bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trigeminal Neuralgia Secondary to Tumor With Normal Exam, Responsive to Carbamazepine
Authors: Metzer W. Steven 
Published: May 2005

SYNOPSISTrigeminal neuralgia is most commonly idiopathic, although it can be associated with multiple sclerosis. Tumors are rare causes of trigeminal neuralgia. A case is presented of trigeminal neuralgia with normal neurological examination and responsive to carbamazepine, secondary to a cerebellopontine angle meningioma.Literature relative to neoplastic etiologies of trigeminal neuralgia is reviewed. The role of electrodiagnostic testingin the evaluation of trigeminal neuralgia is considered. A normal neurological examination and responsiveness to carbamazepine do not exclude tumor as an etiology of trigeminal neuralgia.
Jolt Accentuation of Headache: The Most Sensitive Sign of CSF Pleocytosis
Authors: Uchihara Toshiki , Tsukagoshi Hiroshi 
Published: May 2005

SYNOPSISWe prospectively examined the clinical signs of 54 febrile patients associated with recent‐onset headache. They underwent lumbar puncture (LP) on suspicion of meningitis. The relation of each sign to cerebrospinal fluid (CSF) pleocytosis was estimated. Among 34 patients with pleocytosis, 33 had jolt accentuation(sensitivity: 97.1%), while only 5 of them had neck stiffness or Kernig's sign. Among 20 patients without pleocytosis, 12 had no jolt accentuation (specificity: 60%). We found jolt accentuation to be the most sensitive sign of CSF pleocytosis. If jolt accentuation is noted in a febrile patient associated with recent onset headache, the CSF should be examined even in the absence of neck stiffness or Kernig's sign.
Recurrent Classic Migraine Attacks Following Transdermal Scopolamine Intoxication
Authors: Gordon Carlos R. , Mankuta David , Shupak Avi , Spitzer Orna , Doweck Iiana 
Published: May 2005

SYNOPSISA 20 year old male naval crew‐member suffering from sea sickness was treated with transdermal scopolamine (TS).After 5 months of continuous treatment, he developed scopolamine intoxication followed by the appearance of recurrent classic migraine attacks. He had never suffered from headache or migraine prior to TS intoxication. The migraine attacks comprised a prodrome of apathy, bad mood and loss of appetite lasting several hours. An aura of scintillating spots, left arm numbness and paresthesias lasting several minutes was followed by a severe throbbing unilateral headache with photo‐phobia, sonophobia and nausea. After one year of repeated follow‐up examinations, he continued to suffer from the attacks once every 10 to 14 days, with no identified precipitating factors.We are not aware of similar cases in the medical literature. Although it is not possible to establish TS intoxication as a causal effect of the appearance of classic migraine in our patient, the temporal association and clinical course are very supportive of this assumption. Central nervous system neurotransmitter imbalance or cardiovascular alterations may possibly be implicated.
Short‐lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection, Tearing, etc. (SUNCT): III. Another Norwegian Case
Authors: Sjaastad O. , Zhao J.M. , Kruszewski P. , Stovner L.J. 
Published: May 2005

SYNOPSIS“SUNCT” is a recently reported head pain syndrome characterized by short lasting, unilateral neuralgiform paroxysms with conjunctival injection and tearing, and to a lesser extent nasal secretion, and (subclinical)sweating. Another case‐ that of a 56 year old male‐is reported herein. The attacks lasted 1/2–1 min. and occurred only infrequently, i.e. once or twice in 1–4 weeks, except for a week recently when there were up to 20 or more typical attacks per day, with the usual ipsilateral, autonomic accompaniments. Due to the benign nature and low frequency of attacks, the diagnosis would have been most difficult to establish prior to the occurrence of this short lasting period with more marked symptoms. A variety of precipitation mechanisms were present, partly concerning the V 2–3 areas, partly concerning the neck. Precipitation mechanisms in “SUNCT” to some extent seem to differ from those in trigeminal neuralgia. It is remarkable that all four hitherto reported cases are males.
Migraine ‐ Why and How a Cortical Excitatory Wave May Initiate the Aura and Headache
Authors: Hardebo Jan Erik 
Published: May 2005

