摘要:

SYNOPSISAn extensive questionnaire which addressed general health, headache characteristics, antecedents to headaches, and coping strategies after one gets a headache was administered to 837 high school and university students in south Texas. Hypotheses were confirmed that (a) university students reported greater headache severity than did high school students, and (b) females reported higher frequencies of headaches and greater headache severity than did males. Our sample from south Texas reported a much lower incidence of headache than recent reports of students from other universities. Factor analysis of headache characteristics questions supported traditional headache classification. Factor analysis identified commonalities among headache antecedents and headache coping strategies. Relationships were identified between headache severity, headache antecedents and coping strategies that were consistent with previous studies.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405247.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISThis study was undertaken to evaluate the effect of treatment with prednisone or verapamil on plasma met‐enkephalin (ME), neutrophil met‐enkephalin containing peptides (NMECP) and free and conjugated plasma catecholamines (CA) in cluster headache (CH) patients. After obtaining a basal sample, patients were randomly selected to be treated with either verapamil (n=5) or prednisone (n=5). A second blood sample was obtained 10 days after starting treatment. At this time all patients were free of symptoms. ME (0.49 ± 0.10 pmol/mL) and NMECP 135.1 ± 2.4 pmol/mg protein) levels after prednisone treatment were significantly higher (P<0.05) than in basal conditions (0.29 ± 0.08 pmol/mL and 27.14 ± 2.4 pmol/mg protein), while no differences were found in catecholamine levels. No differences in ME, NMECP or CA were found during verapamil treatment. Our results suggest that in CH the two drugs act through different mechanisms. The relief of the bout obtained with prednisone may be related to the opioid system stimulation observed in these p

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405257.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISObjective: To determine the correlation between cerebrospinal fluid and plasma concentrations of substance P.Patients: 37 patients undergoing lumbar puncture for various diagnostic purposes. Measurements: Samples of cerebrospinal fluid and blood were obtained at the same visit. Substance P was measured by radioimmunoassay technique. At least 4 separate measurements were conducted on each sample to insure accuracy. Results: The mean plasma SP level was 1.195 (± 1.1). The mean cerebrospinal fluid substance P level was 1.075 (± .07). There was a statistically significant positive correlation between substance P level in the plasma and cerebrospinal fluid. The Pearson correlation coefficient was 0.656 (P<.0001) and the Spearman correlationcoefficient was 0.698 (P<.0001). Conclusions: Plasma substance P levels closely correlate with cerebrospinal fluid substance P levels. This will simplify the measurement of substance P in the evaluation of therapeutic agents for headache.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405261.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISA retrospective review was done on medical records of 13 patients with persistent post‐dural‐puncture headaches after one or more epidural blood patches. Headache occurred in nine patients with post‐laminectomy syndrome after “wet taps” while performing epidural blocks. In two patients post‐dural‐puncture headache appeared after long term implanted intrathecal catheters were removed. In two other cases headache developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three patients were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran‐40 was given followed by an infusion of 3 mL/hr, until 12 hours after the head pain and any other related symptoms subsided. In all patients the headache disappeared within 20 hours after initiating therapy (9.55 mean hours, SD ± 0.79). In five patients headache ceased in less than five hours. Nausea and photo‐phobia subsided earlier. Patients with post‐dural‐puncture headache resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405265.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISBackground: The post‐concussion syndrome (PCS) and whiplash syndrome (WS) have been controversial topics among physician for many decades. There is little Information available on the opinions end practices of physicians.Method: In June of 1992, we performed a national survey by mail of the four physician groups most Commonly treating these problems. The number of respondents and response rates were as follows: family physicians, 118, 16%; neurologists, 100, 21%; neurosurgeons, 97, 23%; orthopedists, 82, 13%. The survey Instrument contained items on demographics, definitions, causation, prognosis, medico‐legal aspects, testing, and treatment.Results: Only a minority of respondents believe that PCS and WS are clearly defined syndromes. A substantial minority report that psychogenic and litigation factors are most responsible for the Conditions. Most of the physicians believe that PCS and WS have a 3–6 month recovery time. A significant minority Concur that symptoms of the two syndromes resolve when litigation is settled. Most of the physicians order tests to role out pathology although a minority order tests to reassure patients or because of litigation concerns. Only a minority of respondents believe that effective treatments are available. Not surprisingly, a multitude of Conventional and unconventional treatments are sometimes recommended.Conclusions: Many aspects of PCS end WS are controversial among treating physicians. This Controversy can have a profound impact on the quality and cost of patient care. Ongoing research is required to discover more effective treatments for mild brain injury and chronic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405268.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISWe studied a group of young migraine with aura patients with whom it was possible to reconstruct the course and the characteristics of the disturbances preceding or accompanying the onset of the headache.The 47 subjects, 31 female and 16 male, were diagnosed (IHS classification) as Migraine with typical aura (n=40), Familial hemiplegic migraine (n=1l), Basilar migraine (n=6), and Migraine with prolonged aura (n=5).Visual (43 cases) and sensory disturbances (20 cases) were the most commonly described symptoms; a motor deficit was reported in 10 out of 47 cases. Other disturbances such as vertigo attacks, aphasia, spatial disorientation, loss of consciousness or a decreased level of consciousness with the appearance of automatic movements, were much rarer.In our cases the visual disturbances were not isolated but were accompanied by other symptoms in 29 cases, and in 5 of the 18 cases in which there were only visual symptoms, the disturbances presented in succession; a "march" of the sensory and motor disturbance was found in 66% and 68% of cases, respectively.The data from our cases in which the disturbance seems most frequently to originate in the occipital areas (visual disorders) and then to spread to the temporo‐parietal regions in part confirms that there is a posterior to anterior dynamic in the cerebral areas involve

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405275.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISThe occurrence of headache as a sequela of low back pain was examined in a sample of chronic pain patients. All patients had low back pain without history of head, neck, or upper back injury or headache onset simultaneous with the low back pain, Consistent with prior research, headache was found to be a common concomitant of back pain. In many patients, headache was found to have begun or exacerbated markedly after onset of low back pain. Prevalence of migraine in female patients was significantly higher than the population prevalence for females in the United States; this was not true for male patients. Potential mechanisms for explaining the high prevalence of migraine following low back pain are discussed, including increased muscle tension, psychosocial factors, and analgesic overuse.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405279.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISBasilar artery migraine is a distinctive disorder characterized by recurrent occipital headache with typical migrainous phenomena in conjunction with a variety of symptoms referable to a transient dysfunction of the brainstem, the cerebellum and the occipital lobes. Impairment of consciousness is a common feature but is usually too brief to be captured by electroencephalography. Here we report an unusual case of basilar artery migraine with prolonged attacks of impaired consciousness lasting more than two Weeks, thus allowing electroencephalographic follow‐up. In the acute stage, EEG showed marked generalized slow wave delta activity. After the attack, both the electroencephalographic and clinical findings subsided within the following week

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405282.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405286_1.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3405286_3.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY