摘要:

SYNOPSISIn a pilot study (5 patients) we investigated the effects of subcutaneous sumatriptan, a 5‐HT1‐like receptoragonist, on headache experienced during the withdrawal period of drug‐induced headache. The pilot studyindicated that the substance was effective mostly in patients who originally suffered from migraine. In a patientwith tension headache the substance was less effective. In a second double‐blind study on six migraine patientswith severe drug‐induced headache, the drug was highly effective in ameliorating headache and autonomicdisturbances. Blood flow velocities measured in extracranial parts of internal and external carotid arteries byduplex‐sonography and in middle cerebral and basilar arteries by transcranial Doppler showed no changes afteradministration of sumatriptan or placebo. This result suggests sumatriptan does not act primarily via constrictionof the large cerebr

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104205.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISThis is a report of a patient with chronic cluster headache‐like pain of 12 years duration. Investigation revealed an aneurysm at the junction of the vertebral and posterior inferior cerebellar arteries and after removal the patient experienced resolution of his cluster headache. The headache and aneurysm were both right sided suggesting a possible relationshi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104210.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

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 migra

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104213.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

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 cerebrovascularconstriction. It remains to bedeterminedwhether 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 patho

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104222.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISThe interactions of four abortive anti‐migraine agents and four prophylactic anti‐migraine agents with 5‐HT1Dreceptors in bovine brain were analyzed using radioligand binding techniques and adenylate cyclase assays. In bovine caudate, the affinities of abortive anti‐migraine agents (i.e. 5‐hydroxytryp‐tamine, ergotamine, dihydroergotamine, sumatriptan) for 5‐HT1Dreceptors range from 4.0 – 34 nM while the affinities of prophylactic anti‐migraine agents (i.e. methysergide, amitriptyline, (‐)propranolol, verapamil) range from 46 – 11,000 nM. In adenylate cyclase studies in bovine substantia nigra, all four abortive anti‐migraine agents dose‐dependently inhibit forskolin‐stimulated adenylate cyclase activity, a biochemical effect mediated by 5‐HT1Dreceptors. No agonist effect on cyclase activity is observed with the four prophylactic anti‐migraine agents. These date support the hypothesis that abortive anti‐migraine agents are 5‐HT1Dreceptor agonists and that this effect may un

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104228.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISElectroencephalographic (EEG) changes occurring in patients with migraine have received much attention. However, almost equal number of reports indicate the predominance of normal and abnormal findings. We studied the EEG in symptom‐free, otherwise healthy, unmedicated 18–28 year‐old patients: 22 with common migraine, 20 with classic migraine, and 20 age‐matched controls. The routine EEG findings in the three groups revealed mild non‐specific slowing in 2 (9%), 3 (15%) and 2 (10%), respectively. Simultaneously, topographic EEG mapping and frequency analysis were performed in 13 consecutive patients with common migraine, 10 patients with classic migraine and 11 age‐matched controls. EEG mapping showed minimal regional differences with lower power in the alpha range in patients with eyes closed. The peak alpha power, as well as its reactivity, were lower among patients than controls. This difference reached statistical significance only for patients with classic migraine versus controls in the left occipital region. Patients also had slightly faster peak alpha frequency. No frank right‐left asymmetry was observed in the peak alpha power, neither among the controls, nor the patients. All the findings were rather minor. They may suggest some difference in the posterior background activity in the EEG in migraine patients as compared to the controls, but are not useful in differentiating migraine from non‐mi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104232.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

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.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104237.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

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.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104240.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISIn a questionnaire survey we determined the prevalence of problems with reading, at present as well as in the past, in adult chronic headache sufferers as compared with age‐ and sex‐matched controls. The reading problems inquired about were those with reading in general, reading quickly, prolonged reading and reading comprehension. The subjects were also asked about present and past problems with writing, concentrating, performing mathematics and overall learning.Significant difference in the prevalences of the problems studied between the headache sufferers and controls were observed on just two items and only for the female groups. These items were present problems with reading comprehension (39.3% versus 7.5%; p=0.002) and concentrating (46.4% versus 17.5%; p=0.015). We concluded that adult female headache sufferers have impaired reading comprehension and concentration abilities which do not seem to originate from the p

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104244.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

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 headach

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3104249.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY