Pub Date : 2022-12-31DOI: 10.48208/headachemed.2022.33
Sophia Orsi, E. Melhado, Bárbara Aparecida Klafke Zambelli, Beatriz Andrade Paternost, J. Farina, Sarah Gavião Ferreira, Tarso Vieira Cavalcanti Albuquerque
Introduction Considering the high prevalence of headache, it is necessary a study about the effectiveness of the care of patients with headache by medical resident in Emergency Care Units (EDU) and medical outpatient clinics. Objective The objective of this study was to analyze the effectiveness of care in EDUs, outpatient clinics and medical wards and the management of patients with headache complaints. Method The study was observational descriptive (cross-sectional cohort) through the application of an online questionnaire answered by the medical residents. Results There were 115 residents who answered the survey. In the group of residents who see patients with headache (n=95) the number of visits was 4.87 per week. The resident's idea is that headaches are symptoms of an underlying disease in 49.5% of them. On the question about feeling able to differentiate primary from secondary headaches, 50% of the residents said yes. On the question, "Is Migraine the same as Headache?" 6.1% answered yes. On the question, "Would you use morphine derivatives to treat headache?" 19.1% of the residents answered that they would. On the question about having knowledge about the harms of using morphine derivatives in headache, 60% answered that they did not have in-depth knowledge or that they have no knowledge. In this sample of residents, 74/115 (65%) suffer from headache. Only 36/115 (31%) of the residents sought care because of the headache. Of the residents, 3/115 (2.6%) have chronic daily headache. In the question about knowing what is "chronic daily headache" and from medication overuse, about 35% do not know or did not delve into the concept. Conclusion We conclude that there is a lack of teaching about types of headaches, criteria for diagnosis and treatment. Urgent modifications should be made in the medical course to enable newly graduated doctors to diagnose and treat patients with headache.
{"title":"Knowledge of the medical resident about diagnosis and treatment of patients with headache","authors":"Sophia Orsi, E. Melhado, Bárbara Aparecida Klafke Zambelli, Beatriz Andrade Paternost, J. Farina, Sarah Gavião Ferreira, Tarso Vieira Cavalcanti Albuquerque","doi":"10.48208/headachemed.2022.33","DOIUrl":"https://doi.org/10.48208/headachemed.2022.33","url":null,"abstract":"Introduction\u0000Considering the high prevalence of headache, it is necessary a study about the effectiveness of the care of patients with headache by medical resident in Emergency Care Units (EDU) and medical outpatient clinics.\u0000Objective\u0000The objective of this study was to analyze the effectiveness of care in EDUs, outpatient clinics and medical wards and the management of patients with headache complaints.\u0000Method\u0000The study was observational descriptive (cross-sectional cohort) through the application of an online questionnaire answered by the medical residents.\u0000Results\u0000There were 115 residents who answered the survey. In the group of residents who see patients with headache (n=95) the number of visits was 4.87 per week. The resident's idea is that headaches are symptoms of an underlying disease in 49.5% of them. On the question about feeling able to differentiate primary from secondary headaches, 50% of the residents said yes. On the question, \"Is Migraine the same as Headache?\" 6.1% answered yes. On the question, \"Would you use morphine derivatives to treat headache?\" 19.1% of the residents answered that they would. On the question about having knowledge about the harms of using morphine derivatives in headache, 60% answered that they did not have in-depth knowledge or that they have no knowledge. In this sample of residents, 74/115 (65%) suffer from headache. Only 36/115 (31%) of the residents sought care because of the headache. Of the residents, 3/115 (2.6%) have chronic daily headache. In the question about knowing what is \"chronic daily headache\" and from medication overuse, about 35% do not know or did not delve into the concept.\u0000Conclusion\u0000We conclude that there is a lack of teaching about types of headaches, criteria for diagnosis and treatment. Urgent modifications should be made in the medical course to enable newly graduated doctors to diagnose and treat patients with headache.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79805619","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 : 2022-12-31DOI: 10.48208/headachemed.2022.38
M. Arruda, R. Arruda
The comorbidity of migraine and Autism Spectrum Disorder (ASD) still remain unclear. In spite of plausible evidences of such comorbidity, there is a scarcity of populational studies focusing this hypothesis. The diagnosis of migraine in children with ASD is very challenge due to the large clinical heterogeneity and limited communication skills, particularly verbal abilities in young children and those with intellectual disability. ASD and migraine are chronic prevalent disorders sharing some pathophysiological changes (neurotransmission dysregulation, altered immune response, abnormal findings in the cortical minicolumn organization, and dysfunctions in the gut–brain axis), susceptibility genes (including calcium channel mutations and polymorphisms), and atypical sensory processing. Herein, we take advantage of a prototypical case of an adolescent with episodic migraine transformed to chronic, not responsive to preventive treatment, to explore the diagnostic workup and successful personalized clinical and therapeutical management.
{"title":"Case report: Look at my eyes","authors":"M. Arruda, R. Arruda","doi":"10.48208/headachemed.2022.38","DOIUrl":"https://doi.org/10.48208/headachemed.2022.38","url":null,"abstract":"The comorbidity of migraine and Autism Spectrum Disorder (ASD) still remain unclear. In spite of plausible evidences of such comorbidity, there is a scarcity of populational studies focusing this hypothesis. The diagnosis of migraine in children with ASD is very challenge due to the large clinical heterogeneity and limited communication skills, particularly verbal abilities in young children and those with intellectual disability. ASD and migraine are chronic prevalent disorders sharing some pathophysiological changes (neurotransmission dysregulation, altered immune response, abnormal findings in the cortical minicolumn organization, and dysfunctions in the gut–brain axis), susceptibility genes (including calcium channel mutations and polymorphisms), and atypical sensory processing. Herein, we take advantage of a prototypical case of an adolescent with episodic migraine transformed to chronic, not responsive to preventive treatment, to explore the diagnostic workup and successful personalized clinical and therapeutical management.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83153938","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 : 2022-12-31DOI: 10.48208/headachemed.2022.27
André Luiz Godoi, Erlene Roberta Ribeiro dos Santos, J. Andrade
Incorporation of health technologies: The importance of drug treatment of primary headaches in the Brazilian unified health system
卫生技术的结合:巴西统一卫生系统中原发性头痛药物治疗的重要性
{"title":"Incorporation of health technologies: The importance of drug treatment of primary headaches in the Brazilian unified health system","authors":"André Luiz Godoi, Erlene Roberta Ribeiro dos Santos, J. Andrade","doi":"10.48208/headachemed.2022.27","DOIUrl":"https://doi.org/10.48208/headachemed.2022.27","url":null,"abstract":"Incorporation of health technologies: The importance of drug treatment of primary headaches in the Brazilian unified health system","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83240515","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 : 2022-12-31DOI: 10.48208/headachemed.2022.29
Maria Clea Marinho Lima, Giovanni Silveira Maioli, M. Valença
Introduction The World Health Organization (WHO) ranks migraine as one of the top 20 causes of impaired healthy life years per year worldwide. Migraine alone is responsible for about 400,000 lost workdays per year per one million inhabitants in developed countries. Headache is probably among the five most important causes of disability worldwide. Method This literature review was carried out by searching the Pubmed, Lilacs and Scopus databases, using the following Health Science Descriptors (DeCS) of the Virtual Health Library and in particular the current data collected by the WHO or health entities in the various countries: "secondary headaches" AND "red flags" AND "review". Articles published in Portuguese and English were selected. The eligibility criteria defined for the inclusion of articles were studies that addressed the chosen theme. Results The use of "Red Flags" in clinical practice is of considerable relevance. The combination of "Red Flags", anamnesis, physical examination, laboratory, and imaging examination accentuate the probability of predicting the etiology that may underlie the onset of a secondary headache. However, despite this widely useful screening tool, there are still gaps in the prognosis. Conclusion Much remains unclear as there is a lack of prospective epidemiological studies. In addition, some "Red Flags" such as pattern change are poorly elucidated. Large-scale studies are needed due to the low incidence of many secondary causes. New patients with headache should be screened using the SNNOOP10 list to increase the likelihood of detecting a secondary cause.
{"title":"Red flags for secondary headaches: challenges in clinical practice","authors":"Maria Clea Marinho Lima, Giovanni Silveira Maioli, M. Valença","doi":"10.48208/headachemed.2022.29","DOIUrl":"https://doi.org/10.48208/headachemed.2022.29","url":null,"abstract":"Introduction\u0000The World Health Organization (WHO) ranks migraine as one of the top 20 causes of impaired healthy life years per year worldwide. Migraine alone is responsible for about 400,000 lost workdays per year per one million inhabitants in developed countries. Headache is probably among the five most important causes of disability worldwide. \u0000Method\u0000This literature review was carried out by searching the Pubmed, Lilacs and Scopus databases, using the following Health Science Descriptors (DeCS) of the Virtual Health Library and in particular the current data collected by the WHO or health entities in the various countries: \"secondary headaches\" AND \"red flags\" AND \"review\". Articles published in Portuguese and English were selected. The eligibility criteria defined for the inclusion of articles were studies that addressed the chosen theme. \u0000Results\u0000The use of \"Red Flags\" in clinical practice is of considerable relevance. The combination of \"Red Flags\", anamnesis, physical examination, laboratory, and imaging examination accentuate the probability of predicting the etiology that may underlie the onset of a secondary headache. However, despite this widely useful screening tool, there are still gaps in the prognosis. \u0000Conclusion\u0000Much remains unclear as there is a lack of prospective epidemiological studies. In addition, some \"Red Flags\" such as pattern change are poorly elucidated. Large-scale studies are needed due to the low incidence of many secondary causes. New patients with headache should be screened using the SNNOOP10 list to increase the likelihood of detecting a secondary cause.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73227262","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 : 2022-12-31DOI: 10.48208/headachemed.2022.37
M. Valença, R. Silva-Néto
Introduction Stabbing headache is considered a primary headache and is a prevalent entity in the general population. Objective To present an unusual case of stabbing headache associated with menstruation. Method Data collected through complete anamnesis. Case report The authors report a case of a woman suffering from a stabbing headache which features that has not been previously described – a menstrual pattern in the presentation of stabbing headache attacks. Conclusions We conclude that this menstrual pattern of stabbing headache attacks is unusual in patients with primary stabbing headache and that it does not fulfil diagnostic criteria for migraine or tension-type headache.
{"title":"Menstrually-related stabbing headache in a patient without migraine: case report","authors":"M. Valença, R. Silva-Néto","doi":"10.48208/headachemed.2022.37","DOIUrl":"https://doi.org/10.48208/headachemed.2022.37","url":null,"abstract":"Introduction\u0000Stabbing headache is considered a primary headache and is a prevalent entity in the general population. \u0000Objective\u0000To present an unusual case of stabbing headache associated with menstruation.\u0000Method\u0000Data collected through complete anamnesis.\u0000Case report\u0000The authors report a case of a woman suffering from a stabbing headache which features that has not been previously described – a menstrual pattern in the presentation of stabbing headache attacks.\u0000Conclusions\u0000We conclude that this menstrual pattern of stabbing headache attacks is unusual in patients with primary stabbing headache and that it does not fulfil diagnostic criteria for migraine or tension-type headache.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81982109","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 : 2022-12-28DOI: 10.48208/headachemed.2022.35
P. Fortunato, D. Ueno, M. Sukessada, Gabriel Santaterra Barros, J. Silva, Bruna Franchito Freire, D. Gulhote, A. Piffer, Hilton Mariano da Silva Junior
O seio cavernoso é um plexo venoso localizado na base do crânio. Várias patologias, como processos inflamatórios, aneurismáticos ou metastáticos, podem afetar esse plexo. A síndrome do seio cavernoso ocorre quando os nervos estão envolvidos nessa região (nervos cranianos III, IV, VI e divisões do V). Essas relações anatômicas explicam que a diplopia e a dor são os sintomas iniciais mais comuns nesses pacientes. Os aneurismas carotídeos cavernosos (CCAs) representam 2% a 9% dos aneurismas. Relatamos dois pacientes que apresentaram síndrome do seio cavernoso decorrente de aneurismas da artéria carótida. O reconhecimento da etiologia desse quadro clínico diferenciado é fundamental para evitar complicações e direcionar a melhor conduta para cada paciente.
{"title":"Cefaléia e disfunção de nervos cranianos secundários a aneurisma de artéria carótida: relato de dois casos e revisão da literatura","authors":"P. Fortunato, D. Ueno, M. Sukessada, Gabriel Santaterra Barros, J. Silva, Bruna Franchito Freire, D. Gulhote, A. Piffer, Hilton Mariano da Silva Junior","doi":"10.48208/headachemed.2022.35","DOIUrl":"https://doi.org/10.48208/headachemed.2022.35","url":null,"abstract":"O seio cavernoso é um plexo venoso localizado na base do crânio. Várias patologias, como processos inflamatórios, aneurismáticos ou metastáticos, podem afetar esse plexo. A síndrome do seio cavernoso ocorre quando os nervos estão envolvidos nessa região (nervos cranianos III, IV, VI e divisões do V). Essas relações anatômicas explicam que a diplopia e a dor são os sintomas iniciais mais comuns nesses pacientes. Os aneurismas carotídeos cavernosos (CCAs) representam 2% a 9% dos aneurismas. Relatamos dois pacientes que apresentaram síndrome do seio cavernoso decorrente de aneurismas da artéria carótida. O reconhecimento da etiologia desse quadro clínico diferenciado é fundamental para evitar complicações e direcionar a melhor conduta para cada paciente.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86534475","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 : 2022-12-28DOI: 10.48208/headachemed.2022.31
Reva Mosleh, Georges Hatem, N. Navasardyan, R. Ajrouche, Salam Zein, S. Awada
Introduction Migraine is common among university students and can directly affect their daily activities and learning since students with migraine have difficulties attending classes and missed more school days than other students. Objectives This study aimed to identify triggering factors of migraine along with factors that relieve headaches associated with migraine episodes among university students. Methods An observational cross-sectional study targeted students from different faculties of the public university campus in Lebanon using a survey for data collection. Results Feeling hungry (65.9%), fasting (50.7%), and coffee deprivation (22.7%) were the most commonly reported dietary factors inducing headaches among university students. In comparison, climate changes (77.1%), noise and high volumes (73.9%), and hot weather (60.2%) were the most common environmental triggers. Among the psychological factors, anxiety (53.4%) and crying (47.3%) were highly reported and were significantly higher among women. Fatigue (63.2%), studying for exams (59.5%), and neck pain (46.8%) were the most common physical activity-reported factors. Lack of sleep (72%) and changes in sleeping hours (42.7%) were the primarily reported sleeping habits that can trigger headaches, with no statistically significant differences between men and women. Sleeping (66.3%), relaxing (53.4%), avoiding migraine’s trigger factors (42.9%), and having a warm bath (38.5%) were the most reported relieving factors of headache among students. No statistically significant association was noted between any of the factors and the sex of the participants. Conclusion The triggering and relieving factors of migraine were comparable between men and women. Some triggering factors such as crying, anxiety, and fatigue were found significant among women, while driving was a higher migraine trigger among men. Lifestyle interventions may provide clues on effective relieving strategies and yield the establishment of different medical services and university programs.
{"title":"Triggering and relieving factors of migraine among university students: A cross-sectional study in Lebanon","authors":"Reva Mosleh, Georges Hatem, N. Navasardyan, R. Ajrouche, Salam Zein, S. Awada","doi":"10.48208/headachemed.2022.31","DOIUrl":"https://doi.org/10.48208/headachemed.2022.31","url":null,"abstract":"Introduction\u0000Migraine is common among university students and can directly affect their daily activities and learning since students with migraine have difficulties attending classes and missed more school days than other students.\u0000Objectives\u0000This study aimed to identify triggering factors of migraine along with factors that relieve headaches associated with migraine episodes among university students.\u0000Methods\u0000An observational cross-sectional study targeted students from different faculties of the public university campus in Lebanon using a survey for data collection.\u0000Results\u0000Feeling hungry (65.9%), fasting (50.7%), and coffee deprivation (22.7%) were the most commonly reported dietary factors inducing headaches among university students. In comparison, climate changes (77.1%), noise and high volumes (73.9%), and hot weather (60.2%) were the most common environmental triggers. Among the psychological factors, anxiety (53.4%) and crying (47.3%) were highly reported and were significantly higher among women. Fatigue (63.2%), studying for exams (59.5%), and neck pain (46.8%) were the most common physical activity-reported factors. Lack of sleep (72%) and changes in sleeping hours (42.7%) were the primarily reported sleeping habits that can trigger headaches, with no statistically significant differences between men and women. Sleeping (66.3%), relaxing (53.4%), avoiding migraine’s trigger factors (42.9%), and having a warm bath (38.5%) were the most reported relieving factors of headache among students. No statistically significant association was noted between any of the factors and the sex of the participants.\u0000Conclusion\u0000The triggering and relieving factors of migraine were comparable between men and women. Some triggering factors such as crying, anxiety, and fatigue were found significant among women, while driving was a higher migraine trigger among men. Lifestyle interventions may provide clues on effective relieving strategies and yield the establishment of different medical services and university programs.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"79 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90929145","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 : 2022-12-28DOI: 10.48208/headachemed.2022.40
A. L. B. Carneiro, Lindair Alves da Silva, Lincoln Basilio Alves, Semírames Cartonilho de Souza Ramos
For 4 years, our team has been monitoring the physical and mental complaints of Federal University of Paraíba (UFPB) students, mainly those from the healthcare field. We have verified oscillations in headache complaints and other psycho-emotional symptoms during this period. In 2022, perhaps as a result of the impacts of the Covid-19 pandemic, complaints of headache and anxiety were above 70%. This public, today, demands integral care appropriate to their socio-cultural reality. We warn about the importance of local diagnosis and respective offer of appropriate social support to each reality to foster, care and accompany these communities.
{"title":"The pain of every day: student health before and during the Covid-19 pandemic","authors":"A. L. B. Carneiro, Lindair Alves da Silva, Lincoln Basilio Alves, Semírames Cartonilho de Souza Ramos","doi":"10.48208/headachemed.2022.40","DOIUrl":"https://doi.org/10.48208/headachemed.2022.40","url":null,"abstract":"For 4 years, our team has been monitoring the physical and mental complaints of Federal University of Paraíba (UFPB) students, mainly those from the healthcare field. We have verified oscillations in headache complaints and other psycho-emotional symptoms during this period. In 2022, perhaps as a result of the impacts of the Covid-19 pandemic, complaints of headache and anxiety were above 70%. This public, today, demands integral care appropriate to their socio-cultural reality. We warn about the importance of local diagnosis and respective offer of appropriate social support to each reality to foster, care and accompany these communities.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72776787","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 : 2022-12-28DOI: 10.48208/headachemed.2022.36
C. Folchini, Paulo Sergio Faro Santos, Jessica Giraldes, Amanda Batista Machado, P. Kowacs
This article presents the case of a PFO (patent foramen ovale) closure patient with double antiplatelet therapy in whom aspirin was discontinued before clopidogrel and that, at clopidogrel withdrawal, presented “de novo” migraine with visual aura attacks. Migraines with aura associated with atrial right-to-left shunts (PFO and other atrial septal defects) are attributed to the arrival of vasoactive substances in the brain, since not cleared by the lungs. In this case, discontinuation of clopidogrel one year after PFO closure induced “de novo” migraine with aura. Conclusion Rather than confirming the prophylactic effects of clopidogrel for migraine with aura, its triggering at clopidogrel withdrawal is more likely related to a proinflammatory effect of discontinuing clopidogrel. This proinflammatory effect has been described in cardiological research, and reinforces that patients receiving dual antiplatelet therapy (clopidogrel and aspirin) should always have clopidogrel discontinued before aspirin in order to avoid proinflammatory or pro-thrombotic events.
{"title":"Migraine with aura after clopidogrel withdrawal: evidence of inflammation as a migraine trigger? – Case report","authors":"C. Folchini, Paulo Sergio Faro Santos, Jessica Giraldes, Amanda Batista Machado, P. Kowacs","doi":"10.48208/headachemed.2022.36","DOIUrl":"https://doi.org/10.48208/headachemed.2022.36","url":null,"abstract":"This article presents the case of a PFO (patent foramen ovale) closure patient with double antiplatelet therapy in whom aspirin was discontinued before clopidogrel and that, at clopidogrel withdrawal, presented “de novo” migraine with visual aura attacks. Migraines with aura associated with atrial right-to-left shunts (PFO and other atrial septal defects) are attributed to the arrival of vasoactive substances in the brain, since not cleared by the lungs. In this case, discontinuation of clopidogrel one year after PFO closure induced “de novo” migraine with aura.\u0000Conclusion\u0000Rather than confirming the prophylactic effects of clopidogrel for migraine with aura, its triggering at clopidogrel withdrawal is more likely related to a proinflammatory effect of discontinuing clopidogrel. This proinflammatory effect has been described in cardiological research, and reinforces that patients receiving dual antiplatelet therapy (clopidogrel and aspirin) should always have clopidogrel discontinued before aspirin in order to avoid proinflammatory or pro-thrombotic events.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76607144","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 : 2022-12-28DOI: 10.48208/headachemed.2022.34
Luciana Zelante Ambiel Magalhães, Nilton Amorim de Souza
Recurrent Painful Ophthalmoplegic Neuropathy (RPON) is a rare condition, previously known as Ophthalmoplegic Migraine, it is characterized by headache ipsilateral to paresis of the III, IV or VI cranial nerve, usually affects children or young adults. This is a report of a case of RPON in a 16-year-old woman treated at the Hospital do Servidor Público Estadual de São Paulo.
复发性疼痛性眼截瘫神经病(RPON)是一种罕见的疾病，以前称为眼截瘫性偏头痛，其特征是头痛同侧脑神经轻瘫，IV或VI，通常影响儿童或年轻人。这是一名16岁妇女在Servidor医院Público Estadual de s o Paulo治疗的RPON病例的报告。
{"title":"Case report recurrent painful ophthalmoplegic neuropathy","authors":"Luciana Zelante Ambiel Magalhães, Nilton Amorim de Souza","doi":"10.48208/headachemed.2022.34","DOIUrl":"https://doi.org/10.48208/headachemed.2022.34","url":null,"abstract":"Recurrent Painful Ophthalmoplegic Neuropathy (RPON) is a rare condition, previously known as Ophthalmoplegic Migraine, it is characterized by headache ipsilateral to paresis of the III, IV or VI cranial nerve, usually affects children or young adults. This is a report of a case of RPON in a 16-year-old woman treated at the Hospital do Servidor Público Estadual de São Paulo.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77997559","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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