摘要:

This review focuses on the prevalence, causes, evaluation, and treatment of headache in individuals infected with human immunodeficiency virus type 1 (HIV‐1). Headaches, one of the commonest medical complaints in the general population, occur frequently in patients infected with the HIV‐1. HIV‐related headaches can occur at any time during the infection: at seroconversion, during the incubation period, in patients with symptomatic HIV‐1 infection, or after an AIDS‐defining illness. Causes of HIV‐related headaches include HIV‐1 itself, opportunistic conditions, or HIV‐specific medications. Migraines, tension‐type headaches, depression, and substance abuse enter into the differential diagnosis, particularly in the early stages of disease. The headaches seen in this population reflect a complex web of interactions imposed by immune competency, multiple etiologies, treatments, and premorbid conditions. Prompt recognition and early treatment of headache is essential since it may improve quality of life and, depending on the diagnosis, prolong survival. Physicians need to be alert and adaptable when assessing HIV‐infected individuals with headache since multiple causes can exist in the same patient and new syndromes, complications, and investigational drugs are continual

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505245.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Migraineurs often seek office‐based treatment for acute headache. To compare the efficacy and side effect profile, we entered 27 migraineurs into a prospective, randomized, double‐blind study where each patient received either 75 mg meperidine with 25 mg promethazine IM or .5 mg dihydroergotamine with 10 mg metoclopramide IV. After I hour, pain relief was similar in the two groups, but side effects were significantly greater in the meperidine with promethazine regimen group. The dihydroergotamine with metoclopramide regimen is effective, and has minimal side effects, making it an attractive method for office‐based treatment of acute mig

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505256.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

The effect of a 2‐week course of hyperbaric oxygen on both the duration and frequency of cluster headache attacks was tested in four patients suffering from chronic cluster headache with no clear response to pharmacological treatments. Two patients (two courses in one case) dramatically improved while on hyperbaric oxygen treatment, this positive response remaining for 2 and 31 days posttreatment. Case 3 only improved in frequency, while the remaining patient showed no benefit. These findings suggest that daily hyperbaric oxygen treatment can be used as a transient preventive treatment for desperate cluster headache sufferer

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505260.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

The term “whiplash” was first used in 1928 by the American orthopedist Crowe, although the earliest use that I can find published was in 1945 by the American orthopedist Davis. Although widely used by the medical profession and public, many physicians find the term objectionable. However, when used appropriately to refer only to the mechanism of injury in a motor vehicle accident, the term can be worthwhile. In any case, “whiplash” is well‐entrenched in usage and is here to stay. But what term is used in other languages? Is there a term similar to “whiplash?” To determine terms for whiplash injuries in other languages, members of the American Academy of Neurology living in non‐English‐speaking countries were contacted by mail. Terms used in 11 other languages are listed. Some comments about whiplash injuries by respondents are excerpted. Further cross‐cultural studies may be helpful in studying the influence of physician and popular attitudes, as well as litigation on persistent neck complaints and headaches after moto

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505262.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Cerebral magneticresonanceimaging wasperformed on63 patients with chronic primary headache (28 with migraine with and without aura, 35 with tension‐type headache). Fifty‐four headache‐free individuals of the same age range were used as controls. The headache sufferers showed an incidence of focal white matter abnormalities on T2‐weighted magnetic resonance imaging significantly higher than the age‐matched control group (33.3% vs 7.4%). The incidence of white matter abnormalities did not correlate with age (except for patients older than 60 years), sex, headache history, headache status, or ergotamine consumption. Migraine (with and without aura) and tension‐type headache patients had similarprevalenceof white matter abnormalities (32.1% vs 34.3%). The lesions were predominantly distributed in the frontal region, independent of the side of usual aura or headache. Our findings indicate that both migraine and tension‐type headache may be associated with early pathologic changes in the brain and may share, at least in part, common pathog

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505264.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

A considerable proportion of headache patients fulfill the criteria of “drug abuse” (definition according to the International Headache Society [IHS] criteria). These patients exhibit markedly reduced vigilance and continuous performance, as shown by the results of critical flicker frequency (CFF) analysis.The present study deals with the question whether this impairment of vigilance and continuous performance is reversible. Forty‐eight headache patients with drug abuse were investigated three times by means of CFF analysis: immediately before (A), immediately after (B), and 3 weeks after having finished (C) inpatient drug withdrawal.Immediately after withdrawal, a significant decrease of headache intensity was observed. The CFF values, however, remained unchanged at a depressed level, probably due to withdrawal medication and the initial sedative side effects of thymoleptic agents (given as prophylaxis).Three weeks after withdrawal, however, the CFF values were significantly improved, and were now within a range not far from the normal values known from a healthy general population. Thus, even after many years of drug abuse, headache patients have a good chance to improve their vigilance and continuous performance and to reach normal or close to normal l

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505269.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Headache is a common symptom that constitutes a major health problem to all countries in the world with a variable prevalence from about 20.2% in the African population to about 80% in populations of the civilized world. Community‐based studies in African populations are still scanty, and the impact on health facility utilization and sickness absence from work is unknown.After a simple random selection, 1540 urban workers and students of higher education completed a standardized self‐administered questionnaire on headache. A total of 815 (52%), (620 (51%) men, 195 (60%) women) admitted to having suffered a headache requiring medication or medical consultation in the last year. Of these, 366 (23.7%) had recurrent headache not attributable to systemic disease. Of the total with recurrent headache, there was a significant preponderance of women over men with sex prevalence of 28.9% and 22.4%, respectively (X 2P= 0.0001). Combined vascular‐muscular‐type of headache exceeded all types of headache, accounting for 35.8% of cases, followed by migraine accounting for 30.8% of cases. Organic disease was rare, accounting for 8.5% of cases, and psychogenic causes of headache were even rarer at less than 1.2% of cases.Within 2 months of onset of recurrent headaches, over 32% of sufferers had utilized the health facility at their place of work or study. A significant number of cases (175) had an average of 11.3 lost work days per year in comparison to a control group of 154 persons with an average of 5.7 lost work days per year for reasons other than headache (X 2P= 0.0005).In summary, headache is probably rare in the African population as previously reported. However, the clinical manifestation of headache is similar to those observed in the civilized world. Whenever services are available, patients with headache will seek medical consultation. A significant number of days are lost from work due to severe headache in an urban population in Tanzania. This study underscores the need for early correct diagnosis and treatment of headache to reduce the number of work absences due to h

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505273.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505277_1.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505279.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3505285_a.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY