摘要:

SYNOPSISSome patients with cerebral arteriovenous malformations (AVMs) suffer recurrent migrainous attacks which meet the official criteria for migraine. The relationship of these attacks to the malformations has been poorly substantiated. Instances where attacks disappeared following surgical extirpation of an AVM support a relationship, but several other reported surgical outcomes do not. Both patients presented here had surgical results seemingly antithetical to a relationship: the attacks persisted in the first patient and began in the second after removal of the AVM. Nevertheless, data assembled from the literature attests to a causal role for AVMs in the production of migrainous attacks, by showing an overwhelming correlation between the side of the cranium with the AVM and the side afflicted by unilateral headache. An equally good correlation exists for lateralized auras. The correlative and surgical data together show that migrainous attacks develop in relation to AVMs, but not within the malformation itself. Instead, the neighboring brain is probably the generative site.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108509.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISCluster headache is considered a clinically distinct entity with no underlying gross pathology. However, in ram cases this kind of headache may be mimicked by an arteriovenous malformation. A 49‐year‐old male is described who had severe bouts of unilateral headache resembling those of cluster headache. The usual accompanying autonomic manifestations were minor and the headache attacks were prolonged. Treatment with ergotamine tartrate and pizotifen failed. A large ipsilateral arteriovenous malformation was diagnosed. Prospectively, true clustering of the headache attacks could not be documen

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108514.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISTo define the causes, clinical significance and characteristics of headaches in HIV‐l‐related disorders, we studied 49 consecutive HIV‐1 infected patients who presented with headache. Work‐up included CT scans, cerebrospinal fluid examinations (in the absence of a contraindication) and serologic studies. Overall, 40 of 49 patients (82 percent) had an identifiable serious cause of headache. Cryptococcal meningitis (39 percent) and CNS toxoplasmosis (16 percent) were the leading headache etiologies. Serious causes were more likely in patients diagnosed with AIDS prior to presentation but also occurred in most patients in early stages of infection. Based on this study, we suggest that patients with HIV‐1 infection must be managed with a high index of suspicion when they present with new onset

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108518.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISKetorolac IM was compared to DHE and metoclopramide IV in migraine patients whose regular abortive medication had failed and who presented to a headache clinic for acute treatment. Pain scale ratings and ratings of ability to function were recorded before and after injection. Ketorelac provided moderate relief in headache in six of nine patients compared to eight of nine given DHE and metoclopramide. The average improvement in patients receiving DHE and metoclopramide was greater in pain (p=.031) and disability scores (p=.057), than in those patients given ketorolac.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108523.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISWe reviewed our experience with 54 cluster headache patients (23 episodic, 31 chronic) admitted to our headache center 54 tines over the past five years and treated with repetitive intravenous dihydroergotamine (IV DHE).DHE therapy was initiated on admission and prophylactic medication regimens were started or adjusted.All 54 patients had complete relief of their cluster headache, usually within two days. Most (82.8%) had no side effects. The average length of hospitalization was 6.7 days.At the three month followup, 92.9% of the episodic cluster patients were headache‐free and 7.1% had a 50‐74% improvement; at six months, all wore headache‐free.Of the chronic cluster patients, 44.4% wore headache‐free at three months and 52.8% had at least 50% improvement. At six months, 75% were headache‐free and 22.2% wore at least 75% improved, probably as a result of continued prophylactic medication. Repetitive IV DHE safely, rapidly, and effectively controls cluster

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108525.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSIS20 children with clinically diagnosed migraine were asked to wear either a rose coloured tint or density matched blue tint for a period of 4 months. The frequency, duration and intensity of migraine attacks were recorded, together with the amount of visually provoked beta activity in the EEG. After one month's wear all the children in the study revealed an initial improvement in headache frequency. However, only those children wearing rose tints sustained this improvement up to 4 months, when the mean headache frequency had improved from 6.2 per month to 1.6 per month. The headache frequency of those children wearing blue tints revealed no overall improvement after 4 months. The improvements in headache frequency in children wearing rose tints correlated with a reduction in visually provoked bets activity. Key words: children, migraine, photophobia, tint, visual evoked responses

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108533.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISThirteen patients with both migraine and positive anticardiolipin antibodies (ACL) are discussed. Several of the patients were treated with immunosuppressives, aspirin, and anti‐coagulants. In addition, one underwent plasmapheresis.Sixty‐eight migraineurs were screened for the presence of anticardiolipin antibodies. Low positive IgG ACL were identified in 13 patients, medium positive ACL were present in two patients, and one patient had high IgG levels for ACL. The number of positives in migraineurs was significantly higher than in contr

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108537.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISOne of our 7 patients (14%) with chronic cluster headache had an abnormal orbital phlebogram; this was significantly less than the 61% encountered in our 13 patients with active episodic cluster headache who had this test done.There were no pathologically increased values for serum haptoglobin or orosomucoid in our 9 patients with chronic cluster headache, again significantly less than in our 43 patients with active episodic cluster headache, 51 percent of whom had pathologically increased values of haptoglobin or orosomucoid.These inflammatory signs decreased after the episodic cluster headache was over.Episodic cluster headache we suggest to be due to temporary sympathicoplegia caused by venous vasculitis in the cavernous sinus region; chronic cluster headache we attribute to permanent post‐inflammatory sympathicoplegia in the middle foss

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108540.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISTo investigate the pathophysiology of muscle contraction headache (MCH), several parameters of inflammation were evaluated in 48 patients suffering from MCH, and compared with 50 healthy control subjects: erythrocyte sedimentation rate; C‐reactive protein; white blood cell count; immunoglobulin (Ig) G, A, M; and complement component 3(C3) and C4. Serum C3 and C4 levels were significantly elevated in MCH as compared to control subjects, but the other parameters did not differ significantly. This suggests that the inflammatory process may be involved in the production of MC

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108543.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISBrewerton's observation that meta‐chlorophenylpiperazine, the major metabolite of trazodone, with high affinity and intrinsic activity for the serotonin‐1C receptor precipitates migraine headaches in subjects with a personal and/or family history of migraine, prompted Fozard and Gray to postulate that activation of serotonin‐1C receptors plays a significant role in the initiation of the attack. Little note was taken, however, of the significant delay between administration of meta‐chlorophenylpiperazine and the onset of the headaches. This delay prompts another hypothesis, that the vasoconstrictive action of this substance, as it wears off leads to rebound vasodilation, precipitating migraine. Under this hypothesis, specific sero‐tonin‐1C receptor activation is not a necessary condition for the genesis of the migraine attack. As a practical corollary, the vasoconstrictive effect of meta‐chlorophenylpiperazine may have therapeu

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3108546.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY