摘要:

SYNOPSISEffects of aspirin and indomethacin on cerebral blood flow (CBF) and cerebral vasomotor responsiveness (VMR) to 5% CO2and 100% O2inhalation were compared in patients with vascular and non‐vascular headaches. Indomethacin was 60 times as potent as aspirin in inhibiting cerebrovascular prostacyclin (PGI2) synthesis in humans, as judged by CBF and VMR effects. 972 mgs of aspirin, a dose known to inhibit thromboxane synthesis and platelet aggregation had minimal effects on CBF (−3.8%), attributed to partial PGI2inhibition, since there was no effect on VMR to 5% CO2. Indomethacin (25–50 mgs) reduced CBF (−17.8%), VMR to 5% CO2(−72%) and VMR to 100% O2(−75%). PGI2plays an important role in cerebrovascular control of human subjects. Inhibition of PGI2synthesis by indomethacin relieves cluster‐type headaches more consistently than other headaches. Evidence is offered that 100% O2inhalation causes cerebral vasoconstriction by inhibiting cerebrovascular PGI2synthesis, thereby benefitting cluster headaches. Migraineurs appear to have excessive PGI2synthesis. Patients with hemicephalalgia show asymmetric hemispheric responses to indomethacin, ascribed to asymmetric neurogenic influences on

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202052.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

摘要:

SYNOPSISThe clinical features of the headache and neck pain in 21 cases of spontaneous carotid dissection are described. Twenty of 21 patients had head pain or headache and of the 20, 12 had neck pain as well. One patient had neck pain only. Typically, the headache involved the ipsilateral forequarter of the head and neck pain was of local origin in the region of the upper few inches (10 cm.) of the internal carotid artery. Recognition of the headache as a prodromal manifestation may lead to prevention of a stroke through the use of anticoagulation.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202060.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

摘要:

SYNOPSISSeventy‐six percent of patients with daily headaches were found to have a history of episodic migraine in the past, more than half of them hormone dependent headache such as menstrual migraine. Various factors possibly influencing the transformation of episodic migraine into daily headaches were analyzed in a series of 61 patients who presented with daily headaches. Abnormal personality profile, especially neuroticism including depression, excessive stress, excessive use of medications such as caffeine containing analgesics, narcotic analgesics and ergotamine, and development of hypertension were found to be significant in the transformation of episodic migraine into daily headache.The problem of daily headache is discussed. It is suggested that the majority of daily headaches are a continuum of episodic migraine, influenced and perpetuated by various factors such as neuroticism, excessive medication, stress, and development of hypertension. It is pointed out that diagnosis of tension headache under those circumstances is not justifie

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202066.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

摘要:

SYNOPSISA systematic trial of Cocaine hydrochloride as an abortive therapeutic agent in cluster headache is presented. Headache induction was performed with sublingual Nitroglycerin (1.0 mg) and cocaine was employed for abortive purposes. Subjects were then instructed in a mode of self‐application of cocaine solution to their Sphenopalatine Foramen regions for abortion. Most patients can learn to abort most of their cluster headaches by application of cocaine solution to their Sphenopalatine Foramen region in from 15 seconds to three minutes. The risk of addiction is slight when employing 5 to 10% solution for the period of time that the typical cluster persists (4–12 weeks), and the benefits are great in cessation of the agonizing pain that accompanies this headache. Cocaine may be a valuable adjunctive abortive therapeutic measure in cluster headache when combined with a patient educational program. The rapidity of its effectiveness in some circumstances might suggest that the origin of much of the pain of cluster headache may be found in the Pterygomaxillary Fossa reg

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202069.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

摘要:

SYNOPSISSix migraine patients presented with episodes of impairment of consciousness and neurological deficit indicating dysfunction of upper brainstem and occipital and medial temporal lobes. These episodes were either continuous with migraine attacks or interspersed in courses of frequent migraine attacks. EEG recorded during or shortly after the episodes showed frontal intermittent rhythmic delta activity (FIRDA). The clinical and EEG changes are both explained as results of spasm of the rostral basilar artery. The episodes of impairment of consciousness are interpreted as migraine attacks with insufficient or missing vasodilatation rebound. The FIRDA pattern in these cases appears to be a sign of ischemia of the rostral basilar artery region analogous to focal slowing in “hemiplegic” migraine which indicates ischemia in other cerebrovascular regions. This view is supported by a simultaneous recording of both types of EEG changes in one patient with “hemiplegic” migraine followed by impairment of consci

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202074.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

摘要:

SYNOPSISA second case is reported wherein cerebral infarction complicated the course of a migraine attack during propranolol therapy.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202081.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

摘要:

SYNOPSISA thirty‐year‐old female reported episodic vascular headaches for one year. On physical examination during a headache her average systolic and diastolic blood pressure rose 33 mm Hg and 18 mm Hg respectively. Her headaches ceased after removal of a 100 g left intra‐adrenal tumor located by abdominal CAT scan. Details of the patient's diagnosis and the general evaluation of headache patients for pheochromocytoma are disc

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202084.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202086.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202089.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1982.hed2202090.x

出版商:Blackwell Science Inc    

年代:1982

数据来源: WILEY