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The prevalence and the
clinical features of chronic daily
headache (CDH) were studied in
968 children and adolescents
observed during a period of one
year in the Headache Centre of the
Anna Meyer Paediatric Hospital of
Florence. Nine hundred and fortyfour
patients (97.52%) had primary
headache according to ICHD-II, 24
subjects had secondary headache
and 56 patients had CDH (5.93%
of primary headaches). The mean
age of subjects with CDH was
higher than general (13.5 vs. 11.5
years), with a female preponderance
(69.6% vs. 30.4%). According
to the ICHD-II, headaches were
classified as chronic migraine in 10
patients (1.5.2 ICHD-II), chronic
tension-type headache in 36 (2.3
ICHD-II), new daily persistent
headache in 8 (4.8 ICHD-II) and 2
patients reported mixed pattern
(chronic migraine+chronic tension
type headache). Medication
overuse was not implicated in our
patients. 相似文献
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LE Inan F Cankat Tulunay A Guvener G Tokgoz N Inan 《Cephalalgia : an international journal of headache》1994,14(2):171-173
We evaluated the characteristics of headache in migraine without aura and episodic tension-type headache diagnosed according to the International Headache Society (IHS) Classification. Fifty migraine without aura and 50 tension-type headache patients were selected prospectively. Fifty-eight percent of migraineurs had pain of a pulsating quality; 88% had severe pain and 74% had unilateral pain; aggravation by routine physical activity was reported by 96%. Episodic tension-type headache was of a pressing quality in 52%, moderate in 40%, bilateral in 82% and aggravated by routine physical activity in 16%. Nausea and/or vomiting, photophobia and phonophobia were reported significantly more commonly in migraineurs than tension-type headache patients. 相似文献
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Tansel Terzi Ba?ak Karakurum Serap ü?ler Levent E. ?nan Cankat Tulunay 《The journal of headache and pain》2002,3(3):137-141
The blockade of the greater occipital nerve (GON) has been used in the treatment of migraine without aura (MWOA), tension-type
headache (TTH) and cervicogenic headache (CH). There have been only a few reports about the effectiveness of the GON blockade
in patients with MWOA and TTH and it has not yet been clarified whether or not it is a diagnostic tool for CH. In this study,
we therefore investigated the diagnostic value of GON blockade in patients with CH, MWOA and TTH. Sixty patients who were
affected by TTH, MWOA and CH participated in the study. They were divided into three main groups, each of which consisted
of 20 patients with TTH, MWOA and CH respectively. Each group was then divided into two sub-groups with 10 patients, ten of
whom were injected with 1 ml 2% prilocaine, and the other ten with 1 ml physiological saline (PS). Our results showed that
GON blockade reduced pain in the orbitofrontal (OF) and orbitonuchal (ON) areas in patients with CH. In MWOA and TTH patients,
GON blockade reduced pain only in the ON area. In the light of these findings, we may conclude that GON blockade is a diagnostic
tool if it is effective in the ON and OF areas.
Received: 31 January 2002, Accepted in revised form: 2 July 2002
Correspondence to B. Karakurum 相似文献
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Eva Martínez-Fernández Roman Alberca Pablo Mir Emilio Franco Enrique Montes Pilar Lozano 《The journal of headache and pain》2002,3(2):105-110
The objective of our study is to report the frequency and characteristics of cluster headache with aura among the population
of patients with cluster headache treated in our outpatient neurology clinic. 254 patients were submitted to semi-structured
interviews to identify the presence of symptoms similar to the migraine aura. 5 patients who suffered from a cluster headache
with aura filled a diary with the characteristics of the pain attacks and the aura. All the patients with either episodic
or chronic cluster headache were studied. The pain attacks were associated with symptoms similar to the migraine aura in five
patients (2%). These disorders were usually ipsilateral to the pain and consisted of paresthesias of the trigeminal territory,
clumsiness of the limbs or visual disturbances. Neither paresis nor hypoesthesia could be proved by clinical examination during
the attack. We propose to reserve the name of cluster headache with aura to these cases that show similar symptomatology to
the migraine aura. These manifestations suggest the participation of the central nervous system in this type of cluster headache.
Received: 16 July 2001, Accepted in revised form: 4 December 2001
Correspondence to E. Martínez-Fernández 相似文献
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Katsarava Z Muessig M Dzagnidze A Fritsche G Diener HC Limmroth V 《Cephalalgia : an international journal of headache》2005,25(1):12-15
We present a prospective 4-year follow-up study of 96 patients with medication overuse headache following withdrawal. Complete datasets were available from 85 patients (89%) 6 months, from 79 patients (82%) 1 year and from 75 patients (78%) 4 years after withdrawal. Twenty-six patients (31%) relapsed within the first 6 months after withdrawal. The number of relapses increased to 32 (41%) 1 year and to 34 (45%) 4 years after withdrawal. The 4-year relapse rate was lower in migraine than in tension-type headache (32% vs. 91%, P相似文献
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Tfelt-Hansen P 《The journal of headache and pain》2007,8(2):127-134
Abstract In most migraine patients acute therapy is needed. Migraine can be treated either with specific drugs, the triptans and ergot
alkaloids, or with NSAIDs. Triptans are a major step foreward in migraine therapy. The therapeutic gain for headache relief
is 50% for subcutaneous sumatriptan whereas it is 30-40% for most oral triptans. After oral triptans sustained pain free is
only 30%. There is thus still ample room for improvement of acute therapy in migraine. For tension-type headache there is
no specific therapy and it is treated with NSAIDs. Only 17-32% become pain free after these drugs. For attacks of cluster
headache oxygen and subcutaneous sumatriptan can be used. Intranasal triptans can be an alternative. 相似文献
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We present the results of a community survey based on the diagnostic criteria of the International Headache Society (IHS) describing headache prevalence and symptomatology in the Singapore population. A questionnaire administered by trained personnel was completed by 2096 individuals from a randomized sample of 1400 households. The overall lifetime prevalence of headache was 82.7%. The migraine prevalence was 2.4% in males and 3.6% in females; for episodic tension-type headache and chronic tension-type headache the corresponding figures were 11.1%/11.8% and 0.9%/1.8%, respectively. Inclusion of borderline cases (IHS codes 1.7 and 2.3) resulted in prevalences of 9.3% for migraine, 39.9% for episodic tension headache and 2.4% for chronic tension headache. Headaches described by 31.2% of the respondents were unclassifiable. The different premonitory symptoms, precipitants and aggravating factors in migraine and tension-type headache in our study population suggest that they represent two distinct syndromes rather than opposite ends of a clinical spectrum. 相似文献
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MMPI personality profiles were obtained from three clinical groups (n = 79). One group consisted of men and women with chronic muscle pain (MP; n = 34), a second group of male and female chronic tension headache patients (TH; n = 12), and a third group of female migraine patients (M; n = 33). The M group was subdivided on the basis of source of referral and into groups of classic versus common migraine. Elevation of the MMPI subscales usually interpreted as neuroticism scales were found in all groups. A "psychosomatic V" pattern was found on these scales in the M group but not in female TH patients. The difference in scale configuration between groups was caused primarily by different elevations on the depression scale. A relationship between severity of headache and elevation of the "psychosomatic V" was found in migraine patients. Male MP and TH patients showed a descending slope on the neuroticism scales, not observed in females. There was a tendency for common migraine patients to show a more elevated and psychosomatic configuration on the MMPI, as compared with classic migraine patients. 相似文献
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Alessandra Zicari Mario Giacovazzo Paolo Martelletti 《The journal of headache and pain》2001,2(2):67-72
The involvement of nitric oxide (NO) in the pathophysiology of primary headaches was suggested by several authors during
the last decade. Migraine, cluster headache, tension headache, and cervicogenic headache have been extensively studied on
the basis of NO donor headache pain. Different mechanisms seem to be involved in the generation of pain in these clearly different
clinical head pain disorders. NO could control all the mechanisms leading to head pain. In migraine NO is correlated with
endothelial activation, in cluster headache with a brainstem unravelling of the on/off regulatory clocks, in cervicogenic
headache with a cytokine-dependent pain, and in tension-type headache with a sensitization of pain pathways at the spinal/trigeminal
level. The next natural frontier in the study of pain in primary headaches seems to be the functional study of the relationship
between NO and the immune regulatory system.
Received: 30 Devember 2000 / Accepted in revised form: 9 April 2001 相似文献
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Ravi Gupta Vivek Kumar Kalpana Luthra Basudeb Banerjee Manjeet Singh Bhatia 《The journal of headache and pain》2009,10(2):115-120
Nitric oxide plays an important role in the pathogenesis of migraine as well as tension-type headache. Studies suggest that
the expression of molecules involved in the pathogenesis of headache, i.e., nitric oxide and interleukin, is influenced by
apolipoprotein E (APOE) and is gene specific. Hence, we hypothesized that APOE polymorphism may be associated with migraine
as well as tension-type headache.The study sample comprised of three groups: migraineurs, tension-type headache subjects as
well as a healthy control group. A total of 50 subjects in each group were included after screening for the inclusion and
exclusion criteria. None of the subjects was a blood relative of any other subject included in the present study. Their venous
blood was drawn and stored at −20°C. Genomic DNA extraction was performed with a commercial kit and simple sequence-specific
primer PCR was performed to assess the APOE polymorphism. Data were analyzed with the help of SPSS V11.0 for Windows. χ2 test and logistic regression analysis were run. The results of the study showed that APOE ε2 gene increases the risk of migraine
as compared to the control group and the tension-type headache group (OR = 4.85; 95% CI = 1.92–12.72; P < 0.001 and OR = 2.31; 95% CI = 1.08–4.94; P = 0.01, respectively). Interestingly, APOE ε4 gene was protective against migraine as well as tension-type headache. This
study shows that APOE ε2 gene increases the risk of migraine, while APOE ε4 gene is protective against migraine and tension-type
headache. Further research is required to confirm the findings of the present study in a larger sample and to elucidate the
role of APOE polymorphism in headache. 相似文献
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A 39-year-old woman experienced recurrent, severe bursting headache which was abruptly developed at the time of orgasm. Both magnetic resonance angiography and conventional angiogram of the brain confirmed dissecting aneurysm of the basilar artery. After the neuroradiological intervention using a stent was performed, she has been totally free of the orgasmic headache during the follow-up period for about one year. 相似文献
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Savarese M Guazzelli M Prudenzano MP Carnicelli M Rossi M Cardinali V Genco S Lamberti P Livrea P 《The journal of headache and pain》2005,6(4):231-233
The presence of significant
and confounding psychiatric
comorbidity is greater in patients
attending headache clinics than in
headache patients from the general
population. The frequent comorbidity
of headache with generalized
anxiety disorder can take advantage
of the administration of benzodiazepines.
With regard to depression–related headache, it’s wellknown
that the antidepressive drugs
can improve migraine as well as
tension–type headache.
Antiepileptic drugs give one more
good opportunity. The recognition
of a psychiatric comorbidity is
mandatory for an accurate management
of the patient beacause prevents
the clinicians from using any
drug that might be dangerous for a
mysdiagnosed psychiatric disturbance
and often permits to administer
medications that can efficaciously
control both headache and
psychiatric disorders. 相似文献
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Russell MB 《The journal of headache and pain》2007,8(2):71-76
Abstract
The objective of this study was to investigate the importance of genetics in tension-type headache. A MEDLINE search from
1966 to December 2006 was performed for “tension-type headache and prevalence” and “tension-type headache and genetics”. The
prevalence of tensiontype headache varies from 11 to 93%, with a slight female preponderance. Co-occurrence of migraine increases
the frequency of tension-type headache. A family study of chronic tension-type headache suggests that genetic factors are
important. A twin study analysing tension-type headache in migraineurs found that genetic factors play a minor role in episodic
tension-type headache. Another twin study analysing twin pairs without co-occurrence of migraine showed a significantly higher
concordance rate among monozygotic than same-gender dizygotic twin pairs with no or frequent episodic tension-type headache,
while the difference was minor in twin pairs with infrequent episodic tensiontype headache. Frequent episodic and chronic
tension-type headache is caused by a combination of genetic and environmental factors, while infrequent episodic tensiontype
headache is caused primarily by environmental factors.
1 This is a “Springer Open Choice” article. Unrestricted non-commercial use, distribution, and reproduction in any medium
is permitted, provided the original author and source are credited. 相似文献
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《Disability and rehabilitation》2013,35(7):611-618
Purpose: To review the pacing literature; describe the use of pacing in a specialty headache clinic; and provide client feedback regarding the effectiveness of pacing in headache self-management. Method: The evidence for this report was derived from a structured literature review, an established pacing intervention program for patients with headache, and patient self-report questionnaire. Results: There are frequent references to pacing in the chronic pain and rheumatic disease literature, but no universal definition and, until recently, few outcome studies. References to pacing in the headache literature are limited. For a small sub-group of clients at a specialty headache clinic (n?=?20), pacing principles taught by occupational therapists were reported to prevent increases in headache intensity (70%); decrease headache intensity (65%), and shorten the duration of a headache (40%). Additionally, 70% of respondents used pacing to prevent headache onset. Pacing was seen to contribute to increased quality of life, headache self-efficacy, function, and independence. There were a variety of opinions regarding the most helpful pacing components. The most frequently endorsed were identify and prioritize responsibilities; balance activity and rest; schedule regular rest breaks; and delegate or eliminate tasks. Conclusions: Pacing appears to play an important role in headache self-management. More pacing research is required in both headache and chronic pain populations. 相似文献
Migraine and tension-type headaches are associated with significant pain and disability.
Overexertion and stress are commonly reported headache triggers.
Activity pacing allows individuals with migraine and tension-type headache to self-regulate tasks and activities so they may manage physical exertion and mental stress levels.
Pacing may help decrease headache intensity and duration, as well as increase quality of life, function, and self-efficacy.
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Prudenzano MP Monetti C Merico L Cardinali V Genco S Lamberti P Livrea P 《The journal of headache and pain》2005,6(4):220-222
Literature data concerning
the comorbidity of migraine
and hypertension are conflicting
and lacking in consistency [1–4].
This study was designed to evaluate
the distribution of hypertension
in a sample of migraineurs in comparison
with a group of tensiontype
headache (TTH) patients.
Hypertension prevalence was more
elevated in headache sufferers than
in the general population. This
finding might be due to a
Berkson’s bias; in fact individuals
seeking medical care often show a
high rate of association between
two medical conditions which may
be independent in the general population
[5]. The highest hypertension
prevalence was found in
patients with TTH, supporting the
hypothesis that this type of
headache might be based upon
vascular mechanisms [6]. 相似文献
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The syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) now referred to
in the IHS ICHD–II code 7.8, is only infrequently accompanied by a confusional state and severe agitation. We report the case
of a 34–year–old man who suffered from three episodes of headache with transient focal neurological deficits that were consistent
with HaNDL but that were accompanied by an intense, confusional agitated state that required admission, in the first episode,
in a psychiatric unit. 相似文献