseppe , Tassorelli Cristina , Viotti Elena , Altavilla Teodoro 
Published: May 2005

SYNOPSISIn this study we evaluated the efficacy of a new preparation (Fast Dissolving Dosage Form ‐ FDDF) ofpiroxicam (40 mg in a single sublingual dose) in the acute treatment of migraine. The study plan was ofsingle blind type versus placebo and involved 40 patients with migraine without aura (according to the IHSClassification criteria) who had to take Piroxicam FDDF (or placebo) within 2 hours from the beginning of amigraine attack. Pain intensity and associated symptoms were evaluated in the basal condition and thenmonitored at serial intervals for 24 hours.In the group of patients treated with the active drug (n=20), a significant reduction of pain intensity(Visual Analogue Scale) was observed after only 15 minutes (P=0.0034). After an hour, headache hasdisappeared in 15 patients, become mild in 4 and remained unchanged in only one subject. Associatedsymptoms also quickly disappeared after Piroxicam FDDF administration and headache recurred in onlytwo patients within the 24 hour period. Sublingual administration of Piroxicam FDDF was well tolerated: nosystemic side‐effects were reported and only two subjects complained about mouth dysesthesias whichwere described as mild and short‐lasting.In conclusion, Piroxicam FDDF has been shown in this preliminary study to have striking efficacy in theacute treatment of migraine. The treatment is characterized by quick onset, long duration and goodtolerability.
The Role of Life Event Stress, Coping and Social Support in Chronic Headaches
Authors: Martin Paul R. , Theunissen Chris 
Published: May 2005

SYNOPSISA group of chronic headache sufferers (migraine and tension‐type headache) was compared with twoindividually matched control groups of nonheadache subjects in terms of life event stress, and the stressmoderating factors of coping skills and social support. The headache group did not differ from the controlgroups on the measures of life event stress or coping but significant differences arose on the measure ofsocial support with the headache group achieving lower scores than the control groups. The findings wereinterpreted as suggesting that clinicians and researchers should pay more attention to social aspects ofheadaches, and that interventions aimed at teaching headache sufferers to mobilize social support shouldbe considered as components of treatment packages.
Intracranial Hypertension and Sumatriptan Efficacy in a Case of Chronic Paroxysmal Hemicrania Which Became Bilateral. (The Mechanism ofIndomethacin in CPH.)
Authors: Hannerz Jan , Jogestrand Tomas 
Published: May 2005

SYNOPSISA female patient is described who had a four year long period of unilateral chronic paroxysmalhemicrania (CPH) which then became bilateral. For some years before the CPH started she suffered fromperiods of about one month with chronic hemicrania without nerve involvement. She also suffered fromchronic fatigue, back pain, arthralgia, vertigo, chronic constipation and spontaneous ecchymoses. Bloodtests showed chronic leukocytosis, low serum iron, and signs of inflammation in serum electrophoresisduring the five years she was studied. CPH attacks could be provoked by breathing 6% carbon dioxide inair. Lumbar cerebrospinal fluid pressure was pathologically increased (30 cm water). The attacksdecreased during indomethacin treatment but 275 mg was needed for satisfactory control of the attacks,i.e., more than the 150 mg which, according to the criteria for CPH, should be absolutely effective.Sumatriptan was found to suppress the CPH attacks as well as indomethacin. Due to these findings CPH isconsidered to be another manifestation of venous vasculitis. The beneficiary mechanism of indomethacinin CPH is considered to be due partly to its anti‐inflammatory effects and partly to its reduction of theintracranial blood flow.