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

2019 ◽  
Vol 34 (13) ◽  
pp. 824-829 ◽  
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.

History of Headache Research in Denmark

Cephalalgia ◽  
2001 ◽  
Vol 21 (7) ◽  
pp. 748-752 ◽  
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.

Population-Based Validation of a German-Language Self-Administered Headache Questionnaire

Cephalalgia ◽  
2008 ◽  
Vol 28 (6) ◽  
pp. 605-608 ◽  
Author(s):  
M-S Yoon ◽  
M Obermann ◽  
G Fritsche ◽  
M Slomke ◽  
P Dommes ◽  
...  
Keyword(s):  
General Population ◽  
Population Sample ◽  
Population Based ◽  
Tension Type Headache ◽  
German Language ◽  
General Population Sample ◽  
Trigeminal Autonomic Cephalalgia ◽  
Screening Questionnaires ◽  
Headache Clinic ◽  
Type Headache

We validated a German-language self-administered headache questionnaire for migraine (M), tension-type headache (TTH) and trigeminal autonomic cephalalgia (TAC) in a general population sample of people with headache. Randomly selected subjects ( n = 240) diagnosed by the questionnaire as M ( n = 60), TTH ( n = 60), a combination of M and TTH (M+TTH, n = 60) and TAC ( n = 60) were invited for examination by headache specialists. One hundred and ninety-three subjects (80%) were studied. Sensitivity and specificity for M were 0.85 and 0.85, for TTH 0.6 and 0.88, for M+TTH 0.82 and 0.87, respectively. Cohen's κ was 0.6 (95% confidence interval 0.50, 0.71). Of 45 patients with TAC according to the questionnaire, physicians diagnosed cluster headache in two patients only. We conclude: (i) the questionnaire can be used to diagnose M, TTH and M+TTH, but not TAC; (ii) screening questionnaires for epidemiological research should be validated in a general population sample but not in a tertiary headache clinic.

Frequency of diagnoses in a specialized headache clinic in Buenos Aires

2019 ◽  
pp. 66-69
Author(s):  
Vanessa Nagel ◽  
Sol Cavanagh ◽  
Marina Olivier ◽  
Natalia Larripa ◽  
Maria T Gutierrez ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Buenos Aires ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Craniofacial Pain ◽  
Headache Clinic ◽  
Type Headache

Objective: Headache is one of the most frequent reason for consultations in neurology. The global prevalence among adults with migraine is approximately 10% with migraine, 40% for tension-type headache (TTH) and 3% for chronic daily headache. The purpose of this study is to analyze the prevalence of the diagnoses of headache and craniofacial pain among patients evaluated in a specialized headache clinic of Buenos Aires during 2017. Methods: Retrospective, descriptive study. We reviewed the electronic medical records of patients who consulted for headaches or craniofacial pain from January 1st to December 31st, 2017. Diagnoses were made according to the criteria of the International Classification of Headache Disorders (ICHD-3). Results: We reviewed 3254 electronic medical records and documented 3941 diagnoses: headache (93.03%), craniofacial pain (3.62%) and unclassifiable (3.35%). The average age was 43.14 years. 80.7% were women. Primary headaches were the most frequent diagnoses (78.54%). Migraine represented the main diagnosis (87.42%). Episodic migraine without aura was the most prevalent diagnosis (48%). Tension- type headache (TTH) was found in 8.74% of cases of primary headaches and Trigeminal autonomic cephalalgias (TACs) in 2.89%. Medication-overuse headache (MOH) represented 77.93% of the secondary headaches, and most of them also met chronic migraine criteria fulfilled criteria of chronic migraine. Primary trigeminal neuralgia represented 50% of craniofacial pain and 27% were secondary trigeminal neuralgia, mostly postherpetic or posterior to dental procedures. Regardin to the frecuency, 33.58% of the patients had chronic headache. Conclusion: In our section, migraine is the most frequent diagnosis followed by medication-overuse headache. The percentage of chronic headache is higher than the prevalence in the general population, probably because it is a tertiary center.

scholarly journals Epidemiology of primary and secondary headaches in a Brazilian tertiary-care center

2006 ◽  
Vol 64 (1) ◽  
pp. 41-44 ◽  
Author(s):  
André Carvalho Felício ◽  
Denis Bernardi Bichuetti ◽  
William Adolfo Celso dos Santos ◽  
Clecio de Oliveira Godeiro Junior ◽  
Luis Fabiano Marin ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Population Sample ◽  
Tension Type Headache ◽  
Hypnic Headache ◽  
Secondary Headaches ◽  
The Mean ◽  
Headache Clinic ◽  
Type Headache ◽  
Few Data

OBJECTIVE: To analyze the demographic features of the population sample, the time of headache complaint until first consultation and the diagnosis of primary and secondary headaches. METHOD: 3328 patients were analyzed retrospectively and divided according to gender, age, race, school instruction, onset of headache until first consultation and diagnosis(ICHD-II, 2004). RESULTS: Sex ratio (Female/Male) was 4:1, and the mean age was 40.7±15 years, without statistical differences between sexes. Approximately 65% of the patients were white and 55% had less than eight years of school instruction. Headache complaint until first consultation ranged from 1 to 5 years in 32.99% patients. The most prevalent diagnosis were migraine (37.98%), tension-type headache-TTH (22.65%) and cluster headache (2.73%). CONCLUSION: There are few data on epidemiological features of headache clinic populations, mainly in developing countries. According to the literature, migraine was more frequent than TTH. It is noteworthy the low school instruction of this sample and time patient spent to seek for specialized attention. Hypnic headache syndrome was seen with an unusual frequency.

The International Headache Society (IHS) Headache Classification as Applied to a Headache Clinic Population

Cephalalgia ◽  
1994 ◽  
Vol 14 (6) ◽  
pp. 443-446 ◽  
Author(s):  
LC Sanin ◽  
NT Mathew ◽  
LR Bellmeyer ◽  
S Ali
Keyword(s):  
International Headache Society ◽  
Chronic Cluster Headache ◽  
Tension Type Headache ◽  
Drug Induced ◽  
Advantages And Disadvantages ◽  
Common Diagnosis ◽  
History Of ◽  
Headache Clinic ◽  
Type Headache ◽  
Drug Induced Headache

Four hundred patients attending a headache clinic were classified using the IHS criteria. The majority required more than two, often three or four, diagnoses. Even though migraine was the most common diagnosis, only 1/4 of those with a migraine diagnosis had it as the only diagnosis. Seventy-five percent of migraine patients had coexistent chronic tension-type headache (CTTH), drug-induced headache or both. Ninety-six percent of patients diagnosed as having migraine with aura also suffered from migraine without aura. More than 1/3 of patients (37.7%) attending the clinic suffered from chronic daily headache (CDH) (chronic cluster headache excluded), which is not included as a separate entity in the IHS classification. Pure CTTH formed only a small minority of CDH, whereas 86.6% of CDH had migraine as one of the diagnoses. Drug-induced headache was a prominent second or third diagnosis. The advantages and disadvantages of multiple verses single diagnosis in CDH and the need to recognize the natural history of headache disorders in the classification are discussed.

Chronic Post-Traumatic Headache – A Clinical Analysis in Relation to the International Headache Classification 2nd Edition

Cephalalgia ◽  
2005 ◽  
Vol 25 (2) ◽  
pp. 132-138 ◽  
Author(s):  
L Baandrup ◽  
R Jensen
Keyword(s):  
Multidisciplinary Treatment ◽  
Clinical Analysis ◽  
Tension Type Headache ◽  
Major Influence ◽  
Primary Headaches ◽  
Headache Classification ◽  
Post Traumatic ◽  
International Headache Classification ◽  
Headache Clinic ◽  
Type Headache

The clinical presentation of chronic post-traumatic headache in 53 patients from a highly specialized headache clinic was analysed and classified according to the diagnostic criteria of the primary headaches in The International Headache Classification 2nd Edition, and compared with the 1st Edition. All patients fulfilled the criteria for both editions indicating that the restrictions in the 2nd Edition have no major influence on the prevalence in specialized clinics. We found the phenomenology to be very heterogeneous, but the vast majority (77%) of patients presented with headache resembling chronic tension-type headache, either as the only manifestation or in combination with migraine symptoms. For the first time episodic tension-type headache is described as occurring after head trauma. The prevalence of coexisting analgesic overuse was 42% and the treatment outcome for these patients was just as favourable as in primary headaches, whereas the time-consuming multidisciplinary treatment demonstrated only very modest results.

Interrelation of Chronic Tension-Type Headache With and Without Medication Overuse and Migraine in the General Population: The Akershus Study of Chronic Headache

Cephalalgia ◽  
2009 ◽  
Vol 29 (3) ◽  
pp. 331-337 ◽  
Author(s):  
K Aaseth ◽  
RB Grande ◽  
C Lundqvist ◽  
MB Russell
Keyword(s):  
General Population ◽  
Chronic Headache ◽  
Medication Overuse ◽  
Age At Onset ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Increased Risk ◽  
Type Headache ◽  
Complex Matter

We studied the interrelation of chronic tension-type headache with and without medication overuse (CTTH) and migraine in a random sample of 30 000 persons aged 30–44 years. They received a mailed questionnaire. Those with a possible chronic headache were interviewed by neurological residents. The International Classification of Headache Disorders was used. A total of 386 persons had CTTH. Compared with the general population, men had a 2.8-fold and women a 2.4-fold significantly increased risk of migraine without aura (MO). The risk of migraine with aura (MA) was not increased. The mean age at onset of CTTH was significantly higher in those with than in those without co-occurrence of MO. Bilateral MO attacks were significantly more frequent in those with age at onset of CTTH prior to age at onset of MO compared with those with age at onset in reverse order. CTTH and MO are interrelated, possibly in a complex matter. In contrast, CTTH and MA are not interrelated.

Clinical Features and Burden Scores in Japanese Pediatric Migraines With Brainstem Aura, Hemiplegic Migraine, and Retinal Migraine

2020 ◽  
Vol 35 (10) ◽  
pp. 667-673
Author(s):  
Gaku Yamanaka ◽  
Soken Go ◽  
Shinichiro Morichi ◽  
Mika Takeshita ◽  
Natsumi Morishita ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Impact Test ◽  
Medication Overuse ◽  
Tension Type Headache ◽  
Accurate Diagnosis ◽  
Disability Assessment ◽  
Hemiplegic Migraine ◽  
Pediatric Migraine ◽  
Type Headache ◽  
Headache Impact

Background: Migraines are a broad spectrum of disorders classified by the type of aura with some requiring attentive treatment. Vasoconstrictors, including triptans, should be avoided in the acute phase of migraines with brainstem aura, in hemiplegic migraine, and in retinal migraine. This study investigated the characteristics and burden of these migraines. Methods: Medical charts of 278 Japanese pediatric patients with migraines were retrospectively reviewed. Migraine burden of migraines with brainstem aura, hemiplegic migraines, and retinal migraine was assessed using the Headache Impact Test-6™ (HIT-6) and the Pediatric Migraine Disability Assessment scale (PedMIDAS). Results: Of 278 patients screened, 12 (4.3%) patients with migraines with brainstem aura (n = 5), hemiplegic migraines (n = 2), and retinal migraine (n = 5) were enrolled in the study. All patients had migraine with/without typical aura, whereas some patients had coexisting migraine with another type of headache (chronic tension-type headache in 3 patients, and 1 each with frequent episodic tension-type headache, headache owing to medication overuse, and chronic migraine). Migraines with brainstem aura, hemiplegic migraines, and retinal migraine patients with coexisting headaches had higher HIT-6 or PedMIDAS scores, whereas migraines with brainstem aura, hemiplegic migraines, and retinal migraine patients without coexisting headache did not show high HIT-6 or PedMIDAS scores. Conclusion: All migraines with brainstem aura, hemiplegic migraines, and retinal migraine patients experienced migraine with or without typical aura, and some patients having other coexisting headaches also had high PedMIDAS and HIT-6 scores. PedMIDAS and HIT-6 should not be considered diagnostic indicators of migraines with brainstem aura, hemiplegic migraines, or retinal migraine. In clinical practice for headaches in children, careful history taking and proactive assessment of the aura are needed for accurate diagnosis of migraines with brainstem aura, hemiplegic migraines, and retinal migraine.

Monthly variation of United States pediatric headache emergency department visits

Cephalalgia ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 473-478 ◽  
Author(s):  
Sita Kedia ◽  
Adit A Ginde ◽  
Joseph A Grubenhoff ◽  
Allison Kempe ◽  
Andrew D Hershey ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
School Attendance ◽  
Tension Type Headache ◽  
Emergency Department Visits ◽  
Monthly Variation ◽  
Pediatric Headache ◽  
Ed Visits ◽  
Adjusted Rate ◽  
Type Headache

Objective The objective of this article is to determine the monthly variation of emergency department (ED) visits for pediatric headache. We hypothesized youth have increased headache-related ED visits in the months associated with school attendance. Methods Using a United States representative sample of ED visits in the National Hospital Ambulatory Medical Care Survey from 1997 to 2009, we estimated number of visits associated with ICD-9 codes related to headache, migraine, status migrainosus, or tension-type headache in 5- to 18-year-olds. Age-stratified multivariate models are presented for month of visit (July as reference). Results There was a national estimate of 250,000 ED visits annually related to headache (2.1% of total visits) in 5- to 18-year-olds. In 5- to 11-year-olds, the adjusted rate of headache-related visits was lower in April (OR 0.42, 95% CI 0.20, 0.88). In 12- to 18-year-olds, there were higher rates in January (OR 1.92, 95% CI 1.16, 3.14) and September (OR 1.64, 95% CI 1.06, 2.55). Conclusions In adolescents we found higher ED utilization in January and September, the same months associated with school return from vacation for a majority of children nationally. No significant reduction in the summer suggests that school itself is not the issue, but rather changes in daily lifestyle and transitions.

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