摘要:

Thunderclap headache is an acute high intensity headache similar to that seen in the setting of ruptured saccular aneurysm. We report four patients without subarachnoid hemorrhage who presented with thunderclap headache. Three patients had transient neurologic signs or symptoms. Cerebral angiography revealed diffuse segmental intracerebral arterial vasoconstriction which was reversible in the one patient in whom angiography was repeated. The headaches resolved spontaneously in all cases and after 1 week did not recur. These cases highlight the specific clinical and angiographic features and the self‐limited course of patients with thunderclap headache and suggest that thunderclap headache may represent a unique headache category. On the basis of these cases and others reported in the literature, we propose diagnostic criteria for thunderclap headach

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501001.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Anger and depression are common affective concomitants of chronic headache. Previous research suggests that the affective component of headache may contribute to the patient's perceptions of the degree to which the headache is disabling. The present study examined the relationship between anger expression, anger suppression, depression, and headache‐related disability (interference with function) in a sample of chronic posttraumatic headache patients. A path analytic model indicated a direct relationship between depression and perceived disability. Anger suppression and anger expression each had a direct influence on depression, but their effects on disability were mediated through depression. The results partially replicate apreviouspath analytic study of therelationships among these variables in a chronic headache sampl

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501007.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Using a controlled group outcome design, skin temperature biofeedback with autogenic training and autogenic training only was compared to a waiting list as a treatment for childhood headache. Thirty children with migraine headaches, ages 7 to 18 years were randomly assigned to one of the three conditions. Statistical analyses of headache activity indicated that children in the treatment groups improved in headache frequency and duration but not intensity as compared to the waiting list control group. These findings were consistent through a 6 month follow‐up. In terms of clinical improvement, 80% of the biofeedback group, 50% of the autogenics group, and none of the waiting list control group were symptom‐free. These findings were discussed in relation to past childhood headache studies and implications for current treatment of children with headac

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501010.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Recently an important role for magnesium in establishing the threshold for migraine attacks has become evident. Accordingly, we measured serum and red blood cell magnesium levels in juvenile migraine patients with and without aura interictally. In comparison with normal subjects, migraineurs had significantly lower serum and red blood cell magnesium levels.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501014.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Sixty‐three headache patients (migraine: n = 28; tension‐type headache: n = 35) who fulfilled the IHS criteria of ‘drug abuse’ were investigated by means of the Minnesota Multiphasic Personality Inventory (MMPI) and the Critical Flicker Frequency (CFF) analysis. The results were compared to those of 63 headache patients without drug abuse (matched‐pair case‐control study).With respect to the MMPI results, no statistically significant differences between patients with drug abuse and patients without drug abuse were found. However, patients with drug abuse showed significantly decreased CFF values compared to patients without drug abuse. This was true both for patients with migraine and for patients with tension‐type headache.Thus, CFF analysis may serve as a useful method to differentiate between headache patients with drug abuse and those witho

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501017.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

In order to study the frequency and characteristics of post‐angiography headache, we interviewed 45 consecutive patients (mean age ± SD= 57 ± 15 years; M/F=15/30) who underwent transfemoral cerebral angiography for: ischemic cerebrovascular disease (n=33); suspected arteriovenous malformations (n=4; one confirmed); suspected cerebral aneurysm (n=5; two confirmed); and arterial dissection (n=3; one confirmed and one was a follow‐up study of a previously demonstrated dissection). Postangiography headache developed in 15 (33%) patients, 125 ± 99 min after the completion of the study. It was unilateral in nine (60%) patients, homolateral to the usual side of migraine headache in two of three migraineurs, and pulsating in six (40%). Nausea, vomiting, photophobia, and phonophobia accompanied postangiography headache in 20%, 7%, 33%, and 20% respectively. Postangiography headache fulfilled the International Headache Society criteria for migraine without aura (except for the number of attacks) in 27% of patients. Patients with and those without postangiography headache were comparable in mean age, sex, and indication for angiography. Fifty‐three percent (8/15) of patients with postangiography headache and 23% (7/30) of the non postangiography headache group reported prior recurrent headaches (P =0.047, likelihood ratio chi‐square). Postangiography headache has the characteristics of delayed arterial pain which may be related to a catheter‐induced or contrast dye‐induced release of vasoactive substances, notably nitric oxide

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501021.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Objective.‐Postlumbar puncture headache may represent a model which could be used to test the hypothesis that headache pain is caused by the release of substance P in patients who are predisposed to headache due to hypersensitivity to substance P.Methods.‐We measured substance P in CSF and plasma in 37 patients undergoing diagnostic lumbar puncture. In 9 patients, plasma samples were obtained before lumbar puncture, in 28 patients plasma was obtained after lumbar puncture. Patients were followed up by telephone to determine if they developed postlumbar puncture headache. Patients were also asked about a history of chronic or recurrent headaches. Substance P was determined by radioimmunoassay.Results.‐The mean plasma substance P levels obtained before lumbar puncture was 1.0 ± 0.1 pg/mL and 1.3 ± 1.2 after lumbar puncture (P<0.0005). The mean plasma substance P levels in subjects who developed postlumbar puncture headache was 0.6 ± 0.6 pg/mL compared with 1.4 ± 1.5 in subjects who remained headache‐free (P<0.05). The mean CSF substance P levels in subjects who developed postlumbar puncture headache was 0.7 ± 0.5 pg/mL compared with 1.2 ± 0.8 in subjects who remained headache‐free (P<0.05). There were no significant differences in substance P levels between chronic headache sufferers and nonheadache subjects.Conclusions.‐Postlumbar puncture headache may be mediated by the release of substance P triggered by lumbar puncture, in patients predisposed to headache by a hypersensitivity to substance P. Hypersensitivity to substance P may also represent a mechanism for headache pain in other h

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501025.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

The present prospective‐type study quantified, by way of an ad hoc questionnaire, the impact of the headache attack in its various manifestations and the effect of headache on the quality of life of 400 headache sufferers. In addition, the functional status of episodic headache patients has been compared to that of patients with chronic daily headache.We observed that during headache attacks, episodic headache patients were significantly more disabled by physical symptoms. On the contrary, patients with chronic daily headache showed a significantly greater occurrence of emotional disturbances. A difference was detectable for mental health which was significantly more compromised in chronic daily headache than in episodic headache patients (P<0.05).During the interictal period, quality of life appeared more compromised in chronic daily headache than in episodic headache patients. Chronic daily headache subjects were characterized by higher disability scores in all the sections considered.The results of this investigation confirm that headache negatively influence a patient's quality of life not only during attack phases but also during interictal periods and underline the importance that future studies on the efficacy of headache treatments should also evaluate the impact on patient's quality of lif

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501030.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Secondary syphilis is associated with headaches. We describe two patients with headache from secondary syphilis and we recommend considering this in the differential diagnosis and evaluation of the headache patient.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501036.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Ten patients with cluster headache in an active period and 6 controls were studied as to heart rate, blood pressure, blood flow in the common carotid arteries (CCA), end‐tidal PCO2and pain before, during and after 6 minutes of breathing 6% CO2In air. Heart rate increased significantly during C02breathing in controls but not in patients. The cluster headache patients had significantly lower baseline end‐tidal PCO2than controls. CCA blood flow increased significantly during CO2breathing in both groups. Vascular resistance decreased during CO2provocation and increased above baseline levels 5 minutes after provocation in both groups and related to the end‐tidal PCO2. Six of eight cluster headache patients, who had an increase of blood flow at provocation, reported slight to moderate unilateral pain in relation to the CO2provocation in contrast to controls.One patient treated with 6 mg sumatriptan 2.5 hours before the provocation had an end‐tidal PCO2within the range of the controls, and did not get an increase of CCA blood flow or pain at provocation.Six of the cluster headache patients were restudied when out of the active period. There was still no heart rate increase during CO2breathing and end‐tidal PCO2was still lower than in the controls. Unilateral headache was not

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3501038.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY