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Myers KA, Barmherzig R, Raj NR, Berrahmoune S, Ingelmo P, Saint-Martin C, Khan AQ, Kouri M, Morris C, Hershey AD, Kacperski J, Kabbouche MA, Mohamed N, Rao RR, Lagman-Bartolome AM, Gelfand AA, Szperka CL, Orr SL. The spectrum of indomethacin-responsive headaches in children and adolescents. Cephalalgia 2022; 42:793-797. [PMID: 35302385 PMCID: PMC9218410 DOI: 10.1177/03331024221076483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Headaches with marked, specific response to indomethacin occur in children, but the phenotypic spectrum of this phenomenon has not been well-studied. Methods We reviewed pediatric patients with headache showing ≥80% improvement with indomethacin, from seven academic medical centers. Results We included 32 pediatric patients (16 females). Mean headache onset age was 10.9 y (range 2–16 y). Headache syndromes included hemicrania continua (n = 13), paroxysmal hemicrania (n = 10), primary stabbing headache (n = 2), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (n = 1), primary exercise headache (n = 1) and primary cough headache (n = 1). Adverse events were reported in 13, most commonly gastrointestinal symptoms, which often improved with co-administration of gastro-protective agents. Conclusion Indomethacin-responsive headaches occur in children and adolescents, and include headache syndromes, such as primary cough headache, previously thought to present only in adulthood. The incidence of adverse events is high, and patients must be co-treated with a gastroprotective agent.
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Affiliation(s)
- Kenneth A Myers
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Division of Child Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - Rebecca Barmherzig
- Department of Neurology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Nichelle R Raj
- Department of Neurology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Saoussen Berrahmoune
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Pablo Ingelmo
- Department of Pediatric Anesthesiology, McGill University Health Center, Montreal, Quebec, Canada
| | | | - Afsheen Q Khan
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Megan Kouri
- Faculty of Medicine, 5620McGill University, McGill University, Montreal, Quebec, Canada
| | - Cynthia Morris
- Child and Adolescent Headache Program, University of California San Francisco, San Francisco, CA, USA.,Department of Child Neurology, Cardinal Glennon Children's Hospital, St. Louis University School of Medicine, St. Louis, MO, USA
| | - Andrew D Hershey
- Departments of Pediatrics and Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joanne Kacperski
- Departments of Pediatrics and Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marielle A Kabbouche
- Departments of Pediatrics and Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Nada Mohamed
- Department of Pediatric Anesthesiology, McGill University Health Center, Montreal, Quebec, Canada
| | - Rashmi R Rao
- Department of Neurology, Louisiana State University Health Sciences Center and Children's Hospital New Orleans, New Orleans, LA, USA
| | - Ana Marissa Lagman-Bartolome
- Division of Neurology, Hospital for Sick Children and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Amy A Gelfand
- Child and Adolescent Headache Program, University of California San Francisco, San Francisco, CA, USA
| | - Christina L Szperka
- Department of Neurology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Serena L Orr
- Division of Neurology, Department of Pediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Chen ZX, Shi Z, Wang B, Zhang Y. Intracuff alkalinized lidocaine to prevent postoperative airway complications: A meta-analysis. World J Clin Cases 2021; 9:10626-10637. [PMID: 35004994 PMCID: PMC8686150 DOI: 10.12998/wjcc.v9.i34.10626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/13/2021] [Accepted: 08/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Post-extubation cough is a common phenomenon in surgical patients undergoing general anesthesia, which can lead to potentially dangerous complications. In this meta-analysis, we evaluated the efficacy and safety of intracuff alkalinized lidocaine in patients with tracheal intubation to prevent cough and other airway complications during the perioperative period.
AIM To perform a systematic review and meta-analysis of intracuff alkalinized lidocaine for the prevention of postoperative airway complications.
METHODS PubMed, Embase, Cochrane, and Web of Science were searched for randomized controlled trials (RCTs) that compared intracuff alkalinized lidocaine to placebo. We used risk-of-bias assessment to assess the RCTs, and the quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluations.
RESULTS Twelve randomized trials (1175 patients) were analyzed. Meta-analysis showed that intracuff alkalinized lidocaine was associated with less cough compared to that produced by placebo [risk ratio (RR): 0.38; 95% confidence interval (CI): 0.23-0.63]. Similarly, intracuff alkalinized lidocaine was more effective than the control in reducing postoperative sore throat at 24 h (RR: 0.19; 95%CI: 0.09-0.41) and postoperative hoarseness (RR: 0.38; 95%CI: 0.21-0.69).
CONCLUSION Intracuff alkalinized lidocaine is an effective adjuvant that can decrease airway complications, such as coughing, hoarseness, and sore throat.
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Affiliation(s)
- Zhen-Xing Chen
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Zhou Shi
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Bin Wang
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Ye Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
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Zhang Y, Zhao X, Wang Y, Dong Z, Yu S. Prevalence and characteristics of cough headache in a Chinese respiratory clinic. Cephalalgia 2020; 41:366-374. [PMID: 33175591 DOI: 10.1177/0333102420970187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND To evaluate the prevalence, predictive factors and clinical characteristics of cough headache in our respiratory clinic and to investigate the coexistence between cough headache, migraine and tension-type headache. METHOD We consecutively investigated patients referred to our respiratory clinic with complaints of cough and selected patients with cough headaches to complete a structured interview and examination. RESULTS Six hundred and seventy-nine patients with cough were studied and 122 patients were diagnosed with cough headache. The prevalence of cough headache was 18.0% in these coughing patients. According to multivariate analysis, being of an age between 31-50 years was a risk factor for cough headache (OR 2.0). Cough headache was associated with cough severity: Compared with the mild group, the moderate group (OR 2.3) and the severe group (OR 3.3) were more vulnerable to cough headache. Headache severity had a positive correlation with cough severity (ρ = 0.301, p = 0.028), age (ρ = 0.199, p = 0.029), and headache duration (ρ = 0.242, p = 0.008). In cough headache patients, 30.3% had tension-type headache and 10.7% had migraine in the preceding year. CONCLUSIONS Cough headache is not rare in respiratory clinics and the characteristics are somewhat different from those in headache clinics. An age of between 31-50 years and cough severity were risk factors for cough headache. Headache severity was related to cough severity, age and headache duration.
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Affiliation(s)
- Yimo Zhang
- International Headache Center, Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Xin Zhao
- International Headache Center, Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Yan Wang
- International Headache Center, Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Zhao Dong
- International Headache Center, Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- International Headache Center, Department of Neurology, Chinese PLA General Hospital, Beijing, China
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4
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Demarquay G, Giraud P. Cefalee primarie non emicraniche. Neurologia 2018. [DOI: 10.1016/s1634-7072(18)41287-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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5
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Headache. Neurology 2016. [DOI: 10.1002/9781118486160.ch12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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6
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Chen YY, Lirng JF, Fuh JL, Chang FC, Cheng HC, Wang SJ. Primary Cough Headache is Associated with Posterior Fossa Crowdedness: A Morphometric MRI Study. Cephalalgia 2016; 24:694-9. [PMID: 15315524 DOI: 10.1111/j.1468-2982.2004.00739.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aetiology of primary cough headache (PCH) is obscure. The aim of this study was to investigate the magnetic resonance (MR) morphometric characteristics of the posterior cranial fossa (PCF) in patients with PCH. Eighteen consecutive patients with PCH (14M/4F, mean age 75.1 + 6.0 years) and 18 sex- and age-matched control subjects were recruited for study. Based on the midline sagittal MR images, parameters indicating posterior fossa crowdedness were measured. Compared with controls, patients with PCH had a similar size of hindbrain tissue area but a significantly smaller PCF area, resulting in a higher mean hindbrain/PCF ratio (0.78 + 0.04 vs. 0.73 + 0.06, P = 0.005). In addition, these patients also had a lower position of the cerebellar tonsillar tip, a shorter clivus length and shorter distances from the clivus to the mid-pons and from the basion to the medulla than the control group. Patients with PCH were associated with a more crowded PCF, which might be a contributing factor for the pathogenesis of this headache syndrome.
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Affiliation(s)
- Yen-Yu Chen
- The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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7
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Medrano V, Mallada J, Sempere AP, Fernández S, Piqueras L. Primary Cough Headache Responsive to Topiramate. Cephalalgia 2016; 25:627-8. [PMID: 16033389 DOI: 10.1111/j.1468-2982.2005.00903.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- V Medrano
- Department of Neurology, Hospital General de Elda, Elda, Spain.
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Abstract
The prevalence of headache decreases in elderly age groups; however, headache remains a significant issue with unique diagnostic and therapeutic considerations in this population. While primary headache disorders such as migraine and tension-type headache still occur in the majority of cases, secondary headaches are more common with advancing age. Additionally, several rare primary headache disorders, such as hypnic headache and primary cough headache, occur more frequently in an elderly population and have distinct treatments. In this review, we provide an updated overview of the common, concerning, and unique headache disorders affecting the elderly.
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Affiliation(s)
- Thomas P Bravo
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA,
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9
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Viana M, Sainaghi PP, Stecco A, Mortara F, Sprenger T, Goadsby PJ. Headache in a Patient With Crowned Dens: Report of a New Case. Headache 2014; 54:1211-6. [DOI: 10.1111/head.12383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Michele Viana
- Headache Science Center; C. Mondino National Neurological Institute; Pavia Italy
| | - Pier P. Sainaghi
- Immuno-Rheumatology Outpatient Unit; Azienda Ospedaliero Universitaria “Maggiore della Carità,” and IRCAD (Interdisciplinary Center of Autoimmune Diseases); Novara Italy
| | - Alessandro Stecco
- Department of Radiology; University of Eastern Piedmont “A. Avogadro”; Novara Italy
| | - Franco Mortara
- Department of Neurology; University of Eastern Piedmont “A. Avogadro”; Novara; Italy
| | - Till Sprenger
- Departments of; Neurology and Radiology; Division of Neuroradiology; University Hospital Basel; Basel Switzerland
| | - Peter J. Goadsby
- Headache Group - NIHR-Wellcome Trust Clinical Research Facility; King's College; London UK
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10
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Guidewire advancement is interrupted by an internal jugular vein valve with a restricted opening: an ultrasound image. Can J Anaesth 2013; 60:1163-4. [PMID: 24013876 DOI: 10.1007/s12630-013-0022-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022] Open
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11
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Cordenier A, De Hertogh W, De Keyser J, Versijpt J. Headache associated with cough: a review. J Headache Pain 2013; 14:42. [PMID: 23687906 PMCID: PMC3671207 DOI: 10.1186/1129-2377-14-42] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 05/02/2013] [Indexed: 01/03/2023] Open
Abstract
Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected by coughing. The diagnosis of primary cough headache is made when headache is brought on and occurs only in association with coughing, straining or a Valsalva manoeuvre and in the absence of any abnormalities on neuro-imaging. In case an underlying pathology is identified as a cause of the headache, the diagnosis of symptomatic cough headache is made. The vast majority of these patients present with a Chiari malformation type I. Other frequently reported causes include miscellaneous posterior fossa pathology, carotid or vertebrobasilar disease and cerebral aneurysms. Consequently, diagnostic neuroimaging is key in the diagnosis of cough-related headache and guides treatment. Besides primary and symptomatic cough headache, several other both primary and secondary headache disorders exist where coughing acts as a trigger or aggravator of headache symptomatology.
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Affiliation(s)
- Ann Cordenier
- Headache Clinic, Department of Neurology, Universitair Ziekenhuis Brussel, Brussel, Belgium
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12
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Lane RJM, Davies PTG. Modified Valsalva test differentiates primary from secondary cough headache. J Headache Pain 2013; 14:31. [PMID: 23565708 PMCID: PMC3639158 DOI: 10.1186/1129-2377-14-31] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 11/27/2022] Open
Abstract
Background The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. We sought to question that presumption and to determine whether the Valsalva test might distinguish primary from secondary cough headache. Methods We examined 16 consecutive cough headache patients using a modified Valsalva test (exhalation into the connecting tube of a standard anaeroid sphygmomanometer to 60 mm Hg for 10 seconds). A positive response was recorded if the manoeuvre provoked headache. All patients subsequently underwent brain MRI. Results None of the patients had neurological signs. Eleven had positive modified Valsalva tests. Ten were found subsequently to have posterior fossa pathologies (secondary cough headache: 8 Chiari Type 1 malformations, 2 posterior fossa meningiomas). The cough headache was relieved following surgery in all cases. One patient with a positive Valsalva test had an apparently normal brain MRI but measurements of hindbrain and posterior fossa dimensions were consistent with ‘posterior fossa crowdedness’. The remaining 5 patients had negative (4 patients) or equivocal (1 patient) Valsalva tests and normal MRI scans (primary cough headache). Conclusions These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. The modified Valsalva test can also determine whether tonsillar herniation found on brain MRI is symptomatic. Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation.
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13
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Toldo I, De Carlo D, Mardari R, De Palma L, Gatta M, Bolzonella B, Nosadini M, Bartolini L, Sartori S, Battistella PA. Short lasting activity-related headaches with sudden onset in children: a case-based reasoning on classification and diagnosis. J Headache Pain 2013; 14:3. [PMID: 23565626 PMCID: PMC3606961 DOI: 10.1186/1129-2377-14-3] [Citation(s) in RCA: 5] [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: 11/16/2012] [Accepted: 01/14/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Short lasting headaches related to activity or cough are rare, particularly in childhood, and can be difficult to diagnose, especially in young children who are not able to describe their symptoms. In the literature there are few data on this topic in adults and the paediatric cases reported are even more rare. FINDINGS We present the clinical history of a 7-year-old child and a 3-year-old child both diagnosed as having activity-related headaches, characterized by sudden onset of short lasting (few seconds) attacks, that were triggered by cough or exercise. There were no accompanying symptoms and the neurological examination was normal in both cases. Brain magnetic resonance imaging showed, in the first case, a cerebellar pilocytic astrocytoma and, in the second case, a Chiari 1 malformation. Both cases received an early diagnosis, were surgically treated and had a good prognosis at follow-up. CONCLUSIONS When headache has a recent onset, it presents suddenly, and it is triggered by strain, even with normal neurological examination, neuroimaging is mandatory in order to exclude secondary headaches, especially in children.
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Affiliation(s)
- Irene Toldo
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Debora De Carlo
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Rodica Mardari
- Institute of Neuroradiology, Padua Hospital, Padua, Italy
| | - Luca De Palma
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Michela Gatta
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Barbara Bolzonella
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Margherita Nosadini
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Luca Bartolini
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Stefano Sartori
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
| | - Pier Antonio Battistella
- Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Via Giustiniani, 3, 35128, Padova, Italy
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15
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Maggioni F, Baracchini C, Malvindi ML, Zanchin G. Headache secondary to an unusual Valsalva manoeuvre in a migrainous patient with cacosmia. Neurol Sci 2012; 33:103-5. [DOI: 10.1007/s10072-011-0513-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
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16
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Ozge C, Atiş S, Ozge A, Nass Duce M, Saraçoğlu M, Saritaş E. Cough headache: frequency, characteristics and the relationship with the characteristics of cough. Eur J Pain 2012; 9:383-8. [PMID: 15979018 DOI: 10.1016/j.ejpain.2004.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2003] [Accepted: 09/21/2004] [Indexed: 10/26/2022]
Abstract
Cough headache (CH) is a relatively rare, but an important complication of cough. The aim of this cross-sectional clinical study was to evaluate the frequency, characteristics and etiology of CH among the patients referred to our Outpatient Department with the complaint of cough, and to investigate the relationship between their cough and headache characteristics. We evaluated 96 females and 69 males, a total of 165 patients with cough. Among those, 57 patients (34.5%) had one or more cough complications and 32 patients (19.3%) were diagnosed as CH. Although it was known that most of the patients with CH had benign headache characteristics, the ratio of the symptomatic CH was not low (37.5% of the CH patients and 7% of patients with cough). Also, there was a significant correlation between the frequency of cough and the severity of headache. Logistic regression analysis showed that the incidence of CH was increased 0.4-fold, when frequency of cough increased. Age, sex, tobacco use ad the duration of cough were not found to be predictive factors for CH. Logistic regression analysis showed that the rate of cough complications increased 2.08-fold, when the duration of cough was longer than eight weeks (p=0.03) and 0.4-fold when the frequency of cough increased (p=0.02). In conclusion, CH is a relatively rare, but an important complication of cough and it commonly has an effective treatment available. Radiological work-up was crucial in ruling out other causes of headache and to confirm that the CH was truly benign.
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Affiliation(s)
- Cengiz Ozge
- Chest Disease, Mersin University School of Medicine, Mersin, Turkey
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17
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Evers S, Goadsby P, Jensen R, May A, Pascual J, Sixt G. Treatment of miscellaneous idiopathic headache disorders (Group 4 of the IHS classification)--report of an EFNS task force. Eur J Neurol 2011; 18:803-12. [PMID: 21435110 DOI: 10.1111/j.1468-1331.2011.03389.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Certain miscellaneous idiopathic headache disorders, which are regarded as entities, are grouped in Chapter 4 of the International Classification of Headache Disorders. Recent epidemiological research suggests that these headache disorders are underdiagnosed. OBJECTIVES To give expert recommendations for the different drug and non-drug treatment procedures of these different headache disorders based on a literature search and on consensus of an expert panel. METHODS All available medical reference systems were screened for all kinds of clinical studies on these headache disorders. The findings in these studies were evaluated according to the recommendations of the EFNS resulting in level A, B or C recommendations and good practice points. RECOMMENDATIONS For all headache disorders, acute and prophylactic drug treatment is recommended based on case series and on expert consensus. Furthermore, recommendations for the differential diagnoses are given because these headache disorders can also present with a symptomatic form. The most effective drug for the majority of these headache disorders is indomethacin, mostly applied as long-term or short-term prophylaxis.
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Affiliation(s)
- S Evers
- Department of Neurology, University of Münster, Münster, Germany.
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18
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Pascual J, González-Mandly A, Oterino A, Martín R. Primary cough headache, primary exertional headache, and primary headache associated with sexual activity. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:459-68. [PMID: 20816446 DOI: 10.1016/s0072-9752(10)97040-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Activity-related headaches can be brought on by Valsalva maneuvers ("cough headache"), prolonged exercise ("exertional headache"), and sexual excitation ("orgasmic headache"). These headaches account for 1-2% of the consultations due to headache in a general neurological department. These entities are a challenging diagnostic problem as they can be primary or secondary and as their etiologies differ depending on the headache type. About 50% of patients with cough headache will show no demonstrable etiology, while the other half will be secondary to structural lesions, mostly a Chiari type I malformation at the foramen magnum level. As compared to the primary variety, secondary cough headache begins earlier (average 40 versus 60 years), is located posteriorly, lasts longer (years versus months), is associated with posterior fossa symptoms/signs, and does not respond to indomethacin. Patients with secondary cough headache show difficulties in cerebrospinal fluid circulation in the foramen magnum region in dynamic magnetic resonance imaging studies and preoperative plateau waves, which disappear after posterior fossa reconstruction. Headaches provoked by physical exercise and sexual headache have many points in common. In contrast to cough headache, secondary cases are rare, and sentinel subarachnoid bleeding is the most frequent etiology. The mean age at onset for primary headaches provoked by physical exercise and sexual activity is similar (40 years); they share clinical characteristics (bilateral, pulsating) and respond to beta-blockers. In conclusion, provoked headaches account for a low proportion of headache consultations. Cough headache is a different condition when compared to headache due to physical exercise and sexual activity, which are clinical variants of the same entity.
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Affiliation(s)
- Julio Pascual
- Service of Neurology, University Hospital "Central de Asturias", Oviedo, Spain.
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Abstract
OBJECTIVE To examine the long-term effects of suboccipito-cervical decompression on an intention-to-treat basis in patients with Chiari I malformation (CMI). PATIENTS AND METHODS Twenty-four consecutive patients, 14 females and 10 males with a median age of 26 years, underwent decompressive surgery for CMI during 1998-2006. All patients were contacted by an independent examiner and asked to complete a questionnaire regarding headache, other neurological symptoms and negative impact of the disease on the daily life before and after surgery. The median follow-up time after surgery was 3.2 years (range 1.7-9.2 years). Twenty-three patients (96%) completed the questionnaire. RESULTS On an intention-to-treat basis there was an improvement in headache in 75%, decreased associated neurological symptoms in 88% and less negative impact on daily life in 75% of the 24-operated patients. CONCLUSIONS More than three-quarters of the patients still considered their situation improved at long-term follow-up after surgery. These results support surgical intervention in symptomatic Chiari I patients.
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Affiliation(s)
- M Tisell
- Hydrocephalus Unit, Institute of Clinical Neuroscience, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Abstract
To delineate the differences in clinical characteristics and evaluate the outcome between primary and secondary cough headache, 83 consecutive patients (59M/ 24F, mean age 61.5 ± 17.7 years) with cough headache (1.2%) out of 7100 patients in a headache clinic were studied. All of them received brain imaging studies. Most did not have relevant brain lesions ( n = 74, 89.2%, primary group) except for nine patients (10.8%, the secondary group). Most of the intracranial lesions were located in the posterior fossa ( n = 6, 67%), including only two patients with Chiari malformation. The primary group had a higher response rate to indomethacin than the secondary group (72.7% vs. 37.5 %, P = 0.046). Mild to moderate headache intensity and age onset < 50 years predicted a favourable response. At a mean follow-up of 51.4 months, 83.9% of patients with primary cough headache completely remitted. Inconsistent with the proposed International Classification of Headache Disorders, 2nd edn criteria, 10.8% of patients with primary cough headache had headache duration of > 30 min. Clinical features, neurological examinations and drug response could not safely differentiate primary from secondary cough headache. Neuroimaging studies are required in each patient.
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Affiliation(s)
- P-K Chen
- Department of Neurology, Lin-Shin Hospital, Central Taiwan University of Science and Technology, Taichung
- Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung
| | - J-L Fuh
- National Yang-Ming University School of Medicine
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - S-J Wang
- National Yang-Ming University School of Medicine
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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21
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Abstract
This article reviews "other primary headaches," a classification of the International Headache Society that includes primary stabbing headaches, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, and new daily persistent headache. Clinicians should be aware that these headaches may be symptomatic to structural lesions and therefore usually require careful neuroimaging evaluation.
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Affiliation(s)
- Julio Pascual
- Service of Neurology, University Hospital Marqués de Valdecilla, 39008 Santander, Spain.
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22
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Kim YI, Lee SJ, Lee KS, Park JW, Kim JS. Recurrent thunderclap headache triggered by singing. Eur J Neurol 2008; 15:e116-7. [DOI: 10.1111/j.1468-1331.2008.02350.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Oh K, Kim BJ, Cho SC, Park KW, Lee DH. Concurrent paroxysmal cough and short-lasting hemicrania. Cephalalgia 2007; 27:955-7. [PMID: 17645759 DOI: 10.1111/j.1468-2982.2007.01355.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kyungmi Oh
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
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24
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Abstract
Primary cough headache is defined as head pain brought on by coughing or other Valsalva maneuvers, but not by prolonged physical exercise, in the absence of any intracranial disorder. Primary cough headache is considered to be a rare condition, accounting for 0.4% of all headaches consulting our Neurology Department. Its pathophysiology remains a mystery. Primary cough headache is a sudden-onset headache that usually lasts from 1 second to 30 minutes, tends to be bilateral and posterior, does not begin earlier than the fifth decade of life, is more frequent in men, is not accompanied by other neurologic manifestations, and responds to indomethacin. These clinical characteristics allow its differential diagnosis from other entities, even though a craniocervical magnetic resonance imaging study is mandatory to rule out posterior fossa lesions, especially Chiari type-I malformation.
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Affiliation(s)
- Julio Pascual
- Service of Neurology, University Hospital Marqués de Valdecilla, 39008 Santander, Spain.
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25
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Eidlitz-Markus T, Zeharia A. Bordetella pertussis as a trigger of migraine without aura. Pediatr Neurol 2005; 33:283-4. [PMID: 16194729 DOI: 10.1016/j.pediatrneurol.2005.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2005] [Revised: 03/12/2005] [Accepted: 04/25/2005] [Indexed: 10/25/2022]
Abstract
This report describes a 10-year-old child in whom the clinical and serologic appearance of pertussis coincided with new-onset migraine without aura. The child's mother, who had a history of migraine, also complained of exacerbation of symptoms and was found to be positive for Bordetella pertussis. The migraine improved in both mother and child concomitant with the clinical improvement of symptoms of the pertussis infection. The possible molecular basis of pertussis as a trigger for migraine is discussed.
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Affiliation(s)
- Tal Eidlitz-Markus
- Day Hospitalization Unit, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel
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26
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Bono F, Giliberto C, Lavano A, Quattrone A. Posture-related cough headache and orthostatic drop in lumbar CSF pressure. J Neurol 2005; 252:237-8. [PMID: 15729536 DOI: 10.1007/s00415-005-0623-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Revised: 07/22/2004] [Accepted: 08/02/2004] [Indexed: 10/25/2022]
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