Pub Date : 2023-03-31DOI: 10.48208/headachemed.2023.9
A. Kelly, A. Cardozo, Valentina Jaramillo, P. Parra
IntroductionHeadache is a common reason for presentation to emergency departments (ED) around the world. In many countries, ED are not speciality-focussed, however, in Colombia and some other countries, specialist neurological hospitals have ED with a strong neurological focus. For patients presenting with headache, these ED may have different epidemiology, investigation strategies and treatment patterns from general ED. The objective of this study was to describe the epidemiology of headache presenting to the ED of Instituto Neurológico de Colombia in Medellin, Colombia – an ED which is a referral centre for neurological and neurosurgical diseases. MethodsThis was an observational study by chart review of adults (aged ≥18) with a main presenting compliant of headache. Demographic, clinical, imaging, diagnoses and outcome data were collected. The primary outcome of interest was the rate of serious secondary intracranial headache cause. Analysis was descriptive.ConclusionDiagnosis of headache in ED is challenging with a very wide range of possible causes. A small proportion of patients (approx. 9%) have a serious cause for their symptoms – a proportion similar to that reported in other international emergency department cohorts.
{"title":"Epidemiology of headache in a neurological Emergency Department in Medellin, Colombia","authors":"A. Kelly, A. Cardozo, Valentina Jaramillo, P. Parra","doi":"10.48208/headachemed.2023.9","DOIUrl":"https://doi.org/10.48208/headachemed.2023.9","url":null,"abstract":"IntroductionHeadache is a common reason for presentation to emergency departments (ED) around the world. In many countries, ED are not speciality-focussed, however, in Colombia and some other countries, specialist neurological hospitals have ED with a strong neurological focus. For patients presenting with headache, these ED may have different epidemiology, investigation strategies and treatment patterns from general ED. The objective of this study was to describe the epidemiology of headache presenting to the ED of Instituto Neurológico de Colombia in Medellin, Colombia – an ED which is a referral centre for neurological and neurosurgical diseases. MethodsThis was an observational study by chart review of adults (aged ≥18) with a main presenting compliant of headache. Demographic, clinical, imaging, diagnoses and outcome data were collected. The primary outcome of interest was the rate of serious secondary intracranial headache cause. Analysis was descriptive.ConclusionDiagnosis of headache in ED is challenging with a very wide range of possible causes. A small proportion of patients (approx. 9%) have a serious cause for their symptoms – a proportion similar to that reported in other international emergency department cohorts.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90484921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.48208/headachemed.2023.6
Lucas Augusto Marcon, K. F. Pereira, F. F. D. Santos, A. R. D. A. César
ObjectiveThe present article aims to popularize the temporomandibular disorder as a possible diagnosis when the phisician is facing a primary headache that was first thought to be a migraine headache or tension type headache, specially when they are not responsible to the treatment.MethodologyThis study focused on the clinical manifestation of the headache caused by temporomandibular disorder, with data searched in the National Library of Medicine, Scielo and PubMed libraries, from 2002 to 2022; also the 3rd edition of the International Classification of Headache Disorders (2018) and the Continuum Headache (2021). The aspects of the clinical manifestation chosen for comparison were location of the pain, type of pain, crisis duration, improvement and worsening factors and associated symptoms.ConclusionIt is very reasonable to consider TMD headache as a first diagnosis when the complaint is a primary headache, as much as it is reasonable to consider this diagnosis when the refractoriness is the complaint. Also, considering the TMD as a trigger to the other headaches.
{"title":"The importance of the temporomandibular joint in the differential diagnosis of primary headaches and recurrent primary headaches","authors":"Lucas Augusto Marcon, K. F. Pereira, F. F. D. Santos, A. R. D. A. César","doi":"10.48208/headachemed.2023.6","DOIUrl":"https://doi.org/10.48208/headachemed.2023.6","url":null,"abstract":"ObjectiveThe present article aims to popularize the temporomandibular disorder as a possible diagnosis when the phisician is facing a primary headache that was first thought to be a migraine headache or tension type headache, specially when they are not responsible to the treatment.MethodologyThis study focused on the clinical manifestation of the headache caused by temporomandibular disorder, with data searched in the National Library of Medicine, Scielo and PubMed libraries, from 2002 to 2022; also the 3rd edition of the International Classification of Headache Disorders (2018) and the Continuum Headache (2021). The aspects of the clinical manifestation chosen for comparison were location of the pain, type of pain, crisis duration, improvement and worsening factors and associated symptoms.ConclusionIt is very reasonable to consider TMD headache as a first diagnosis when the complaint is a primary headache, as much as it is reasonable to consider this diagnosis when the refractoriness is the complaint. Also, considering the TMD as a trigger to the other headaches.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"144 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79223779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.48208/headachemed.2023.1
M. Valença, R. Silva-Néto
In this study we evaluate the validity of the ICHD II-2004 diagnostic criteria of post-dural (post-lumbar) puncture headache (PDPH) in 640 patients submitted to a raquianesthesia. Forty eight patients (7.5%) presented PDPH. The period of latency between the lumbar puncture and the headache onset varied from 6-72 hours and the headache duration raged between three and 15 days. In 34/48 (70.8%) patients with PDPH at least one of the following – neck stiffness, tinnitus, hypacusia, photophobia, or nausea – was also present. Thus 14/48 patients (29.2%) did not present any of the cited symptoms, indicating that a significant number of patient may progress with PDPH in the absence of any other symptoms. We suggested a few modification in the PDPH diagnostic criteria.
{"title":"Post-dural puncture headache","authors":"M. Valença, R. Silva-Néto","doi":"10.48208/headachemed.2023.1","DOIUrl":"https://doi.org/10.48208/headachemed.2023.1","url":null,"abstract":"In this study we evaluate the validity of the ICHD II-2004 diagnostic criteria of post-dural (post-lumbar) puncture headache (PDPH) in 640 patients submitted to a raquianesthesia. Forty eight patients (7.5%) presented PDPH. The period of latency between the lumbar puncture and the headache onset varied from 6-72 hours and the headache duration raged between three and 15 days. In 34/48 (70.8%) patients with PDPH at least one of the following – neck stiffness, tinnitus, hypacusia, photophobia, or nausea – was also present. Thus 14/48 patients (29.2%) did not present any of the cited symptoms, indicating that a significant number of patient may progress with PDPH in the absence of any other symptoms. We suggested a few modification in the PDPH diagnostic criteria.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"339 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77780081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.48208/headachemed.2023.12
Prakit Anukoolwittaya, Sekh Thanprasertsuk, K. Phanthumchinda
IntroductionTrigeminal neuralgia and Short-lasting Unilateral Neuralgiform Headache with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform Headache Attacks with Cranial Autonomic Symptoms (SUNA) are characterized by similar clinical manifestations, which may lead to diagnostic confusion. However, the transformation of trigeminal neuralgia into SUNCT/SUNA is a rare phenomenon. This report describes a case of trigeminal neuralgia transformation into SUNCT/SUNA due to neurovascular compression and reviews all previously published cases of trigeminal neuralgia to SUNCT/SUNA transformation in the literature.Case presentationA 49-year-old Thai male patient presented with progressive right facial pain for a period of three months. One year prior, he developed trigeminal neuralgia along the maxillary branch of the trigeminal nerve, characterized by electrical shock-like pain in the right upper molar, exacerbated by eating. His symptoms were effectively managed with carbamazepine. Nine months later, he began experiencing recurrent electrical shock-like pain along the ophthalmic division of the right trigeminal nerve, accompanied by lacrimation, which failed to respond to continued treatment with carbamazepine. Three months prior to presentation, his symptoms evolved into SUNCT/SUNA, characterized by electrical shock-like pain in the right periorbital area and conjunctival injection, lacrimation. Neuroimaging revealed high-grade neurovascular compression of the right trigeminal nerve by the right superior cerebellar artery. The patient's symptoms resolved following microvascular decompression.ConclusionClinicians should be aware that patients with longer disease duration of trigeminal neuralgia who develop new neuralgic pain in the ophthalmic branch division with mild autonomic symptoms may be at risk for transformation into SUNCT/SUNA.
{"title":"A transformation of trigeminal neuralgia into SUNCT/SUNA: A case report and literature review","authors":"Prakit Anukoolwittaya, Sekh Thanprasertsuk, K. Phanthumchinda","doi":"10.48208/headachemed.2023.12","DOIUrl":"https://doi.org/10.48208/headachemed.2023.12","url":null,"abstract":"IntroductionTrigeminal neuralgia and Short-lasting Unilateral Neuralgiform Headache with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform Headache Attacks with Cranial Autonomic Symptoms (SUNA) are characterized by similar clinical manifestations, which may lead to diagnostic confusion. However, the transformation of trigeminal neuralgia into SUNCT/SUNA is a rare phenomenon. This report describes a case of trigeminal neuralgia transformation into SUNCT/SUNA due to neurovascular compression and reviews all previously published cases of trigeminal neuralgia to SUNCT/SUNA transformation in the literature.Case presentationA 49-year-old Thai male patient presented with progressive right facial pain for a period of three months. One year prior, he developed trigeminal neuralgia along the maxillary branch of the trigeminal nerve, characterized by electrical shock-like pain in the right upper molar, exacerbated by eating. His symptoms were effectively managed with carbamazepine. Nine months later, he began experiencing recurrent electrical shock-like pain along the ophthalmic division of the right trigeminal nerve, accompanied by lacrimation, which failed to respond to continued treatment with carbamazepine. Three months prior to presentation, his symptoms evolved into SUNCT/SUNA, characterized by electrical shock-like pain in the right periorbital area and conjunctival injection, lacrimation. Neuroimaging revealed high-grade neurovascular compression of the right trigeminal nerve by the right superior cerebellar artery. The patient's symptoms resolved following microvascular decompression.ConclusionClinicians should be aware that patients with longer disease duration of trigeminal neuralgia who develop new neuralgic pain in the ophthalmic branch division with mild autonomic symptoms may be at risk for transformation into SUNCT/SUNA.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77098380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.48208/headachemed.2023.11
Renata Coelho Chaves Gaspar, A. Silva, A. Simoni, R. C. F. Bonatti
IntroductionHeadache is a very common complaint in doctors' offices, with primary causes being the majority in relation to secondary ones. Despite this, the identification of secondary headaches is very relevant in clinical practice, since these can be a life-threatening condition, functionality or even a reversible cause. However, imaging screening for all individuals with headache is costly and unrewarding. Therefore, it is important to know the warning signs that, together with the clinical context, lead to a more precise indication of these exams and early and well-targeted therapeutic interventions.Clinical caseThis is a 60-year-old man, previously dyslipidemic and smoker, with migraine with aura reported since childhood, who underwent treatment with sodium valproate, with headache attack suppression. About 4 months before admission, he presented with an alteration in the pain pattern, amaurosis fugax in the right eye, dizziness and mild paresis and hypoesthesia in the left side of the body, primarily treated by him as migraine crises, without improvement with the use of triptans. A new outpatient investigation was carried out, which showed multiple small infarcts in the right hemisphere secondary to atheromatous plaque in the right carotid bulb with an obstruction of approximately 85%. Diagnostic and therapeutic arteriography was performed, with stent implantation, uneventfully.ConclusionThe differential diagnosis between migraine with aura and a cerebrovascular event has already been widely reported in the literature and constitutes a pitfall in the routine of headaches, since a serious and potentially disabling condition can be overlooked. The joint evaluation of the alarm signs with the global context becomes an important tool in the propaedeutics of these patients, with knowledge of this casuistry being something relevant within clinical practice.
{"title":"Migraine with aura and stroke - the role of warning signs in the context of secondary headaches: case report","authors":"Renata Coelho Chaves Gaspar, A. Silva, A. Simoni, R. C. F. Bonatti","doi":"10.48208/headachemed.2023.11","DOIUrl":"https://doi.org/10.48208/headachemed.2023.11","url":null,"abstract":"IntroductionHeadache is a very common complaint in doctors' offices, with primary causes being the majority in relation to secondary ones. Despite this, the identification of secondary headaches is very relevant in clinical practice, since these can be a life-threatening condition, functionality or even a reversible cause. However, imaging screening for all individuals with headache is costly and unrewarding. Therefore, it is important to know the warning signs that, together with the clinical context, lead to a more precise indication of these exams and early and well-targeted therapeutic interventions.Clinical caseThis is a 60-year-old man, previously dyslipidemic and smoker, with migraine with aura reported since childhood, who underwent treatment with sodium valproate, with headache attack suppression. About 4 months before admission, he presented with an alteration in the pain pattern, amaurosis fugax in the right eye, dizziness and mild paresis and hypoesthesia in the left side of the body, primarily treated by him as migraine crises, without improvement with the use of triptans. A new outpatient investigation was carried out, which showed multiple small infarcts in the right hemisphere secondary to atheromatous plaque in the right carotid bulb with an obstruction of approximately 85%. Diagnostic and therapeutic arteriography was performed, with stent implantation, uneventfully.ConclusionThe differential diagnosis between migraine with aura and a cerebrovascular event has already been widely reported in the literature and constitutes a pitfall in the routine of headaches, since a serious and potentially disabling condition can be overlooked. The joint evaluation of the alarm signs with the global context becomes an important tool in the propaedeutics of these patients, with knowledge of this casuistry being something relevant within clinical practice.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81058479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-26DOI: 10.48208/headachemed.2023.10
Ney Adson Leal II, Nágila Pereira Mendes, Caroline Moraes Tapajós Bolzani, J. Borri, Hilton Mariano da Silva Júnior
IntroductionRamsay-Hunt syndrome, also called otic zoster, is a rare complication of herpes zoster. The syndrome is characterized by peripheral facial nerve palsy and an erythematous vesicular eruption in the ear or mouth. Preceding the appearance of the vesicles, unilateral otalgia or neck pain may occur more commonly. However, persistent hemicrania is infrequent in the pre-eruptive phase.ObjectivesTo present an atypical case of Ramsay Hunt syndrome with continuous unilateral headache preceding the onset of other symptoms and signs of the syndrome.Case reportReport of a 69-year-old woman who presented subacute onset of moderate to severe left hemicrania with no autonomic signs. Eight days after the start and continuous headache maintenance, she presented with peripheral facial paralysis. After four days, she noticed the presence of vesicles in the left ear and odynophagia. She developed nausea with several episodes of vomiting and severe imbalance that made it impossible for her to walk unassisted. On physical examination, she presented vesicles in the left ear and oropharynx, left peripheral facial palsy (House Brackmann grade IV), left hypoacusis, nystagmus, and vestibular gait. Diagnostic tests for screening several metabolic diseases and diagnosis of infection (including HIV) were unremarkable. Brain computed tomography and cerebrospinal fluid analysis showed no abnormalities.ConclusionsRamsay-Hunt syndrome mainly involves the facial and vestibulocochlear nerves, causing peripheral facial palsy, otalgia, hypoacusis, and, less frequently, imbalance. Although pain is a frequent manifestation of the pre-eruptive phase of RHS, unilateral headache is not common in this scenario. On the other hand, it is a prevalent complaint in the emergency department and has several different etiologies. Hence, diagnosing RHS when patients present exclusively unilateral headaches is challenging for clinicians. Physicians must consider RHS a vital differential diagnosis of sided-locked headaches, avoiding diagnostic errors and treatment delays.
{"title":"Continuous hemicrania as the initial manifestation of Ramsay Hunt syndrome: a case report","authors":"Ney Adson Leal II, Nágila Pereira Mendes, Caroline Moraes Tapajós Bolzani, J. Borri, Hilton Mariano da Silva Júnior","doi":"10.48208/headachemed.2023.10","DOIUrl":"https://doi.org/10.48208/headachemed.2023.10","url":null,"abstract":"IntroductionRamsay-Hunt syndrome, also called otic zoster, is a rare complication of herpes zoster. The syndrome is characterized by peripheral facial nerve palsy and an erythematous vesicular eruption in the ear or mouth. Preceding the appearance of the vesicles, unilateral otalgia or neck pain may occur more commonly. However, persistent hemicrania is infrequent in the pre-eruptive phase.ObjectivesTo present an atypical case of Ramsay Hunt syndrome with continuous unilateral headache preceding the onset of other symptoms and signs of the syndrome.Case reportReport of a 69-year-old woman who presented subacute onset of moderate to severe left hemicrania with no autonomic signs. Eight days after the start and continuous headache maintenance, she presented with peripheral facial paralysis. After four days, she noticed the presence of vesicles in the left ear and odynophagia. She developed nausea with several episodes of vomiting and severe imbalance that made it impossible for her to walk unassisted. On physical examination, she presented vesicles in the left ear and oropharynx, left peripheral facial palsy (House Brackmann grade IV), left hypoacusis, nystagmus, and vestibular gait. Diagnostic tests for screening several metabolic diseases and diagnosis of infection (including HIV) were unremarkable. Brain computed tomography and cerebrospinal fluid analysis showed no abnormalities.ConclusionsRamsay-Hunt syndrome mainly involves the facial and vestibulocochlear nerves, causing peripheral facial palsy, otalgia, hypoacusis, and, less frequently, imbalance. Although pain is a frequent manifestation of the pre-eruptive phase of RHS, unilateral headache is not common in this scenario. On the other hand, it is a prevalent complaint in the emergency department and has several different etiologies. Hence, diagnosing RHS when patients present exclusively unilateral headaches is challenging for clinicians. Physicians must consider RHS a vital differential diagnosis of sided-locked headaches, avoiding diagnostic errors and treatment delays.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85989755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.48208/headachemed.2023.7
R. Domingues, Carlos Giafferi, Márcio Vega, Daiane Salomão, Carlos Senne
Introduction Post-dural puncture headache (PDPH) is defined as an orthostatic headache that develops within the first few days after performing a spinal tap and it is related to extravasation of cerebrospinal fluid (CSF) into the epidural space, resulting in CSF hypovolemia and hypotension. The risk factors for PDPH are not yet fully understood. Objective To evaluate the risk of spontaneously reported PDPH according to the size and type of spinal tap needle. Methods A total of 4589 patients undergoing outpatient lumbar puncture (LP) were included. All CSF collections were performed at Senne Liquor Diagnostico, a laboratory specialized in CSF collection and analysis. Patients were instructed to report by telephone if they had orthostatic headache during the first 7 days after LP to the medical team of the laboratory. Patients with previous headache were instructed to report any change in the headache pattern during the same period. Needle gauge was classified into two groups: 1) 25G or less and 2) greater than 25G. Two types of needles were used and compared: 1) Pencil point and 2) Quincke. Comparisons of the percentages of spontaneous reports of PDPH were made using the chi-square test. Results 141 patients (3.07%) reported PDPH to the laboratory's medical team. Needles of 25G gauge or less were used in 31.8% of cases. The percentage of patients reporting PHD in the group of 25G or less needles was 1.9% versus 3.6% in the group of larger than 25G needles (P=0.003). Pencil point needles were used in 10.6% of cases. The percentage of PHD among pencil point group was 1.4% versus 3.2% in Quincke group (P=0.026). Conclusion 25G or finer gauge needles as well as pencil point type needles significantly reduced the risk of spontaneously reported PHD.
{"title":"Needle caliber and design are associated with the risk of post-dural puncture headache after diagnostic lumbar puncture","authors":"R. Domingues, Carlos Giafferi, Márcio Vega, Daiane Salomão, Carlos Senne","doi":"10.48208/headachemed.2023.7","DOIUrl":"https://doi.org/10.48208/headachemed.2023.7","url":null,"abstract":"Introduction\u0000Post-dural puncture headache (PDPH) is defined as an orthostatic headache that develops within the first few days after performing a spinal tap and it is related to extravasation of cerebrospinal fluid (CSF) into the epidural space, resulting in CSF hypovolemia and hypotension. The risk factors for PDPH are not yet fully understood.\u0000Objective\u0000To evaluate the risk of spontaneously reported PDPH according to the size and type of spinal tap needle.\u0000Methods\u0000A total of 4589 patients undergoing outpatient lumbar puncture (LP) were included. All CSF collections were performed at Senne Liquor Diagnostico, a laboratory specialized in CSF collection and analysis. Patients were instructed to report by telephone if they had orthostatic headache during the first 7 days after LP to the medical team of the laboratory. Patients with previous headache were instructed to report any change in the headache pattern during the same period. Needle gauge was classified into two groups: 1) 25G or less and 2) greater than 25G. Two types of needles were used and compared: 1) Pencil point and 2) Quincke. Comparisons of the percentages of spontaneous reports of PDPH were made using the chi-square test.\u0000Results\u0000141 patients (3.07%) reported PDPH to the laboratory's medical team. Needles of 25G gauge or less were used in 31.8% of cases. The percentage of patients reporting PHD in the group of 25G or less needles was 1.9% versus 3.6% in the group of larger than 25G needles (P=0.003). Pencil point needles were used in 10.6% of cases. The percentage of PHD among pencil point group was 1.4% versus 3.2% in Quincke group (P=0.026).\u0000Conclusion\u000025G or finer gauge needles as well as pencil point type needles significantly reduced the risk of spontaneously reported PHD.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85823126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-02DOI: 10.48208/headachemed.2022.39
M. Valença, M. Valença, M. A. Valença, L. Leitão, L. P. Valença, R. Silva-Néto
Background Cervical carotid dissection is a commonly reported arteriopathy and is associated with stroke in young, healthy patients. Case report The authors present a case of a woman with pain of recent onset secondary to a dissection of the cervical segment of the carotid artery on the same side and that evolved with stroke. Conclusion The diagnosis of arterial dissection is based on clinical suspicion and angiographic images of the encephalic vessels.
{"title":"Pain as an alarm signal in cervical carotid dissection: report of a case with catastrophic evolution","authors":"M. Valença, M. Valença, M. A. Valença, L. Leitão, L. P. Valença, R. Silva-Néto","doi":"10.48208/headachemed.2022.39","DOIUrl":"https://doi.org/10.48208/headachemed.2022.39","url":null,"abstract":"Background \u0000Cervical carotid dissection is a commonly reported arteriopathy and is associated with stroke in young, healthy patients. \u0000Case report \u0000The authors present a case of a woman with pain of recent onset secondary to a dissection of the cervical segment of the carotid artery on the same side and that evolved with stroke. \u0000Conclusion \u0000The diagnosis of arterial dissection is based on clinical suspicion and angiographic images of the encephalic vessels.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75289993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-02DOI: 10.48208/headachemed.2022.41
Patrick Emanuell Mesquita Sousa-Santos, R. Silva-Néto
Medical history - A tribute to Yara Dadalti Fragoso
医学史——向雅拉·达达尔蒂·弗拉戈索致敬
{"title":"From the curves of Santos Road to the world: A tribute to Yara Dadalti Fragoso","authors":"Patrick Emanuell Mesquita Sousa-Santos, R. Silva-Néto","doi":"10.48208/headachemed.2022.41","DOIUrl":"https://doi.org/10.48208/headachemed.2022.41","url":null,"abstract":"Medical history - A tribute to Yara Dadalti Fragoso","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74135676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-02DOI: 10.48208/headachemed.2022.32
Bruno Teixeira Gomes, A. Costa, M. Mazzali
Introduction Headache is a common symptom among hemodialysis patients, with a prevalence around 70%. Dialysis headache is defined according to International Classification of Headache Disorders (ICHD-3) as a headache without specific characteristics, occurring during and caused by hemodialysis that spontaneously disappears within 72 hours after the dialysis session. There is no consensus on trigger factors or physiopathology. Objective To evaluate prevalence, clinical characteristics, and associated factors with dialysis headache. Methods Observational study with quantitative analysis. Study patients were divided into two groups: (HD) 25 hemodialysis patients and (Tx) 25 early post kidney transplant patients. A structured questionnaire was applied to all patients, including Hospital Anxiety and Depression Scale (HADS) and Epworth Sleepiness Scale. Laboratory data, blood pressure and body weight were analyzed before and after one dialysis session. Results: In group HD, eight patients (32%) had diagnosis of dialysis headache, with pulsating headache (n=6, 75%), photophobia (n=6, 75%), phonophobia (n=4, 50%), and nauseas or vomiting (n=6, 75%), with a mean pain score of 7.75 ± 1.58. Headache group had higher scores of anxieties (7.00 ± 3.93 vs. 3.82 ± 3.23, p=0.03) and sleepiness (9.13 ± 3.94 vs. 4.76 ± 3.85, p=0.01), lower levels of serum calcium (p=0.01), and higher systolic (p=0.02) and diastolic (p=0.02) blood pressure pre dialysis. In group Tx, five patients (20%) reported dialysis headache, with pulsating headache (n=4, 80%), nauseas or vomiting (n=4, 80%), with a mean pain score of 8.0 ± 1.41. Headache group had a higher score of sleepiness (9.20 ± 4.32 vs. 4.80 ± 4.51, p=0.029) and were younger (38.93 ± 14.43 vs. 54.02 ± 8.31, p=0.03). Conclusion Headache is frequent among hemodialysis patients and had similar symptoms of migraine. In this series dialysis headache was associated with higher scores of anxieties and sleepiness, higher blood pressure and lower calcium pre dialysis.
{"title":"Dialysis headache: prevalence and clinical presentation in hemodialysis and kidney transplant patients","authors":"Bruno Teixeira Gomes, A. Costa, M. Mazzali","doi":"10.48208/headachemed.2022.32","DOIUrl":"https://doi.org/10.48208/headachemed.2022.32","url":null,"abstract":"Introduction\u0000Headache is a common symptom among hemodialysis patients, with a prevalence around 70%. Dialysis headache is defined according to International Classification of Headache Disorders (ICHD-3) as a headache without specific characteristics, occurring during and caused by hemodialysis that spontaneously disappears within 72 hours after the dialysis session. There is no consensus on trigger factors or physiopathology.\u0000Objective\u0000To evaluate prevalence, clinical characteristics, and associated factors with dialysis headache.\u0000Methods\u0000Observational study with quantitative analysis. Study patients were divided into two groups: (HD) 25 hemodialysis patients and (Tx) 25 early post kidney transplant patients. A structured questionnaire was applied to all patients, including Hospital Anxiety and Depression Scale (HADS) and Epworth Sleepiness Scale. Laboratory data, blood pressure and body weight were analyzed before and after one dialysis session. Results: In group HD, eight patients (32%) had diagnosis of dialysis headache, with pulsating headache (n=6, 75%), photophobia (n=6, 75%), phonophobia (n=4, 50%), and nauseas or vomiting (n=6, 75%), with a mean pain score of 7.75 ± 1.58. Headache group had higher scores of anxieties (7.00 ± 3.93 vs. 3.82 ± 3.23, p=0.03) and sleepiness (9.13 ± 3.94 vs. 4.76 ± 3.85, p=0.01), lower levels of serum calcium (p=0.01), and higher systolic (p=0.02) and diastolic (p=0.02) blood pressure pre dialysis. In group Tx, five patients (20%) reported dialysis headache, with pulsating headache (n=4, 80%), nauseas or vomiting (n=4, 80%), with a mean pain score of 8.0 ± 1.41. Headache group had a higher score of sleepiness (9.20 ± 4.32 vs. 4.80 ± 4.51, p=0.029) and were younger (38.93 ± 14.43 vs. 54.02 ± 8.31, p=0.03).\u0000Conclusion\u0000Headache is frequent among hemodialysis patients and had similar symptoms of migraine. In this series dialysis headache was associated with higher scores of anxieties and sleepiness, higher blood pressure and lower calcium pre dialysis.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78255431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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