bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Payment Experience With DRGs in Headache Patients
Authors: Sands George H. , Mulloy Katherine , Goldstein Jonathan , Munoz Eric 
Published: May 2005

SYNOPSISThe new Diagnostic Related Group (DRG) Prospective Hospital Payment System pays a set fee to hospitals depending on the patient's diagnosis. Care of certain patients covered by Neurology DRGs has proven to be unprofitable. The purpose of this project was to study hospital resource consumption for hospitalized patients with a principal or secondary diagnosis of headache. We studied various resource parameters for patients in the three neurology DRGs for headache (#24‐seizure and headache, age greater than 69 and/or complicating condition; #25 and #26‐seizure and headache age 18–69 without complicating condition, and age 0–17, respectively) by whether or not the patients had a diagnosis of headache.As demonstrated in Table 1, patients with headache had (on average) lower hospital resource utilization than patients in these same DRGs without a headache diagnosis. Headache patients had lesser total hospital costs, a lower severity of illness, and generated profits under DRGs compared to non‐headache patients. We found that our headache patients were adequately reimbursed by the DRG hospital payment system and suggest that this could be a financially attractive population to hospitals.
Influence of Quality of Life and Stress Coping Behaviour on Headaches in Adolescent Male Students: an Explorative Study
Authors: van den Bree M.B.M. , Passchier J. , Emmen H.H. 
Published: May 2005

SYNOPSISQuality of life (QL) and stress coping behaviour were evaluated in 194 adolescent male students, and related to their headache complaints. Negative correlations were found between headache duration and intensity versus satisfaction with autonomy, and between headache intensity versus satisfaction with the home situation. Both headache duration and intensity were found to correlate positively with depressive stress coping behaviour. Further, positive correlations were found between palliative and avoidant stress coping strategies versus headache intensity. Our findings suggest that active rather than passive stress coping strategies are effective in reducing headache intensity. In addition, this study indicates the relevance of focussing future research into headaches in adolescents on the home situation.
Transcranial Doppler Evaluation of Common and Classic Migraine. Part I. Ultrasonic Features During the Headache‐Free Period
Authors: Thie Andreas , Fuhlendorf Agnes , Spitzer Klaus , Kunze Klaus 
Published: May 2005

SYNOPSISTo study vascular abnormalities in migraine, transcranial Doppler (TCD) was used for evaluation of 100 consecutive patients with either common or classic migraine during the headache‐free period. We insonated the basal cerebral arteries and the internal carotid artery (ICA) in the neck. Particular ultrasonic features in migraineurs included intracranial elevations of mean flow velocity (MFV) above 3 standard deviations of normal values in 16%, probably reflecting increased vasotonus. Marked asymmetry of MFV in corresponding intracranial arteries was found in 12%, and could represent “asymmetrical” vascular tone. Characteristic vascular bruits of low frequency and sometimes harmonic quality were detected in 56%. When compared to TCD findings in 40 young controls, MFV were significantly higher in all intracranial arteries in migraineurs, but not in the cervical ICA. Marked differences were also found for incidence of MFV elevations and vascular bruits (p<0.0001). Vascular reactivity in response to eye closing as measured by flow changes in the posterior cerebral artery (visually evoked flow) was significantly greater in migraineurs than in controls (%MFV change, 14.1 ± 5.4 vs 11.4 ± 4.8; p = 0.004). TCD features did not discriminate common from classic migraine.Taken together, our results support the view of intracranial vascular abnormality in migraineurs reflecting, in particular, a narrower and more reactive arterial tree. The value of TCD in the differential diagnosis of ”vascular headache“ and in the study of migraine pathophysiology will have to be determined in the future.
Transcranial Doppler Evaluation of Common and Classic Migraine. Part II. Ultrasonic Features During Attacks
Authors: Thie Andreas , Fuhlendorf Agnes , Spitzer Klaus , Kunze Klaus 
Published: May 2005

SYNOPSISTranscranial Doppler (TCD) examinations were performed in 13 patients with common and 5 patients with classic migraine during attacks and compared to TCD findings during the headache‐free period. Two distinct patterns of flow changes were detected to distinguish common from classic migraine on the basis of TCD findings.During attacks, patients with common migraine exhibited reduction of flow velocities associated with an increase of pulse wave amplitudes. Vascular bruits that were heard during the headache‐free interval often disappeared. Opposite changes were found in attacks of classic migraine during the headache phase with increase of flow velocities, decrease of pulsatility and more prominent or newly appearing bruits. These findings were often diffuse and did not appear to correlate with side of headache or side of neurological aura.Uniform changes occurred in the cervical internal carotid artery and the basal cerebral arteries in either form of migraine. We propose that these changes represent caliber fluctuations of the large arteries, suggesting vasodilatation during attacks of common migraine and vasoconstriction during attacks of classic migraine.We do not intend to imply a casual role of these preliminary findings in migraine pathogenesis, but we suggest that TCD be used in combination with other methods to study vascular changes in migrainous disorders.
Migraine Occurring for the First Time in Pregnancy
Authors: Chancellor Andrew M. , Wroe Stephen J. , Cull Roger E. 
Published: May 2005

SYNOPSISNine patients referred for neurological opinion over a 4 yr. period were identified as having migraine occurring for the first time with pregnancy. The nature of their attacks, results of investigation, the progress of the pregnancy and the prognosis for headache post‐partum are presented. One patient had common migraine, the remainder, either classical or complicated attacks. Patients presented at variable stages of pregnancy; four developed complications, including pre‐eclamptic toxemia in two. The prognosis for headache during the follow up period of up to 54 months was excellent. The factors influencing migraine in pregnancy are discussed.
Defective Expression of IL‐2 Receptors on Peripheral Blood Lymphocytes from Patients with Cluster Headache
Authors: Martelletti R , Stirparo G. , De Stefano L. , Di Sabato F. , Giacovazzo M. , Rinaldi‐Garaci C. 
Published: May 2005

SYNOPSISIn a previous study we demonstrated that cluster headache (CH) patients present an increased Natural Cytotoxic response after incubation of their peripheral blood lymphocytes (PBL) with Interleukin‐2 (IL‐2). This phenomenon led to an investigation of the phenotypic expression of PBL before and after IL‐2 incubation, and of the IL‐2 lymphocyte receptor. IL‐2 receptor is expressed on T‐lymphocytes activated with an high‐affinity binding site. The analysis of the function of human IL‐2 receptor was facilitated by the production of a specific monoclonal antibody (MAb). This MAb identifies the IL‐2 receptors by blocking the binding of radiolabelled IL‐2 to T‐cells. In addition, we studied the expression of Leu‐4, specific for T‐cells; of Leu‐11b, specific for FC receptor on NK cells; and the Transferrin Receptor, specific for lymphoblasts and monocytes.Twenty‐three episodic CH patients were selected for this study. Ten sex and age‐matched healthy volunteers were used as the control group. We evaluated the PBL phenotypic expression of cells subsets before incubation with IL‐2 (1,000 I.U./ml) and after 72 hours. The following Becton Dickinson MAbs have been used: anti‐Leu‐4 (CD3), anti‐lL‐2 receptors (CD25), anti‐Transferrin receptor (TFR) and anti‐Leu‐11b (CD16). Indirect fluorescence with a Becton Dickinson FACS‐420 flow cytometer was used to analyze the cells.The results showed no significant variations in Leu‐4, Leu‐11b and Transferrin receptor in PBL of CH patients when compared to those of control subjects, both before and after incubation with IL‐2, whereas the percentage of PBL expressing receptors for IL‐2 was markedly reduced in CH patients as compared to normal individuals after incubation with IL‐2. This defective expression of IL‐2 receptors seems to be independent of the cluster period. These data suggest that the failure of IL‐2 receptor expression in CH can be inserted into a complex network of abnormalities of the immunoneuromodulating system in this disease.
Migraine Associated with Periorbital Ecchymosis
Authors: DeBroff Brian M. , Spierings Egilius L.H. 
Published: May 2005

SYNOPSISTwo patients are reported who developed periorbital ecchymosis in association with migraine. The association is rare, having only been reported in the literature almost a century ago. The possible mechanism of the occurrence of periorbital ecchymosis in migraine is discussed.
A Placebo‐Controlled Crossover Trial of Nimodipine in Pediatric Migraine
Authors: Battistella P.A. , Ruffilli R. , Moro R. , Fabiani M. , Bertoli S. , Antolini A. , Zacchelo F. 
Published: May 2005

SYNOPSISAn 8‐month, double‐blind, placebo‐controlled crossover trial was carried out on the use of nimodipine in migraine prophylaxis in 37 patients aged 7 to 18 years old.After a 4‐week medication‐free run‐in period, 19 subjects (Group 1) received a placebo while 18 (Group 2) received nimodipine (10–20 mg t.i.d., according to body weight), for 12 weeks. After a 4‐week wash‐out period, the groups switched therapy for a further 12 weeks. 30 patients completed the trial and the number of dropouts was comparable in the 2 groups. The only side‐effect during nimodipine treatment was mild abdominal discomfort (3 cases). The treatments were evaluated on the basis of frequency and duration of attacks. There was a significant reduction in both parameters during the first period of treatment. During the second period of treatment, nimodipine proved to have a significantly greater effect than the placebo with regard to frequency, whereas the response was similar with the placebo as regards duration of attacks. The latter parameter shows a significant decrease during the treatment periods, regardless of type of therapy.
Migraine With and Without Aura: The Same Disease Due to Cerebral Vasospasm of Different Intensity. A hypothesis based on CBF studies during migraine.
Authors: Olsen Tom Skyhøj 
Published: May 2005

SYNOPSISThe CBF studies performed so far during attacks of migraine, may be interpreted as favouring “the vascular theory.” This applies to migraine with aura as well as to migraine without aura. Migraine without aura may be due to mild focal CBF reduction ‐ too mild to be detected by the available CBF techniques (i.e. 20% or less) and too mild to produce ischemia and aura phenomena. Migraine with aura may be due to focal CBF reduction severe enough to produce ischemia (i.e. 50% or more) and therefore also aura phenomena.The phenomenon termed “spreading oligemia” typically seen in CBF studies during migraine with aura, may be an artifact reflecting a gradual decrease of CBF in an area of constant size. The typical “march” of the aura symptoms may reflect differences in the ischemic threshold of various neurones leading to dysfunction of more and more neurones as the blood flow gradually decreases.It is concluded that migraine with and without aura may be due to the same disease process‐the only difference being the intensity of vasospasm and CBF reduction.
Demographics of Headache in Elderly Patients
Authors: Solomon Glen D. , Kunkel Robert S. , Frame Joy 
Published: May 2005

SYNOPSISThis study seeks to define the types of headache and the sex and age distribution, of headache patients aged 65 and older. A computer search was performed of outpatients with a diagnosis of headache or temporal arteritis seen during 1988 at the Cleveland Clinic Foundation. Of over 120,000 outpatients treated at the clinic 9,950 had a diagnosis of headache; of these, 359 were 65 or older. We found that, compared with younger patients, older headache patients had more tension headache and less migraine headache. In our population, temporal arteritis occurred with the same frequency as migraine, and in patients with a similar demographic profile.
Trigeminal Neuralgia‐Like Pain in an Aged Woman with Fibrous Dysplasia of the Skull Base
Authors: Bollen E. , Vielvoye J. , Van Dijk J. G. , Roos R. A. C. 
Published: May 2005

SYNOPSISA 72 year old women with attacks of severe lancinating pain in the right frontotemporal region of her face had, on CT scan of the skull base, fibrous dysplasia of the right sphenoid bone, involving the areas traversed by the trigeminal nerve. Her pain ceased following treatment with methysergide.In patients with hemifacial pain but no evident facial or skull deformities, CT scan of the skull base may be helpful in elucidating the diagnosis.
Tuberoinfundibular Dopaminergic Tonus in Common Migraine
Authors: Capellan J.I. Lara , Dacosta C. Varela , Garcia J.M. Gutierrez , Servan P. Riobo , Cermeño J.C. Alvarez 
Published: May 2005

SYNOPSISChanges in dopaminergic tonus have been hypothesized in patients with common migraine, suggesting that prolactin may play a role in the pathogenesis of the migraine. We investigated the prolactin response to domperidone, a dopamine receptor blocker.We tested 22 patients with common migraine (8 men, 7 women in the follicular phase of the menstrual cycle, and 7 women in the luteal phase), and 22 normal subjects adjusted for age, sex and phase of the menstrual cycle. Domperidone produced a significant rise of serum prolactin (p<0.01) in migrainous patients (7.77 ± 3.09 vs 71.06 ± 9.97 in men, 7.05 ± 2.3 vs 129.58 ± 14.15 in women in the follicular phase of the menstrual cycle, and 14.28 ± 3.51 vs 169.71 ± 16.63 in women in the luteal phase) and control subjects. The response did not show significant differences between migrainous patients and normal subjects. These data do not suggest changes in the tuberoinfundibular dopaminergic tonus in migrainous patients, in contrast to reports of other authors.
The VEP in Acephalgic Migraine
Authors: Mortimer M. J. , Good R A , Marsters J. B. 
Published: May 2005

