scholarly journals Diagnosis of primary headache in children younger than 6 years: A clinical challenge

Cephalalgia ◽  
2016 ◽  
Vol 37 (10) ◽  
pp. 947-954 ◽  
Author(s):  
Roberto Torriero ◽  
Alessandro Capuano ◽  
Rosanna Mariani ◽  
Roberto Frusciante ◽  
Samuela Tarantino ◽  
...  
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Preschool Age ◽  
Clinical Feature ◽  
Primary Headaches ◽  
Clinical Challenge ◽  
Adults And Children ◽  
Type Headache

Background Criteria defined by the International headache Society are commonly used for the diagnosis of the different headache types in both adults and children. However, some authors have stressed some limits of these criteria when applied to preschool age. Objective Our study aimed to describe the characteristics of primary headaches in children younger than 6 years and investigate how often the International Classification of Headache Disorders (ICHD) criteria allow a definitive diagnosis. Methods This retrospective study analysed the clinical feature of 368 children younger than 6 years with primary headache. Results We found that in our patients the percentage of undefined diagnosis was high when either the ICHD-II or the ICHD-III criteria were used. More than 70% of our children showed a duration of their attacks shorter than 1 hour. The absence of photophobia/phonophobia and nausea/vomiting significantly correlate with tension-type headache (TTH) and probable TTH. The number of first-degree relatives with migraine was positively correlated to the diagnosis of migraine in the patients ( p < 0.001). Conclusions Our study showed that the ICHD-III criteria are difficult to use in children younger than 6 years. The problem is not solved by the reduction of the lowest duration limit for the diagnosis of migraine to 1 hour, as was done in the ICHD-II.

Diagnosis and Clinical Management of Headaches

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 32-37
Author(s):  
Daniel P. Greenfield ◽  
Subramanian Hariharan
Keyword(s):  
Clinical Management ◽  
International Headache Society ◽  
Brain Lesion ◽  
Pain Syndrome ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Primary Headache Disorders ◽  
Primary Disorder ◽  
Type Headache

AbstractIn this article, we will first present an overview of the epidemiology and classification of headaches, distinguishing between primary headaches (in which the headache itself is the primary disorder) and secondary headaches (ie, headaches due to an underlying condition, such as a neoplastic and/or space-occupying lesion, a cerebrovascular accident, or other type of structural brain lesion). We will use the current classification system of the International Headache Society, focusing on primary headache disorders (migraine, tension-type headache, cluster headache), which we will discuss from the practical clinical perspectives of diagnosis and clinical management. Throughout this article, we will emphasize the chronicity and periodicity of headaches as a type of chronic pain syndrome.

scholarly journals Alcohol-induced headaches: Evidence for a central mechanism?

2016 ◽  
Vol 07 (02) ◽  
pp. 269-275 ◽  
Author(s):  
Alessandro Panconesi
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Familial Hemiplegic Migraine ◽  
Tension Type Headache ◽  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
Primary Headaches ◽  
Study Approach ◽  
Type Headache ◽  
International Headache Society Classification

ABSTRACTAlcoholic drinks (ADs) have been reported as a migraine trigger in about one-third of the migraine patients in retrospective studies. Some studies found that ADs trigger also other primary headaches. The studies concerning the role of ADs in triggering various types of primary headaches published after the International Headache Society classification criteria of 1988 were reviewed, and the pathophysiological mechanisms were discussed. Many studies show that ADs are a trigger of migraine without aura (MO), migraine with aura (MA), cluster headache (CH), and tension-type headache (TH). While data on MO and CH are well delineated, those in MA and TH are discordant. There are sparse reports that ADs are also triggers of less frequent types of primary headache such as familial hemiplegic migraine, hemicrania continua, and paroxysmal hemicrania. However, in some countries, the occurrence of alcohol as headache trigger is negligible, perhaps determined by alcohol habits. The frequency estimates vary widely based on the study approach and population. In fact, prospective studies report a limited importance of ADs as migraine trigger. If ADs are capable of triggering practically all primary headaches, they should act at a common pathogenetic level. The mechanisms of alcohol-provoking headache were discussed in relationship to the principal pathogenetic theories of primary headaches. The conclusion was that vasodilatation is hardly compatible with ADs trigger activity of all primary headaches and a common pathogenetic mechanism at cortical, or more likely at subcortical/brainstem, level is more plausible.

Prevalence of Primary Headaches in People with Multiple Sclerosis

Cephalalgia ◽  
2004 ◽  
Vol 24 (11) ◽  
pp. 980-984 ◽  
Author(s):  
D D'Amico ◽  
L La Mantia ◽  
A Rigamonti ◽  
S Usai ◽  
N Mascoli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Exact Test ◽  
Relapsing Remitting ◽  
Type Headache ◽  
Ms Therapy

The aim was to investigate the lifetime prevalence of headache and primary headache (diagnoses according to International Headache Society criteria) in multiple sclerosis (MS). The relationships between headache and clinical features of MS and MS therapy were also investigated. We studied 137 patients with clinically definite MS; 88 reported headache, 21 of whom developed headache after the initiation of interferon. The prevalence of all headaches in the remaining 116 patients was 57.7%. Migraine was found in 25.0%, tension-type headache in 31.9%, and cluster headache in one patient. A significant correlation ( P = 0.007, Fisher's exact test) between migraine and relapsing-remitting MS was found. Primary headaches are common in MS patients. Further studies are needed to clarify the mechanisms underlying this association, particularly the association between migraine and relapsing-remitting MS, and the role of interferon in the development of new headache.

Clinical Features of Primary Headache in Children: A Multicentre Hospital-Based Study in France

Cephalalgia ◽  
2008 ◽  
Vol 28 (11) ◽  
pp. 1145-1153 ◽  
Author(s):  
J-C Cuvellier ◽  
A Donnet ◽  
È Guégan-Massardier ◽  
F Nachit-Ouinekh ◽  
D Parain ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Single Type ◽  
Primary Headaches ◽  
Diagnostic Categories ◽  
Prospective Multicentre Study ◽  
Probable Migraine ◽  
Type Headache

The aim of this study was to evaluate the concordance between clinical diagnosis and the International Classification of Headache Disorders, 2nd edn (ICHD-II) in children and adolescents with primary headaches. This 6-month prospective multicentre study of 486 patients (mean 9.8 ± 3.1 years; 52.6± girls) assessed the headache features through a structured questionnaire. In 398 patients with a single type of headache, headaches were bilateral (78.1±), frontal (62.4±), pulsatile (56.1±), with associated symptoms in 84.4±. The most frequently assigned diagnoses were migraine without aura (50.8±), probable migraine (14.1±), migraine with aura (11.1±) and frequent episodic tension-type headache (7.5±). For most of the diagnostic categories, the consistency of the investigator's diagnosis with the ICHD-II criteria was good (K > 0.6 and ≤ 0.8) or excellent (K > 0.8). We conclude that migraine was predominant with regard to headache diagnoses repartition and that the ICHD-II seems usable in practice for evaluation of primary headache in French children and adolescents.

Psychopathology in children and adolescents with primary headaches: Categorical and dimensional approaches

Cephalalgia ◽  
2013 ◽  
Vol 33 (16) ◽  
pp. 1311-1318 ◽  
Author(s):  
Francesco Margari ◽  
Elisabetta Lucarelli ◽  
Francesco Craig ◽  
Maria G Petruzzelli ◽  
Paola A Lecce ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Child Psychopathology ◽  
Psychiatric Comorbidity ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Emotional And Behavioral Problems ◽  
Control Group ◽  
Primary Headaches ◽  
Healthy Children ◽  
Type Headache

Background Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.

scholarly journals Prevalence and impact of headache in undergraduate students in Southern Brazil

2010 ◽  
Vol 68 (6) ◽  
pp. 873-877 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Alisson Roberto Teles ◽  
Maíra Cristina Velho ◽  
Viviane Maria Vedana ◽  
Roberta Castilhos da Silva ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Significant Difference ◽  
Headache Episode ◽  
Headache Type ◽  
Probable Migraine ◽  
Type Headache ◽  
The University

OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS), to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001). In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

Characteristics of Brain Tumour-Associated Headache

Cephalalgia ◽  
2007 ◽  
Vol 27 (8) ◽  
pp. 904-911 ◽  
Author(s):  
CJ Schankin ◽  
U Ferrari ◽  
VM Reinisch ◽  
T Birnbaum ◽  
R Goldbrunner ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Univariate Analysis ◽  
Positive Family History ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Moderate Intensity ◽  
Secondary Headache ◽  
History Of ◽  
Type Headache

Eighty-five brain tumour patients were examined for further characteristics of brain tumour-associated headache. The overall prevalence of headache in this population was 60%, but headache was the sole symptom in only 2%. Pain was generally dull, of moderate intensity, and not specifically localized. Nearly 40% met the criteria of tension-type headache. An alteration of the pain with the occurrence of the tumour was experienced by 82.5%, implying that the preexisting and the brain tumour headaches were different. The classic characteristics mentioned in the International Classification of Headache Disorders (worsening in the morning or during coughing) were not found; this might be explained by the patients not having elevated intracranial pressure. Univariate analysis revealed that a positive family history of headache and the presence of meningiomas are risk factors for tumour-associated headache, and the use of β-blockers is prophylactic. Pre-existing headache was the only risk factor according to logistic regression, suggesting that patients with pre-existing (primary) headache have a greater predisposition to develop secondary headache. Dull headache occurs significantly more often in patients with glioblastoma multiforme, and pulsating headache in patients with meningioma. In our study, only infratentorial tumours were associated with headache location, and predominantly with occipital but rarely frontal pain.

The need for preventive therapy in primary headaches

2011 ◽  
pp. 46-49
Author(s):  
Mario Fernando Prieto Peres ◽  
Daniel Krempel Amado ◽  
André Leite Gonçalves ◽  
Reinaldo Ribeiro ◽  
Jorge Roberto Pagura ◽  
...  
Keyword(s):  
Preventive Treatment ◽  
Primary Headache ◽  
Preventive Therapy ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Correct Treatment ◽  
Treatment Type ◽  
Geographical Regions ◽  
Probable Migraine ◽  
Type Headache

Introduction: Primary headaches are common conditions. In Brazil, the prevalence of migraine is 15.2%, tension-type headache 13% and chronic daily headache (CDH) 6.9%. Although frequent disorders a proportion of patients are undertreated. Patients patterns of headache care can trend toward acute medication only and those in need of prevention may not receive it. Objective: To estimate the rates of preventive treatment in primary headache sufferers. Methods: A telephone interview containing questions about headache and socio-demographic characteristics was applied to 3,848 people from 27 States of Brazil, in its five geographical regions. We considered MIDAS > 10 points as a marker for the need of preventive treatment. Patients were asked if they were taking any medication on a daily basis or any treatment to prevent headaches from happening. Subjects were divided into: 1. Those who responded positively for the question regarding preventive treatment regardless of the treatment type. 2. Those who responded positively for the question, but only medications or treatments studied for migraine prevention, labeled as "Correct treatment" 3. Those who responded positively for the question, but only medications or treatments from the prevention consensus (Brazilian Headache Society), labeled as "Consensus treatment" Results: In total, 12.8% of primary headache sufferers had MIDAS higher than 10, meeting criteria for prophylactic treatment, but only 8.4% of them reported it, 3.9% were using a right preventive treatment. The percentage of patients in need for prevention was 24.7% in migraine, 15.6 % in probable migraine, 5 % for tension-type headache (TTH) and 4% for probable TTH. Only 2.6% of migraineurs, 7.5% of probable migraine patients, 4.3% of tension-type headache and 0% of probable TTH received proper preventive treatment Conclusion: Primary headaches are common, debilitating conditions but a substantial proportion of those who might need prevention do not receive it. Patient education, public health initiatives in order to deliver migraine and other primary headaches treatment for the general population should be considered not only in Brazil, but worldwide.

