摘要:

SYNOPSISRecent interest in the possible role of substance P and other vaso‐active polypeptides of the trigeminal vascular system, in the pathogenesis of vascular headache, has lad to a reconsideration of the value of ablative procedures on the trigeminal nerve in the control of chronic, medically intractable cluster headache. Twenty‐seven patients with disabling intractable chronic cluster headache underwent radiofrequency trigeminal gangliorhizolysis. Indications included total resistance to prophylactic treatment, narcotic dependency, hypercorticism, and contra‐indications to ergotamine and methysergide as a result of severe ischemic heart disease. The procedure had to be repeated in 6 patients, once in 4 and twice in 2. The average follow‐up period was 28 months with a range of 6 to 63 months. Excellent results were obtained in 15 patients, very good in 2, good in 3, fair in 1 and poor in 6. Complications were anesthesia dolorosa, stabbing pain over the vertex, ice‐pick like pain over the ipsilateral eye, transient corneal infection, transient diplopia, localized dermatosis, and recurrent stye. Complications were mild and transient in the majority of the patients, and the benefits from the surgery far outweighed the discomfort from the complications. The reasons for poor results in some patients were analyzed.It is concluded that radiofrequency trigeminal gangliorhizolysis is a reasonable alternative in patients with chronic cluster headache 1) who are totally resistant to medical treatment, 2) with a history of strictly unilateral headache, and 3) with stable personality profile and low addiction

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805328.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISWe describe 20 patients with migraine headaches and/or migraine equivalents who had positive antinuclear antibodies (ANA) on routine laboratory screening: 17 of the 20 (85%) had elevated anti‐smooth muscle antibodies (ASMA) that were cytotoxic on Cr51studies. No patient met criteria for defined autoimmune disorders and the remainder of an extensive autoantibody screen was unremarkable. Details of the clinical features and immunology of these patients are presented. The cytotoxicity of the ASMA suggests that they are capable of producing tissue damage and inflammation and could play a pathogenic role in the production of vascular headaches and/or central nervous system symptoms in these patient

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805332.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISThe utility of Biofeedback (BFB) techniques in the treatment of tension headache in a small group of young adult patients is demonstrated. A psychological assessment was conducted before and after the treatment: the possible effects of the treatment on some psychological aspects of personality are discussed. The eventual relationships between the clinical improvement and the decrease of muscular tension values are also considered.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805337.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISThis study investigated change in cognitions of migraine patients as they progressed through biofeedback training. Specific cognitions investigated were beliefs about their ability to control physiological processes and their health in general, and coping strategies used.Subjects were male and female patients presenting with chronic migraine headache at Sunnybrook Medical Centre. They completed the Health Locus of Control, PSC Belief Survey and Cognitive Coping Questionnaire at three different intervals ‐ pre‐, mid‐ and post‐treatment. The results showed that patients became more internal about their beliefs to control their general health, held higher beliefs of ability to control their physiological processes, and were ignoring their pain sensations more than when they started treatment. There was a trend for patients to increase the use of coping self‐statements and to decrease catastrophizing. Interestingly, the significant change in cognitions took place between pre‐ and mid‐treatment (i.e. before biofeedback training occurred). There were some significant correlations between the cognitive and physiological measures, and hea

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805339.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISFor two years we have tested the prophylactic efficacy of budipine for the treatment of cluster headache. The open study was carried out on 27 men and 8 women. 23 patients suffered from episodic and 2 from chronic cluster headache. 7 patients had cluster‐migraine, and 3 chronic paroxysmal hemicrania. 20 patients were free of cluster headache attacks 2–6 days after beginning daily prophylactic budipine therapy with 15–60 mg. 14 patients showed a markedly decreased frequency of attacks and the intensity of persisting attacks was diminished. One patient reported only a slight improvement. There were no non‐responders to budipine therapy. 10 patients showed only mild budipine side effects. Budipine was found very effective for treatment of cluster h

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805344.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISWe explore the importance certain extracranial peripheral neural structures have in the pathogenesis of the painful second phase of migraine. The role of leptomeningeal arteries in the migraine pain, and the laudatory nature of the leptomeningeal and extracranial vasodilatation responsible for the migraine phenomenon are presented. When patients understand the concept that the oligemic first phase of the attack of migraine is the actual noxious event which should be targeted for comprehensive management, they are able to improve their quest to identify precipitating environmental factors and obtain clues that will serve as guidelines in the prevention of the attacks.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805347.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISA case is reported of focal headache caused by traction on the left middle cerebral artery by an intracerebral electrode placed in the left amygdala. The character and location of the headache suggested the involvement of vascular structures. CT confirmed the diagnosis, and the headache was relieved by removal of the electrode. The features of pain referred from intracranial vessels are reviewed.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805350.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISIn a patient presenting with sudden headache and right unilateral asterixis, a computed tomography scan (CT) showed a left thalamic hematoma. This and other four similar cases reported previously, indicate that the acute development of headache and focal asterixis should alert the clinician to the possibility of an intracranial hemorrhage.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805352.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

摘要:

SYNOPSISRecent data suggest that common migraine, particularly catamenial (menstrual), is characterized by dopaminergic (DA) receptor supersensitivity. This dopaminergic dysfunction may be related to gonadal steroidal patterns (abnormal estrogen/ progesterone ratio).In order to distinguish between altered DA‐neurotransmission and the effect of sex hormones we studied prolactin (PRL) response to drugs considered direct and indirect DA‐agonists in a group of prepubertal children with common migraine, in whom the effect of sex hormones is minimal.Basal PRL plasma levels were measured every 30 minutes up to 240 minutes, after oral administration of L‐DOPA, nomifensine, lisuride and placebo in headache‐free migraineurs. Results obtained show no significant differences in plasma PRL levels between migraineurs and control subjects. This suggests that in a situation of reduced interferences by sex hormones, inhibitory TIDA (tuberoinfundibular dopaminergic) function may be normal. However a drawback of our study may have been that we were inhibiting TIDA function in prepubertal subjects with already low baseline prolactin levels. It is our belief that further understanding of dopaminergic involvement in childhood migraine may come from studies utilizing substances that enhance prolactin levels through dopaminergic inh

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.hed2805354.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1988.t01-1-.x

出版商:Blackwell Science Inc    

年代:1988

数据来源: WILEY