SYNOPSISA large number of clinical and neurophysiological observations are reviewed that clearly indicate that the symptoms of migraine aura result from a spread of an excitatory wave along the cortex from a primary focus. This excitation may start as a consequence of information overload to a low threshold cortical area. The transient neuronal excitation is followed by a long‐lasting period of reduced cortical flow, which involves a substantial component of active constriction of resistance vessels, even persisting for several hours during the headache phase. When the excitatory wave has reached and activated free pain fiber endings in sufficiently many cortical vessels, off‐branching peripheral motor endings of these fibers may become activated via axon reflexes. These motor endings may be located in cortical microvessels or in small vessels around large dural vessels. This leads to a neurogenic inflammation in the vessel walls, experienced as headache by the sufferer. The wall of dural sinuses offers a rational explanation for the beneficial effect of most medications used in migraine.
Cerebral Hyperemia During Spontaneous Cluster Headaches With Excessive Cerebral Vasoconstriction to Hyperoxia
Authors: Kawamura Jan , Meyer John Stirling , Terayama Yasuo , Weathers Susan 
Published: May 2005

SYNOPSISValues for local cerebral blood flow (LCBF) were measured in three dimensions utilizing xenon enhanced computerized tomography among patients during spontaneously occurring cluster headaches, during headache‐free intervals and immediately after terminating attacks by inhalation of 100% oxygen. Results were compared with values measured among age‐matched normal volunteers. LCBF values measured in five cluster patients while headache‐free did not differ from similar measures among age‐matched normal volunteers. In three patients during attacks of spontaneously occurring cluster headache, LCBF values for temporal cortex, basal ganglia and subcortical white matter were increased. Immediately after terminating attacks of cluster by 100% oxygen inhalation for five minutes, LCBF values for temporal cortex and basal ganglia became significantly decreased below normal values in five patients with spontaneously occurring cluster headache. Prompt relief of head pain by inhalation of 100% oxygen is associated with abolition of the hyperperfusion of both cortical and subcortical brain structures that occurs during spontaneously occurring cluster headaches and is followed by excessive cerebrovascular constriction. It remains to be determined whether the cerebral hyperemia occurring during cluster headaches is causally related to the head pain or is secondary to the pain itself. Rapid termination of head pain by hyperoxia associated with excessive cerebral vasoconstriction suggests that this vascular phenomenon is unique to cluster headache and offers clues to its pathogenesis.
Claudication: An Unusual Side Effect of DHE Administration
Authors: Schulman Elliott A. , Rosenberg Scott B 
Published: May 2005

SYNOPSISDHE is effective in the treatment of acute and chronic migraine. The side effects most commonly observed are abdominal discomfort, muscle pain, diarrhea and anxiety.DHE is a dehydrogenated amino acid ergot alkaloid and, as such, causes only limited vasoconstriction; indeed, its overall effects include peripheral vasodilatation.The literature is replete with reports of clinical vasospasm and claudication occurring with therapeutic doses of ergotamine. There has not been any previous description of claudication caused by DHE.This paper describes pulselessness in two patients during relatively short courses of DHE. Treatment consisted of calcium channel blockers and discontinuation of DHE. Recovery was complete.
Atypical MRI Findings of Venous Sinus Thrombosis in Pregnancy: Clinical Significance Relating to Episodic Vascular Headache
Authors: Turkewitz L. Jay , Jacobs Alan K. , Bidwell J. Keith 
Published: May 2005

SYNOPSISTwo cases of headache during pregnancy were associated with MRI findings suggestive of venous sinus thrombosis. The findings, however, were atypical, and of uncertain clinical significance. Venous sinus thrombosis typically does not occur during the first and second trimesters (less than 10 percent of reported cases). Thus, these two cases are doubly unusual. The correct significance of these equivocal MRI findings of possible venous sinus thrombosis must be understood so that unnecessary and potentially harmful therapies are not employed, and so that appropriate management of what may otherwise be a typical vascular headache syndrome may be undertaken.
Psychological Changes Accompanying Non‐Pharmacological Treatment of Chronic Headache: The Effects of Outcome
Authors: Blanchard Edward B. , Steffek Bruce D. , Jaccard James , Nicholson Nancy L. 
Published: May 2005

SYNOPSISSeveral prior studies suggest that non‐drug treatment for chronic headache is accompanied by concomitant reductions in patients' anxiety, depression and somatization. It is currently unclear, however, whether such beneficial side effects are a function of degree of headache relief or are due simply to receiving treatment. Most work to date in this area has treated outcome as a dichotomous variable. The present report employed a regression approach which treats outcome (degree of headache relief) as a continuous variable in the study of 149 chronic headache patients and their accompanying psychological changes. Anxiety and depression were significantly reduced for headache patients regardless of degree of headache relief. With somatization, however, degree of headache relief had a significant effect; the greater the reduction in headache, the fewer somatic concerns were expressed, especially for mixed headache.
Magnesium Prophylaxis of Menstrual Migraine: Effects on Intracellular Magnesium
Authors: Facchinetti Fabio , Sances Grazia , Borella Paola , Genazzani Andrea R. , Nappi Giuseppe 
Published: May 2005

SYNOPSISThe effects of oral Magnesium (Mg) pyrrolidone carboxylic acid were evaluated in 20 patients affected by menstrual migraine, in a double‐blind, placebo controlled study. After a two cycles run‐in period, the treatment (360 mg/day of Mg or placebo) started on the 15th day of the cycle and continued till the next menses, for two months. Oral Mg was then supplemented in an open design for the next two months. At the 2nd month, the Pain Total Index was decreased by both Placebo and Mg, with patients receiving active drug showing the lowest values (P<0.03). The number of days with headache was reduced only in the patients on active drug. Mg treatment also improved premenstrual complaints, as demonstrated by the significant reduction of Menstrual Distress Questionnaire (MDQ) scores. The reduction of PTI and MDQ scores was observed also at the 4th month of treatment, when Mg was supplemented in all the patients. Intracellular Mg++ levels in patients with menstrual migraine were reduced compared to controls. During oral Mg treatment, the Mg++ content of Lymphocytes (LC) and Polymorphonucleated cells (PMN) significantly increased, while no changes in plasma or Red Blood Cells were found. An inverse correlation between PTI and Mg++ content in PMN was demonstrated. These data point to magnesium supplementation as a further means for menstrual migraine prophylaxis, and support the possibility that a lower migraine threshold could be related to magnesium deficiency.
Headache Syndromes as Detected by Configural Frequency Analysis
Authors: Koehler Thomas , Dulz Kay , Buck‐Emden Eckart 
Published: May 2005

SYNOPSISData on headache symptoms obtained in two samples (N=422 and 304) by means of questionnaires were subjected to configural frequency analysis (CFA). This not widely‐known method tests whether certain symptom combinations appear more often or less often than expected by chance. In both samples symptom combinations corresponding to the syndromes of migraine with aura, migraine without aura and tension headache did indeed occur with significant frequency. The same clear‐cut symptom patterns appeared when patients with preceding visual disturbances were excluded from analysis. These results seem to lend strong support to a categorical model of headache, rather than to the concept of headache as a spectrum.
The Impact of Cigarette Smoking on Headache Activity in Headache Patients
Authors: Payne Thomas J. , Stetson Barbara , Stevens Vivian M. , Johnson Cheryl A. , Penzien Donald B. , Van Dorsten Brent 
Published: May 2005

SYNOPSISThe present study was designed to explore the relationship between cigarette smoking and headache activity in a sample of patients presenting for treatment. Subjects completed various self‐report measures and monitored headache activity four times per day over a 4‐week period. Analyses revealed that smokers experienced greater weekly peak headache intensity, and reported higher levels of depression and general physical symptoms. Among smokers, nicotine content of the preferred brand was associated with mean headache index and weekly headache‐free days, as well as depression and anxiety scores. Daily smoking rate and pack‐year history were related to level of general physical symptoms only. Thus, both smoking status and the nicotine content of the preferred cigarette appear to adversely impact headache activity. Further, smokers who are more anxious or depressed may increase their headache activity via their preference for higher nicotine‐content cigarettes. These results are discussed in the context of possible mechanisms underlying these effects, and implications for the clinical management of headache sufferers who smoke. Key words: cigarette smoking, headaches.
Propranolol in the Management of Recurrent Migraine: A Meta‐analytic Review
Authors: Holroyd Kenneth A. , Penzien Donald B. , Cordingley Gary E. 
Published: May 2005

SYNOPSISWe used meta‐analytic statistical techniques to synthesize findings from studies that evaluated propranolol HCI for the prevention of recurrent migraine (2,403 treated patients). The modal migraine sufferer treated in these studies was a female, about 37 years of age, who suffered from common (rather than classical) migraines and reported a 17‐year history of problem migraines. The modal treatment was 160 mg. propranolol per day. Meta‐analysis revealed that, on average, propranolol yielded a 44% reduction in migraine activity when daily headache recordings were used to assess treatment outcome, and a 65% reduction in migraine activity when less conservative measures (e.g., clinical ratings of improvement, global patient reports) were used. Meta‐analysis thus revealed substantial support for short‐term effectiveness of propranolol. However, little information was available concerning the long‐term effectiveness of propranolol.
Criteria for the Diagnosis of Migraine in Clinical Practice
Authors: Solomon Seymour , Lipton Richard B. 
Published: May 2005

SYNOPSISCriteria for the diagnosis of migraine have evolved from generalized descriptions to specific rules designed to ensure the selection of homogenous groups of patients for research studies. For clinical practice, the former are insufficiently specific and the latter are too complex. For care of headache patients by primary care physicians, we propose that the diagnosis of migraine without aura (common migraine) is war‐rented if any two of the following symptoms are present: unilateral site, throbbing quality, nausea, photophobia or phonophobia. These criteria are derived from a study comparing the features of 100 patients with migraine without aura and 100 patients with chronic daily headache. The proposed criteria for the diagnosis of migraine without aura were highly sensitive and adequately specific in discriminating groups. These simple criteria should facilitate the diagnosis of migraine by primary care physicians.
Flunarizine in Migraine: A Minireview
Authors: Leone Massimo , Grazzi Licia , Mantia Loredana La , Bussone Gennaro 
Published: May 2005

SYNOPSISFlunarizine is a non‐selective calcium antagonist. It distributes preferentially in the adipose tissue and passes the blood brain barrier. Numerous controlled clinical studies have established that flunarizine is efficacious in migraine prophylaxis, including double‐blind studies in which the drug was compared with placebo or other antimigraine drugs. To avoid side effects a special schedule or administration is necessary. Flunarizine has no myogenic effect on smooth muscle cells of the vessles. It is said to be the only calicum antagonist able to protect brain cells against hypoxic damage. In addition, the considerable body of information which shows flunarizine capable of directly influencing the central nervous system, suggests that the drug's anti‐migraine action may depend on its ability to influence central phenomena.
Visual Evoked Potentials and Background EEG Activity in Migraine
Authors: Dijk J.G. van , Dorresteijn M. , Haan J. , Ferrari M.D. 
Published: May 2005

SYNOPSISTo investigate whether quantification of the background EEG during a visual evoked potential (VEP) study is of value for the diagnosis of migraine we studied 8 unmedicated migraineurs between attacks, and 10 age‐matched controls. Three paradigms were used: the first two concerned pattern‐reversal VEPs with different analysis times (500 and 1500 ms), and in the third paradigm the pattern did not reverse. Power spectra were calculated for individual responses, and the delta, theta, alpha and beta areas of the averaged spectre were noted as indicators of background reactivity.Alpha and beta powers were consistently but not significantly higher in the migraine group. The difference was too small to be of value as a diagnostic test. Alpha power was (not significantly) lower in the presence of photic stimulation than in its absence. As this was the case in both groups photic stimulation does net explain the higher alpha powers in the migraine group.We conclude that EEG background activity during the VEP does not distinguish reliably between migraineurs and controls.
Shortlasting, Unilateral, Neuralgiform Headache Attacks With Conjunctival Injection, Tearing, and Subclinical Forehead Sweating ("Sunct" Syndrome): II. Changes in Heart Rate and Arterial Blood Pressure During Pain Paroxysms.
Authors: Kruszewski Piotr , Fasano Maria Luisa , Brubakk AIf O. , Shen Jie Ming , Sand Trond , Sjaastad Ottar 
Published: May 2005