SYNOPSISThe diagnosis of acephalgic migraine is complicated by the fact that other neurological conditions such as transient ischaemic attacks, demyelinating disease, simple partial epilepsy, and even glaucoma, can present with similar symptoms.Using both flash and pattern stimulation, visual evoked potentials (VEPs) were examined as a means of differentiating between acephalgic migraine, migraine with aura, migraine without aura, demyelinating disease and a control group.This study demonstrated that by analysing the amplitude of the background fast activity in the flash and pattern VEP, acephalgic migraine can be differentiated from demyelinating disease, migraine with aura, migraine without aura and absolute controls.
“Hemicrania Episodica”‐A New Type of Headache or a Pre‐Chronic Stage of Hemicrania Continua?
Authors: Pareja Juan A. , Palomo Tomás , Gorriti Miguel A. , Pareja Julia , Espejo José 
Published: May 2005

SYNOPSISFor seventeen years, a young man suffered from headaches of one to three days duration occurring once every six or seven days and totally disappearing between episodes. These were strictly unilateral (always on the left side), and were absolutely responsive to indomethacin. They differ clinically from the other two indomethacin‐responsive headaches described up to now: Hemicrania Continua (HC) and Chronic Paroxysmal Hemicrania (CPH). He has a sister suffering from HC.Similar to HC, but unlike CPH, topical tyramine in our patient's eyes resulted in anisocoria before, but not after, indomethacin treatment. Our case differs from HC, however, in its time pattern; it could either be a pre‐chronic stage of HC or a new type of headache. it seems unlikely that a time pattern that has remained unchanged for 17 years will become continuous, as in HC, in the future, and thus it is possible that our patient represents a case of a new type of headache that we propose to name “Hemicrania Episodica.” In any case, it seems probable that this type of headache, although clinically different, may share a common pathogenic basis with HC.
Nuchal Features of Cluster Headache
Authors: Solomon Seymour , Lipton Richard B. , Newman Lawrence C. 
Published: May 2005

SYNOPSISNuchal symptoms were found in the majority of 100 consecutive patients with cluster headache. In 10%, pain was experienced in the neck with the initial typical orbitotemporal pain; in 37%, pain radiated from the orbit or temple to the ipsilateral side of the neck. Sometimes, neck pain heralded the onset of the attack by a few minutes. During an attack, neck stiffness was reported in 40% and tenderness in 29%. Movement of the neck, especially flexion, precipitated cluster headache in 9% of patients. This was particularly true of patients with chronic cluster headache. Neck movement aggravated the headache in 16 of 100 patients and an equal number reported amelioration of pain by neck movement, especially extension.The nuchal features did not necessarily accompany every attack and were usually overshadowed by the severity of the typical headache. Nevertheless, symptoms referable to the neck occur more commonly than is generally appreciated.
Cluster Headache: MRI Studies of the Cavernous Sinus and the Base of the Brain
Authors: Sjaastad Ottar , Rinck Peter 
Published: May 2005

SYNOPSISFourteen patients with cluster headache (13 with the episodic and I with the chronic form; 11 males and 3 females) were studied. One patient was in remission at the time of investigation; no one was studied during an ongoing attack. The cavernous sinus and its immediate surroundings were studied at 0.5 Tesla (n=7) and 1.5 Tesla (n=7). No definite pathological changes were found in the area of particular interest. Since the evidence implicating the cavernous sinus in cluster headache pathogenesis is rather strong, the search for abnormalities in this area should continue.
Migraine Headache in the Infant and Young Child
Authors: Elser Joseph M. , Woody Robert C. 
Published: May 2005

SYNOPSISMigraine is a common clinical diagnosis, occurring in 4–10% of school age children. Migraine in the infant and preschool child has been infrequently described in retrospective studies. We report the prospective evaluation and therapy of six children (5–42 months) with migraine. In four of the children, Prensky's criteria were used for diagnosis, while the two youngest children presented with ophthalmoplegic migraine. All children had a strong family history of migraine and presented with headache and prominent features including facial pallor, irritability, sleep disturbance or mood changes. The oldest four children were successfully treated with either amitriptyline or imipramine in low doses. Theinfants with ophthalmoplegic migraine failed to completely respond to any therapy. At followup 2 to 18 months later, all children were well and without toxicity. The pediatrician should be aware that migraine may begin in infancy and can be effectively and safely treated.
Flunarizine Plasma Concentrations and Side Effects in Migraine Patients
Authors: Albani Fiorenzo , Baldrati Anna , Cortelli Pietro , Riva Roberto , Baruzzi Agostino 
Published: May 2005

SYNOPSISFlunarizine plasma concentrations and side effects were evaluated in migraine patients during a 3 month course of prophylactic treatment. Plasma concentrations did not correlate with daily dose (in mg/kg). Mean flunarizine levels were higher in patients showing sleepiness or sedation. Weight gain was independent of plasma concentrations. Future clinical trials of flunarizine should be supported by drug monitoring in order to clarify the relationship between plasma levels and drug effects.
Magnetoencephalographic Studies of Migraine
Authors: Barkley G.L. , Tepley N. , Nagel‐Leiby S. , Moran J.E. , Simkins R.T. , Welch K.M.A. 
Published: May 2005

SYNOPSISWe report for the first time the detection by magneto‐encephalography (MEG) of signals observable inmigraine patients during headache, but not in controls. These signals consisted of three features: suppression of spontaneous cortical activity, long duration field changes, and large amplitude waves(LAW) of several seconds duration. LAW were also seen during the interictal period. We discuss the possible relationship of these signals to spreading depression (SD), and why the LAW have not been observed in previous studies of SD.
Pattern Reversal Visual Evoked Potentials (VEP‐PR) in Migraine Subjects With Visual Aura
Authors: Mariani Emilio , Moschini Vincenzo , Pastorino GianCarlo , Rizzi Franco , Severgnini Amelia , Tiengo Mario 
Published: May 2005

SYNOPSISTwenty patients with migraine with visual aura, aged 19 to 55 years (2 men and 18 women) were studied by the method of Visual Evoked Potentials (VEP). The control group consisted of an equal number of healthy subjects, comparable for age and sex. The most important finding in our study is that migraine patients with visual prodromata have a significantly longer P100 latency than the subjects of control group. These modifications of the VEP‐PR could indicate, as other investigators have pointed out, that there are some special metabolic conditions and abnormalities of neuromediators during and between attacks.
Thermographic Findings in Cranio‐Facial Pain
Authors: Mongini F. , Caselli C. , Macri V. , Tetti C. 
Published: May 2005

SYNOPSISThis work assesses the differences in the thermographic findings in the craniofacial and neck areas between normal individuals and patients with craniofacial pain or headache, and investigates the influence of muscle contraction on such findings. Thermographic records were taken in 10 healthy subjects and 47 patients suffering from craniofacial pain or headache of different kinds. In the patients with painful episodes the record was taken between attacks. In all the normal subjects and in 19 patients lateral thermograms were also taken during and after maximal tooth clenching for three minutes. The majority of the patients, as compared to the normal group, showed some thermal alterations and asymmetry. Such alterations seem to be due both to vascular instability and muscle contraction: these two factors may be variably superimposed in the different conditions. In patients with cluster headache or chronic paroxysmal hemicrania the presence on the symptomatic side of a cold spot along the supraorbital area and/or the inner orbital canthus, was a constant finding. We conclude that thermography is useful as an additional diagnostic means in patients with head and face pain, and that the clenching test may increase the amount of information provided.
A Study of the Seasonal Variation of Migraine
Authors: Brewerton Timothy D. , George Mark S. 
Published: May 2005

SYNOPSISAvailable evidence supports the contention that migraine involves a disturbance in serotonin function.Several parameters of serotonin function in humans have been found to vary seasonally and may underliethe seasonal fluctuations observed in many clinical neuropsychiatric phenomena that are thought toinvolve serotonin dysfunction. We therefore postulated that migraine headaches might also varyseasonally and examined the admissions to our hospital over a 20‐year period with a primary diagnosis ofmigraine. Peak admissions were found to occur most frequently in the spring for females in comparison tomales (p£0.04, chi‐square). The implications of these findings are discussed.