Prevalence and characteristics of headache attributed to ingestion or inhalation of a cold stimulus (HICS): A cross-sectional study

Cephalalgia ◽  
2019 ◽  
Vol 40 (3) ◽  
pp. 299-306
Author(s):  
Torsten Kraya ◽  
Malte Schulz-Ehlbeck ◽  
Philipp Burow ◽  
Stefan Watzke ◽  
Stephan Zierz
Keyword(s):  
Rating Scale ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Cross Sectional ◽  
Cold Stimulus ◽  
Clinical Criteria ◽  
Number Of Patients ◽  
Accompanying Symptoms ◽  
Type Headache

Background Headache attributed to ingestion or inhalation of a cold stimulus (HICS), colloquially called ice-cream headache, is a common form of a primary headache in adults and children. However, previous studies on adults are limited due to the small number of patients. Furthermore, most of the subjects in previous studies had a history of other primary headaches. Methods Biographic data, clinical criteria of HICS and prevalence of primary headache were collected by a standardized questionnaire. A total of 1213 questionnaires were distributed; the return rate was 51.9% (n = 629); 618 questionnaires could be analyzed. Results In a cohort of 618 people aged between 17–63 years (females: n = 426, 68.9%), the prevalence of HICS was 51.3% (317 out of 618). There was no difference between men and women (51.3% vs. 51.6%). The duration of HICS was shorter than 30 sec in 92.7%. In the HICS group, localization of the pain was occipital in 17%. Trigemino-autonomic symptoms occurred in 22%, and visual phenomena (e.g. flickering lights, spots or lines) were reported by 18% of the HICS group. The pain intensity, but not the prevalence of HICS, was higher when tension-type headache and migraine or both were present as co-morbid primary headaches (Numeric Rating Scale (NRS) 4.58 and 6.54, p = 0.006). There was no higher risk of participants with migraine getting HICS than for those who did not have migraine (odds ratio = 1.17, 95% confidence interval (CI) 0.75–1.83; p = 0.496). Conclusion The results of this study modified the current criteria for HICS in the ICHD-3 regarding duration and localization. In addition, accompanying symptoms in about one fifth of the participants are not mentioned in the ICHD-3. Neither migraine nor tension-type headache seems to be a risk factor for HICS. However, accompanying symptoms in HICS are more frequent in subjects with another primary headache than in those without such a headache.

scholarly journals Clinical features, diagnosis and treatment of acute primary headaches at an emergency center: why are we still neglecting the evidence?

2007 ◽  
Vol 65 (4b) ◽  
pp. 1130-1133 ◽  
Author(s):  
Facundo Burgos Ruiz Jr ◽  
Márcia Silva Santos ◽  
Helen Souto Siqueira ◽  
Ulisses Correa Cotta
Keyword(s):  
Clinical Features ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Main Diagnosis ◽  
Management Protocol ◽  
Headache Management ◽  
Probable Migraine ◽  
Type Headache ◽  
Acute Headache

In order to analyze the clinical features, approach and treatment of patients with acute primary headaches seen at the Clinics Hospital of the Federal University of Uberlândia (HC-UFU) throughout 2005, the medical charts of 109 patients were evaluated through a standardized questionnaire as to age, gender, main diagnosis, characteristics of the headache attacks, diagnostic tests and treatment. Probable migraine was the most common type of primary headache (47.7%), followed by probable tension-type headache (37.6%), unspecified headache (11.9%), and headache not elsewhere classified (2.8%). As to characteristics of the crisis, the location of the pain was described in 86.2% of the patients. The most commonly used drugs for treatment of acute headache attacks were dipyrone (74.5%), tenoxicam (31.8%), diazepam (20.9%), dimenhydrate (10.9%), and metochlopramide (9.9%). The data collected are in agreement with those reported in literature. In most cases, treatment was not what is recommended by consensus or clinical studies with appropriate methodology. Therefore, we suggest the introduction of a specific acute headache management protocol which could facilitate the diagnosis, treatment and management of these patients.

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