摘要:

SYNOPSIS123I‐IMP‐SPECT brain imaging was performed in patients with classic migraine (n=5) and migraine accompagnée (n =18) during the headache‐free interval. A regional reduction of tracer uptake into brain was observed in all patients with migraine accompagnée, while in patients with classic migraine only one case showed an area of decreased activity. The most marked alteration was found in a patient with persisting neurological symptoms (“complicated migraine”). In most cases the areas of decreased tracer uptake corresponded to headache localization as well as to topography of neurologic symptoms during migraine attacks. It may be concluded that migraine attacks occur in connection with exacerbations of preexisting changes of cerebral autoregulation due to endogenous or exogen

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906344.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA 71 year old man sought neurological advice because for two years he had suffered from headache every time he made an effort. A treadmill stress test showed a relation between effort, headache and depression of ST segments on E.C.G. With isosorbide dinitrate and diltiazem, the manifestations improved. This suggests a referred head pain due to myocardial ischemia.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906350.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe efficacy of a clinic‐based cognitive‐behavioral program for the treatment of common migraine was compared to the same approach using a minimal‐therapist‐contact format by means of a randomized controlled trial. Forty‐eight subjects between 18 and 50 years of age completed the program. Following four weeks of recording headache activity, subjects were randomly assigned to a waiting list control condition or to one of the two treatment conditions. Treatment was followed by four weeks of recording of headache activity immediately posttreatment and again six months later. Multivariate analysis of variance indicated that there was a significant reduction in headache frequency, duration and peak intensity following treatment for both treated groups. These reductions were maintained at six months follow‐up. Treatment for the minimal‐contact group was significantly more cost‐effective than for t

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906352.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISTwo hypotheses were tested in this study: (1) that a short course of cognitive behavioral therapy (CBT) is effective in the treatment of chronic headache; and (2) that group CT is as effective as individually administered CBT. Twenty‐two chronic headache sufferers were randomly assigned to one of three treatment conditions: group administered CBT, individually administered CBT, or no treatment (wait list) control. Wait list subjects ultimately received treatment identical to that offered to subjects in the group treatment condition. Treatment outcome measures included the Brief Symptom Inventory, the McGill Pain Questionnaire, and several measures calculated from self‐monitoring data. Tentative support was found for the hypothesis that CBT as provided in this study is effective in the treatment of chronic headache. There was no evidence that group versus individually treated subjects differed significantly on any of the measures used, although the small N and large variance among subjects limit us to preliminary conclusions for our findings. Clinical implications and suggestions for future research are discus

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906358.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe treatment of patients suffering with menstrual migraine is sometimes a difficult and frustrating problem for the physician. As many menstrual migraine headaches are refractory to abortive therapy, prophylactic therapy is often needed. Ergonovine maleate, an ergot derivative with vasoconstrictive properties, has been used with some success in migraine headache patients. Forty patients who were treated with intermittent prophylactic ergonovine were studied over six months. The patients ranged in age from 22 to 40 years, and all suffered with menstrual migraine headaches which were refractory to abortive therapy. Each patient took ergonovine maleate 0.2 mg three to four times daily during menses and recorded headache occurrence and severity. After three months, 24 patients (60%) reported significantly less severe attacks, six patients (15%) reported less frequent headaches and 14 patients (35%) reported no improvement. After six months there was a decrease in effectiveness with 20 patients (50%) reporting significantly less severe headaches and two patients (5%) reporting less frequent headaches. This limited study suggests that ergonovine maleate may be of value in the treatment of difficult menstrual migraine patients.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906366.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906368.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISIntraocular pressure and pulsatile ocular blood flow were recorded during and between attacks in patients suffering from cluster headache (n = 18) or chronic paroxysmal hemicrania (n=7). Similarities, as well as significant differences, were observed between the two groups of patients, pointing to fundamental differences. between the two disorders with regard to pathophysiology. Compared with healthy controls, the cluster headache patients demonstrated low pulsatile ocular blood flow values between attacks, with an increase to normal levels during pain. The chronic paroxysmal hemicrania patients, however, had normal values between attacks with a marked and significant increase to high values during attacks.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906373.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA young man suffering from both cluster headache and epilepsy is reported. Since the age of 37 he had recurrent generalized tonic‐clonic seizures; one year later cluster headache attacks began. Neurological examination, standard laboratory tests and CT‐scan were normal. The EEG showed medium‐voltage sharp waves, not blocking upon eye opening, over the right parieto‐temporal region. Flunarizine was added to his phenytoin therapy; it controlled both paroxysmal disorders. After six months, flunarizine was discontinued and during a one year follow‐up the patient remained symptom‐free. This calcium channel blocker can be regarded as an ideal drug in patients suffering from both cluster headache and epilepsy; it controls this headache syndrome and is a useful add‐on to standard anti‐con

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906377.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISRegional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non‐invasive Xenon‐133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2could prove helpful in children whoseheadache is atypi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906379.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2906384_1.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY