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Erdoğan FF, Öztürk A, Unalan D, Mazıcıoğlu M, Serin IS, Tucer B. Prevalence of and influencing factors for chronic headaches among pregnant women. Int J Gynaecol Obstet 2012; 117:144-7. [PMID: 22365591 DOI: 10.1016/j.ijgo.2011.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 11/28/2011] [Accepted: 01/24/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the prevalence of headaches and their influencing factors among pregnant women. METHODS A cross-sectional study was conducted from January 3 to April 29, 2005, with 1357 women receiving routine pregnancy check-ups at the obstetric clinics of the community health institutions of Kayseri, Turkey. A structured questionnaire and the Zung Depression Scale were used to collect data. RESULTS Overall, 24.6% (95% confidence interval, 22.3%-26.9%) of the participants had headaches before pregnancy, whereas only 17.9% (95% confidence interval, 15.9%-20.1%) had headaches during pregnancy. Although the headache prevalence was lower during than before pregnancy, it was high among the participants aged 35 years or older, those who received help in their housework, and those who were multiparous. Moreover, the Zung depression score was significantly high among those experiencing headaches. CONCLUSION The significant decrease in headache prevalence observed during pregnancy may be the result of a pregnancy-specific hormonal status. However, the most significant factors influencing the frequency of headaches in the participants were related to their socioeconomic status and the severity of depression.
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Atasoy HT, Atasoy N, Unal AE, Emre U, Sumer M. Psychiatric comorbidity in medication overuse headache patients with pre-existing headache type of episodic tension-type headache. Eur J Pain 2012; 9:285-91. [PMID: 15862478 DOI: 10.1016/j.ejpain.2004.07.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Accepted: 07/13/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Medication overuse headache (MOH) mostly evolves from migraine and episodic tension-type headache (ETTH). Chronic tension-type headache (CTTH) is another headache type that evolves over time from ETTH. It is well known that psychiatric comorbidity is high in MOH patients. AIM To investigate the frequency of psychiatric comorbidity, and the intensity of depression and anxiety in MOH patients evolving from ETTH and to compare results with CTTH patients and MOH patients evolving from migraine. METHODS Twenty-eight CTTH (Group C) and 89 MOH patients were included into the study. MOH patients were divided into two groups according to their pre-existing headache types: MOH patients with pre-existing ETTH (Group E, n = 31), and with pre-existing migraine (Group M, n = 58). All patients were interviewed with a psychiatrist and SCID-CV and SCID-II were applied. Beck Anxiety Inventory and Beck Depression Inventory scales were also performed. RESULTS Eleven patients (39.3%) in Group C, 21 patients (67.7%) in Group E, and 31 patients (53.7%) in Group M were diagnosed to have comorbid psychiatric disorders. The psychiatric comorbidity was found significantly higher in Group E than Group C. In Group E, mood disorders were found significantly higher, but the difference between the two groups with regard to anxiety disorders was insignificant. Mean depression scores were significantly higher in Group E than Group C. The mostly diagnosed type was obsessive-compulsive personality disorder in all the three groups, and was statistically significant in Group M than Group C. CONCLUSION Psychiatric comorbidity in MOH patients with pre-existing ETTH is common as in those with pre-existing migraine headache and MOH with regard to developing psychiatric disorders should be interpreted as a risk factor in chronic daily headache patients.
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Tursunova KB, Chutko LS. [Emotional disorders in the pathogenesis of cervical headache]. Zh Nevrol Psikhiatr Im S S Korsakova 2012; 112:74-76. [PMID: 22810747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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79
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Fujita M, Fujiwara J. [Validity of graphic headache diary for children having primary headaches]. NO TO HATTATSU = BRAIN AND DEVELOPMENT 2011; 43:443-447. [PMID: 22180958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We investigated whether the graphic headache diary is useful for diagnosing headache types in children, especially suffering from chronic daily headaches. Our study involved 109 children who completed the diaries for more than 3 weeks. The headache diary was a modified version of that used in the study by Sakai et al. Of 109, 84 had migraine, 15 had tension-type headache and 10 had both tension-type headache and migraine from the questionnaire and the first interview. The diary disclosed that 20 children, initially diagnosed as having migraine, had co-existing chronic tension-type headache with a variety of psychosocial problems. The graphic headache diary seems to be helpful for headache diagnosis and awareness of stress in children who suffered from strong and persistent headaches. Our study suggested that the graphic headache diary is useful not only for diagnosing headache types in children but also for finding out problems in school and/or family.
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Toribio-Díaz ME, Morera-Guitart J, Medrano V, Sempere ÁP, Más-Sesé G, Palao-Duarte S, Beltrán-Blasco I, Callejo-Domíínguez JM, Moltó-Jordá JM. [Menstrual headache: subtypes, clinical phenotypes and treatment]. Rev Neurol 2011; 53:470-476. [PMID: 21960387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Up to 60% of women relate their episodes of headache to menstrual cycle. Menstrual migraine has been included in the second edition of the International Classification of Headache disorders. Menstrual tension-type headache has not yet been recognised by the International Headache Society. AIMS To evaluate the prevalence of different subtypes of menstrual headache and to analyze their clinical features and the treatment prescribed. PATIENTS AND METHODS We prospectively included women attending several neurology outpatient clinics, from January to November 2008 whose headache appeared during the menstrual period. RESULTS A total of 108 patients were included during the study period. Mean age was 34.8 ± 8.9 years-old. 29.3% suffered from pure menstrual migraine, 58.7% from menstrual related migraine, 4.5% from pure menstrual tension-type headache and 7.5% from menstrual related tension type headache. CONCLUSIONS Our data suggest that menstrual related tension-type headaches exist with a prevalence found about 12%, in our neurology outpatient clinics.
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Chhetri MK, Bhattacharya AK, Kumar T. Headache in rheumatological disorders. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 2011; 109:646-649. [PMID: 22480097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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83
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Lowney AC, Ryan SA, Ryan A, Harney S. Waking up to darkness. BMJ 2011; 343:d4783. [PMID: 21828203 DOI: 10.1136/bmj.d4783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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84
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Madsen SA, Fomsgaard JS, Jensen R. Epidural blood patch for refractory low CSF pressure headache: a pilot study. J Headache Pain 2011; 12:453-7. [PMID: 21461591 PMCID: PMC3139086 DOI: 10.1007/s10194-011-0331-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/14/2011] [Indexed: 11/23/2022] Open
Abstract
Once believed an exceedingly rare disorder, recent evidence suggests that low cerebrospinal fluid (CSF) pressure headache has to be considered an important cause of new daily persistent headaches, particularly among young and middle-aged individuals. Treatment of low CSF pressure headache consists of non-invasive/conservative measures and invasive measures with epidural blood patch providing the cornerstone of the invasive measures. In the present pilot study we therefore aimed to evaluate the treatment efficacy of epidural blood patch (EBP) in treatment-refractory low-pressure headache. Our primary effect parameter was total headache burden defined as area under the curve (AUC: intensity × duration) and as secondary effect parameters we identified: intensity (VAS 0-10), frequency (days per month), duration in hours (total hours/month) and also medication days (days on medication/month). In our primary effect parameter we found a significant reduction in AUC with more than 25% and this is considered to be clinically relevant. We found also a significant and relevant reduction at -22% in intensity. A trend towards reduction in duration was seen. We found no statistically significant reduction in frequency. An increase in days with use of medication was found. Increased awareness of low CSF pressure headache is emphasized and a controlled larger randomized study is needed to confirm the results. However the present results, allows us to conclude that EBP in treatment-refractory low CSF pressure headache can be considered as a treatment option.
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Perry JJ, Stiell IG, Sivilotti MLA, Bullard MJ, Emond M, Symington C, Sutherland J, Worster A, Hohl C, Lee JS, Eisenhauer MA, Mortensen M, Mackey D, Pauls M, Lesiuk H, Wells GA. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011; 343:d4277. [PMID: 21768192 PMCID: PMC3138338 DOI: 10.1136/bmj.d4277] [Citation(s) in RCA: 191] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To measure the sensitivity of modern third generation computed tomography in emergency patients being evaluated for possible subarachnoid haemorrhage, especially when carried out within six hours of headache onset. DESIGN Prospective cohort study. SETTING 11 tertiary care emergency departments across Canada, 2000-9. PARTICIPANTS Neurologically intact adults with a new acute headache peaking in intensity within one hour of onset in whom a computed tomography was ordered by the treating physician to rule out subarachnoid haemorrhage. MAIN OUTCOME MEASURES Subarachnoid haemorrhage was defined by any of subarachnoid blood on computed tomography, xanthochromia in cerebrospinal fluid, or any red blood cells in final tube of cerebrospinal fluid collected with positive results on cerebral angiography. RESULTS Of the 3132 patients enrolled (mean age 45.1, 2571 (82.1%) with worst headache ever), 240 had subarachnoid haemorrhage (7.7%). The sensitivity of computed tomography overall for subarachnoid haemorrhage was 92.9% (95% confidence interval 89.0% to 95.5%), the specificity was 100% (99.9% to 100%), the negative predictive value was 99.4% (99.1% to 99.6%), and the positive predictive value was 100% (98.3% to 100%). For the 953 patients scanned within six hours of headache onset, all 121 patients with subarachnoid haemorrhage were identified by computed tomography, yielding a sensitivity of 100% (97.0% to 100.0%), specificity of 100% (99.5% to 100%), negative predictive value of 100% (99.5% to 100%), and positive predictive value of 100% (96.9% to 100%). CONCLUSION Modern third generation computed tomography is extremely sensitive in identifying subarachnoid haemorrhage when it is carried out within six hours of headache onset and interpreted by a qualified radiologist.
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Preissler C, Gössi U, Eichhorn P. [Recurrent episodes of headache]. PRAXIS 2011; 100:367-371. [PMID: 21412749 DOI: 10.1024/1661-8157/a00467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Mollaret's meningitis is a recurrent meningitis, usually caused by Herpes simplex virus type 2. Symptoms are typical for meningitis, but other causes for recurrent and chronic meningitis have to be excluded in the cerebrospinal fluid. Usually Mollaret's meningitis is a benign form of meningitis without sequelae. There are no evidence-based data about therapy because of few reported cases.
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L'Europa GA. Headache: differentiating among the types, use of imaging, and medication overuse headache. MEDICINE AND HEALTH, RHODE ISLAND 2011; 94:74-76. [PMID: 21488529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Anagnostis P, Adamidou F, Polyzos SA, Efstathiadou Z, Panagiotou A, Kita M. Pituitary incidentalomas: a single-centre experience. Int J Clin Pract 2011; 65:172-7. [PMID: 21235697 DOI: 10.1111/j.1742-1241.2010.02537.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIM Pituitary incidentalomas (PIs) are diagnosed in about 10% of the patients undergoing radiological investigation for non-pituitary disorders. The aim of this study was to describe the morphological and hormonal characteristics of PIs in a cohort of patients, followed up in a single centre from 1982-2009. METHODS Retrospective analysis of electronic medical records of patients with PIs was carried out. All patients underwent basal and dynamic evaluation of the hypothalamus-pituitary axis. Mass size was assessed at yearly intervals. RESULTS Sixty-one patients (38 men/23 women, aged 53±2 years) were studied. The mean follow-up time was 48±8 months, and mean size of PIs was 20±2 mm. Twelve PIs (20%) were microadenomas, 48 (78%) were macroadenomas and one (2%) was a Rathke's cyst. The most common reasons that led to their discovery were headaches, dizziness, syncope, stroke and head injury. Forty-seven of the 61 PIs (77%) were non-functioning, 11 (18%) prolactinomas, and two (3%) GH-secreting adenomas. Hypopituitarism was present in 12% at diagnosis. Forty-eight per cent of the patients were submitted to surgery with conventional radiotherapy in 8%. Relapse in size was observed in 48% of the surgically treated patients. Of the PIs followed conservatively, 78% remained stable, 11% showed decrease and 11% increase in size during follow up. Hypopituitarism rose to 57% postoperatively. CONCLUSIONS Majority of PIs are non-functioning adenomas that remain stable in size. Relapse in size and hypopituitarism postoperatively are common. PIs, for which conservative management was initially considered appropriate, did not progress in size.
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Stefanescu AM, Gradinaru SL, Tugui A, Ciuluvica R. [Headache--from an ophthalmic point of view]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2011; 55:30-37. [PMID: 22428290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The authors approach a subject keen to neuroophthalmologists, which is becoming more and more frequent with the overuse of VTU (videoterminal unit). They hope to better understand the headache (from an ophthalmic point of view), and how to diagnose it better and faster.
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Jenkins AJ. Subarachnoid haemorrhage. Reinventing the wheel, square. BMJ 2010; 341:c7414. [PMID: 21193509 DOI: 10.1136/bmj.c7414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lamb J. Subarachnoid haemorrhage. Cases may have been missed. BMJ 2010; 341:c7406. [PMID: 21193506 DOI: 10.1136/bmj.c7406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Moulis G, Delavigne K, Alvarez M, Brassat D, Bonneville F, Massip P, Adoue D. [Chronic headaches]. Rev Med Interne 2010; 32:46-7. [PMID: 21145627 DOI: 10.1016/j.revmed.2010.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 04/10/2010] [Indexed: 11/18/2022]
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Domitrz I. Airplane headache: a further case report of a young man. J Headache Pain 2010; 11:531-2. [PMID: 20689975 PMCID: PMC3476235 DOI: 10.1007/s10194-010-0245-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Accepted: 07/12/2010] [Indexed: 11/16/2022] Open
Abstract
Headache with normal examinations and imaging, occurring during an airplane flight has been rarely reported. We present a young patient with a new type of headache that appeared during flights: take-off and landing of a plane and was not associated with other conditions. This airplane headache is rather rare in population and the pathophysiology of this type is not clear. Secondary causes must be ruled out before the diagnosis of a primary headache is made.
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Kawale J, Mahore A, Dange N, Bhoyar K. Adiposis dolorosa of scalp presenting with severe headache: an unusual case. J Headache Pain 2010; 11:539-41. [PMID: 20811764 PMCID: PMC3476222 DOI: 10.1007/s10194-010-0253-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Accepted: 08/16/2010] [Indexed: 11/25/2022] Open
Abstract
A 46-year-old female, known case of adiposis dolorosa since adolescence, noticed painful thickening of scalp in bilateral parieto-occipital areas and vertex 1 year back. Six weeks prior to the presentation to our service, she developed severe occipital headache refractory to drug treatment. She improved after bilateral greater occipital nerve blocks. She was subjected to bilateral greater occipital chemical neurolysis which has given her complete pain relief.
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Ipekdal HI, Karadaş O, Erdem G, Vurucu S, Ulaş UH. Airplane headache in pediatric age group: report of three cases. J Headache Pain 2010; 11:533-4. [PMID: 20714775 PMCID: PMC3476231 DOI: 10.1007/s10194-010-0249-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 07/30/2010] [Indexed: 10/26/2022] Open
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Förderreuther S. [Overweight and headache]. MMW Fortschr Med 2010; 152:41-43. [PMID: 21171471 DOI: 10.1007/bf03367291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Perry JJ, Stiell IG, Sivilotti MLA, Bullard MJ, Lee JS, Eisenhauer M, Symington C, Mortensen M, Sutherland J, Lesiuk H, Wells GA. High risk clinical characteristics for subarachnoid haemorrhage in patients with acute headache: prospective cohort study. BMJ 2010; 341:c5204. [PMID: 21030443 PMCID: PMC2966872 DOI: 10.1136/bmj.c5204] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify high risk clinical characteristics for subarachnoid haemorrhage in neurologically intact patients with headache. DESIGN Multicentre prospective cohort study over five years. SETTING Six university affiliated tertiary care teaching hospitals in Canada. Data collected from November 2000 until November 2005. PARTICIPANTS Neurologically intact adults with a non-traumatic headache peaking within an hour. MAIN OUTCOME MEASURES Subarachnoid haemorrhage, as defined by any of subarachnoid haemorrhage on computed tomography of the head, xanthochromia in the cerebrospinal fluid, or red blood cells in the final sample of cerebrospinal fluid with positive results on angiography. Physicians completed data collection forms before investigations. RESULTS In the 1999 patients enrolled there were 130 cases of subarachnoid haemorrhage. Mean (range) age was 43.4 (16-93), 1207 (60.4%) were women, and 1546 (78.5%) reported that it was the worst headache of their life. Thirteen of the variables collected on history and three on examination were reliable and associated with subarachnoid haemorrhage. We used recursive partitioning with different combinations of these variables to create three clinical decisions rules. All had 100% (95% confidence interval 97.1% to 100.0%) sensitivity with specificities from 28.4% to 38.8%. Use of any one of these rules would have lowered rates of investigation (computed tomography, lumbar puncture, or both) from the current 82.9% to between 63.7% and 73.5%. CONCLUSION Clinical characteristics can be predictive for subarachnoid haemorrhage. Practical and sensitive clinical decision rules can be used in patients with a headache peaking within an hour. Further study of these proposed decision rules, including prospective validation, could allow clinicians to be more selective and accurate when investigating patients with headache.
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Gökçay F, Eyigör C, Bayram E, Dönmez I, Uyar M. [Epidural blood patch treatment in a patient with chronic headache related to spontaneous intracranial hypotension]. AGRI-THE JOURNAL OF THE TURKISH SOCIETY OF ALGOLOGY 2010; 22:170-174. [PMID: 21153936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Intracranial hypotension is usually seen in middle-aged adults and appears with orthostatic headache. It is characterized by low cerebrospinal fluid (CSF) pressure and pachymeningeal-dural thickening on magnetic resonance imaging (MRI). Lumbar puncture, dural rupture with CSF leakage secondary to spinal anesthesia or spinal traumas, and under-production or over-absorption of CSF due to some metabolic events such as dehydration, uremia and diabetic coma are the main etiologic factors. It is sometimes considered as idiopathic when no etiologic factor is present. In addition, some connective tissue disorders have risk of CSF leakage due to spontaneous dural rupture. Neck pain, tinnitus, nausea and vomiting, and diplopia may accompany headache. CSF leakage can be identified by computerized tomography (CT) myelography, CSF-flow MRI, and radionuclide cisternography. Bed rest, fluid resuscitation, caffeine, theophylline, and non-steroidal antiinflammatory drugs (NSAIDs) are important treatment options. In patients resistant to therapy, interventional measures such as epidural saline or blood patch can be applied. In this case report, we evaluated the results of pain treatment options in a patient having headache due to intracranial hypotension who was hospitalized in the Neurology Department of Ege University Hospital.
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