SYNOPSISThe recently described “Sunct” syndrome is a rare picture of unilateral, shortlasting headache attacks accompanied by autonomic phenomena (conjunctival injection, tearing, etc.) on the symptomatic side. Heart rate and blood pressure were monitored in two elderly “Sunct” patients during and outside headache attacks. An ultrasound Doppler servo method was used for the non‐invasive, continuous, beat‐to‐beat determination of instantaneous arterial blood pressure. In a third patient, systolic and diastolic blood pressure, both outside and during pain paroxysms, were assessed using the standard Korotkoff method. Heart rate was found to be significantly decreased during pain paroxysms. Systolic blood pressure was observed to be significantly increased during attacks, when compared with the inter‐attack period, while a less consistent pattern was observed for diastolic blood pressure. Some of the changes in the cardiovascular system seemed to start prior to pain onset. Therefore, it seems unlikely that these changes were caused by pain activation of the sympathetic nervous system or the oculocardiac reflex.
Changes in Neutrophil Met‐Enkephalin Containing Peptides in Episodic Cluster Headache
Authors: Figuerola Maria de Lourdes , Vindrola Osvaldo , Beatrizini Marta , Leston Jorge Alberto 
Published: May 2005

SYNOPSISWe have previously demonstrated an increase in plasma met‐enkephalin levels during the pain attacks in episodic cluster headache.2 The present study was undertaken in orderto clarify the sourceof the plasma met‐enkephalin increase.Recent evidence has shown that peripheral blood polymorphonuclear cells contain peptides derived from the proenkephalin A system, which can be released by specific stimuli. We studied neutrophil met‐enkephalin containing peptides (NMECP) in 27 episodic cluster headache patients: 24 in a cluster period (6 of them during a pain attack), and 3 in the remission period. Neutrophil met‐enkephalin containing pep‐tide levels (after sequential enzymatic digestion with trypsin and carboxypeptidase B) were determined by radioimmunoassay with specific antiserum. Neutrophil peptide concentration (pmol/mg prot) was lower (p<0.01) in patients during the pain attack (14.4 ± 0.36) than after their pain had subsided {36.7 ± 0.31) and lower than in the remission period patients (35.8 ± 0.4).We conclude that neutrophil met‐enkephalin containing pep‐tides decrease during pain in episodic cluster headache, and that they may be involved in the concomitant plasma met‐enkephalin increase.
Solved and Unsolved Headache Problems
Authors: Lance James W. 
Published: May 2005

SYNOPSISTwo unusual cases of vascular headache, one caused by jugular venous compression from a goiter and one triggered by flushing associated with a CGRP‐producing renal tumour, are reported. Their histories are compared with those experiencing other headaches of vascular origin. Two patients with a primary neural irritative lesion, one with a sphenoid sinus carcinoma and one with Tolosa‐Hunt syndrome, presented with headaches resembling migraine. These case‐histories are used to illustrate the interaction of nervous system and vascular system in the production of headache which has implications for the pathophysiology of migraine and cluster headache.
Myocardial Ischemia Related to Ergot Alkaloids: A Case Report and Literature Review
Authors: Galer Bradley S. , Lipton Richard B. , Solomon Seymour , Newman Lawrence C. , Spierings Egilius L.H. 
Published: May 2005

SYNOPSISErgotamine tartrate and methysergide are widely used headache treatments with important vasoconstrictive properties. We report a 31‐year‐old man with cluster headaches who developed severe, prolonged myocardial ischemia following combination therapy with ergotamine tartrate and methysergide. We reviewed the cardiovascular complications of each agent alone and in combination. Given the pharmacologic similarity of these agents, we propose that they may have additive or synergistic cardiac toxicity, at least in vulnerable individuals. We recommend caution when these agents are used together.