A Headache Clinic's Experience: Diamond Headache Clinic, Ltd.

Objectives: To study the clinical profiles, imaging findings and outcomes and field test the diagnostic criteria proposed by the International Classification of Headache Disorders, 2nd edition (ICHD-II) in patients with headache associated with sexual activity (HSA). Methods: We recruited 30 patients (16 men, 14 women, mean age at onset 40.2 ± 10.0 years) with headache associated with sexual activity at a headache clinic from 2004 to 2009. None of the patients had neurological deficits at onset. Results: Twenty patients (67%) had secondary causes, including one subarachnoid hemorrhage, one basilar artery dissection, and 18 cases reversible cerebral vasoconstriction syndrome (RCVS). Ten patients (33%) had primary HSA. The demographics, headache profiles, drug response and clinical course were similar between primary and secondary HSA. Compared to prior studies done in Western societies, our patients had similar clinical features but with a higher ratio of females (50%) and a higher frequency of chronic course (39%). Discussion: Sixty-seven percent of patients with RCVS could not fulfill the criteria of reversible angiopathy of the central nervous system (Code 6.7.3) proposed by the ICHD-II. The most common reason was headache resolution in more than two months. In addition, 40% of patients with primary HSA could not fulfill the ICHD-II criteria for primary HSA (Code 4.4). Conclusions: Our study found that intracranial vascular disorders were very common in patients with HSA. Thorough neurovascular imaging is required for all patients with HSA.

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History of Headache Research in Denmark

Cephalalgia ◽

10.1177/033310240102100702 ◽

2001 ◽

Vol 21 (7) ◽

pp. 748-752 ◽

Cited By ~ 1

Author(s):

P Tfelt-Hansen

Keyword(s):

Migraine With Aura ◽

Tension Type Headache ◽

Regional Cerebral Blood ◽

Danish Population ◽

Genetic Studies ◽

History Of ◽

Headache Clinic ◽

Type Headache ◽

Acute Headache ◽

First Time

Headache research in Denmark started with the description in 1949 by Dalsgaard-Nielsen of the percutaneous nitroglycerin test. In 1976 Jes Olesen started The Copenhagen Acute Headache Clinic and from that time modern headache research began in Denmark. Specific changes in regional cerebral blood flow during attacks of migraine with aura, spreading oligaemia, were described for the first time in 1980. The first headache classification with operational diagnostic criteria was published in 1988 and used in a Danish population study from 1989. The lifetime prevalence of migraine was 8% in men and 25% in women. An intravenous nitroglycerin test was introduced in 1989 and has been developed as an experimental headache model. In 1993 it was suggested by Jes Olesen et al. that NO supersensitivity could be a possible molecular mechanism of migraine pain. Recent genetic studies have supported the distinction between migraine with aura and migraine without aura. From the middle of the 1980s the pathophysiology of tension-type headache has been investigated and recent results indicate central sensitization in patients with chronic tension-type headache.

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Multidisciplinary Headache Clinic-Impact of a new model for headache care in Dubai

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2021.106845 ◽

2021 ◽

pp. 106845

Author(s):

Maria Khan ◽

Abubaker Al Madani ◽

Samah Habboush ◽

Manal Abdulla ◽

Ayesha K Al Basti ◽

...

Keyword(s):

New Model ◽

Headache Clinic ◽

Headache Care

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High rates of (treated) hypothyroidism among chronic migraine patients consulting a specialized headache clinic: are we missing something?

Neurological Sciences ◽

10.1007/s10072-021-05424-7 ◽

2021 ◽

Author(s):

Marcelo Filipchuk ◽

Jesica Gassmann ◽

Tatiana Castro Zamparella ◽

Maria Cecilia Tibaldo ◽

Mariela Carpinella ◽

...

Keyword(s):

Chronic Migraine ◽

Headache Clinic

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G327(P) Characteristics and outcome of headaches in children from a tertiary care headache clinic

10.1136/archdischild-2018-rcpch.317 ◽

2018 ◽

Author(s):

A Michael ◽

K Vraka ◽

A Ponnampalam ◽

W Whitehouse

Keyword(s):

Tertiary Care ◽

Headache Clinic

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Longitudinal changes in cerebral blood flow velocities in different clinical courses of migraine

Cephalalgia ◽

10.1177/0333102416658715 ◽

2016 ◽

Vol 37 (10) ◽

pp. 927-937 ◽

Cited By ~ 5

Author(s):

Mi Ji Lee ◽

Min Kyung Chu ◽

Hanna Choi ◽

Hyun Ah Choi ◽

Chungbin Lee ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Clinical Course ◽

Episodic Migraine ◽

Longitudinal Changes ◽

Blood Flow Velocities ◽

Headache Clinic ◽

Flow Velocities

Objective To assess longitudinal changes in cerebral blood flow velocities (ΔCBFVs) according to the clinical course of migraine. Methods We retrospectively included migraine patients with two or more attacks per month at baseline who were followed up within 2 years with transcranial Doppler in a tertiary headache clinic. ΔCBFVs were analyzed in relation to clinical courses, defined as remission (0–1 headache days/month), persistence (2–14/month), or progression (≥15/month) in episodic migraine (EM), and conversion to EM (<15/month) and persistence (≥15/month) in chronic migraine (CM). Results A total of 166 patients (90 EM and 76 CM) were included. In EM, the remission group ( n = 30) showed a decrease in CBFV in the middle cerebral artery (MCA) and the basilar artery (BA). The progression group ( n = 10) showed increasing CBFVs in the bilateral MCAs. Patients with the persistence course ( n = 50) showed generally unchanged CBFVs. In CM, ΔCBFVs decreased in the BA and increased in the posterior cerebral artery (PCA) after conversion to EM ( n = 61), whereas they remained unchanged in the persistence group ( n = 15). In all patients, % change in headache days was positively correlated with the %ΔCBFVs of the bilateral MCAs and the BA. Conclusions CBFV changes are associated with the different clinical courses of migraine. The association is more prominent in EM than CM.

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New Daily Persistent Headache in a Pediatric Population

Journal of Child Neurology ◽

10.1177/08830738211004514 ◽

2021 ◽

pp. 088307382110045

Author(s):

Eric Strong ◽

Emily Linda Pierce ◽

Raquel Langdon ◽

Jeffery Strelzik ◽

William McClintock ◽

...

Keyword(s):

Pediatric Patients ◽

Medication Overuse ◽

Pediatric Population ◽

Medication Overuse Headache ◽

Activity Level ◽

New Daily Persistent Headache ◽

Tertiary Referral Center ◽

Preventive Medication ◽

Headache Clinic ◽

Persistent Headache

Introduction: New daily persistent headache (NDPH) is a primary headache disorder characterized by an intractable, daily, and unremitting headache lasting for at least 3 months. Currently, there are limited studies in the pediatric population describing the characteristics of NDPH. Objective: The objective of the current study is to describe the characteristics of NDPH in pediatric patients presenting to a headache program at a tertiary referral center. Methods: The participants in the current study were pediatric patients who attended the Headache Clinic at Children’s National Hospital between 2016 and 2018. All patients seen in the Headache Clinic were enrolled in an institutional review board–approved patient registry. Results: Between 2016 and 2018, NDPH was diagnosed in 245 patients, representing 14% of the total headache population. NDPH patients were predominantly female (78%) and white (72%). The median age was 14.8 years. The median pain intensity was 6 of 10 (standard deviation = 1.52). Most patients reported experiencing migrainous features, namely, photophobia (85%), phonophobia (85%), and a reduced activity level (88%). Overall, 33% of patients had failed at least 1 preventive medication, and 56% had failed at least 1 abortive medication. Furthermore, 36% of patients were additionally diagnosed with medication overuse headache. Conclusion: NDPH is a relatively frequent disorder among pediatric chronic headache patients. The vast majority of these patients experience migrainous headache characteristics and associated symptoms and are highly refractory to treatment—as evidenced by a strong predisposition to medication overuse headache and high rates of failed preventive management.

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Comparison of Thrombocyte Count Between Pediatric Patients With Migraine or Tension-Type Headache: A Retrospective Cohort Study

Journal of Child Neurology ◽

10.1177/0883073819862738 ◽

2019 ◽

Vol 34 (13) ◽

pp. 824-829 ◽

Cited By ~ 1

Author(s):

Aviv Benedick ◽

Avraham Zeharia ◽

Tal Eidlitz Markus

Keyword(s):

Negative Correlation ◽

Pediatric Patients ◽

Tension Type Headache ◽

Thrombocyte Count ◽

Laboratory Parameters ◽

Pediatric Headache ◽

Increased Risk ◽

Migraine Group ◽

Headache Clinic ◽

Type Headache

Hypercoagulability may explain the increased risk of thromboembolic cerebrovascular events in patients with migraine. Thrombocytes play a crucial part in the coagulation process, and some studies have demonstrated hyperaggregation of thrombocytes in adult migraineurs. We aimed to compare thrombocyte count between pediatric patients with migraine or tension-type headache and to evaluate the correlation of thrombocyte count with headache parameters. The electronic database of a tertiary pediatric headache clinic was retrospectively searched for all children and adolescents diagnosed with migraine or tension-type headache in 2016-2018. Data on thrombocyte counts were collected from the medical files and compared between the groups by parametric and nonparametric statistical tests. The cohort included 299 patients, 176 girls (59.0%) and 123 (412.0%) boys, of mean age 12.2 ± 3.4 years; 198 had migraine and 101 had tension-type headache. Among the laboratory parameters evaluated, a significantly lower mean thrombocyte number was found in the migraine group than in the tension-type headache group (282 ± 60 vs 304±71 ×103/μL, P = .004). Within the migraine group, there was a significant negative correlation between the thrombocyte count and the duration of headache attacks in hours ( P < .05). No significant between- or within-group differences were found in other laboratory parameters. The low relative thrombocyte count in pediatric headache clinic patients with migraine and its negative correlation with duration of migraine suggest that migraine may be associated with a different underlying pathogenesis from tension-type headache.

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