scholarly journals Headaches in the emergency department –a survey of patients’ characteristics, facts and needs

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Alberto Doretti ◽  
◽  
Irina Shestaritc ◽  
Daniela Ungaro ◽  
John-Ih Lee ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Treatment ◽  
Primary Headache ◽  
Headache Disorder ◽  
Efficacy Rate ◽  
Headache Disorders ◽  
Secondary Headaches ◽  
Primary Headache Disorder ◽  
Life Threatening ◽  
Inflammatory Drugs

Abstract Background and aim Headache is very often the cause for seeking an emergency department (ED). However, less is known about the different diagnosis of headache disorders in the ED, their management and treatment. The aim of this survey is to analyse the management of headache patients in two different ED in Europe. Methods This retrospective survey was performed from September 2018 until January 2019. Patients were collected from the San Luca Hospital, Milan, Italy and the Ordensklinikum Barmherzige Schwestern, Linz, Austria. Only patients with a non-traumatic headache, as the primary reason for medical clarification, were included. Patients were analysed for their complexity and range of examination, their diagnoses, acute treatment and overall efficacy rate. Results The survey consists of 415 patients, with a mean age of 43.32 (SD ±17.72); 65% were female. Technical investigation was performed in 57.8% of patients. For acute treatment non-steroidal-anti-inflammatory drugs (NSAIDs) were the most used, whereas triptans were not given. A primary headache disorder was diagnosed in 45.3% of patients, being migraine the most common, but in 32% of cases the diagnosis was not further specified. Life-threatening secondary headaches accounted for less than 2% of cases. Conclusions The vast majority of patients attending an ED because of headache are suffering from a primary headache disorder. Life-threatening secondary headaches are rare but seek attention. NSAIDs are by far the most common drugs for treating headaches in the ED, but not triptans.

An Overview of the Treatment Options for Acute Migraine

2011 ◽  
Vol 6 (4) ◽  
pp. 265 ◽  
Author(s):  
Fabio Antonaci ◽  
Natascia Ghiotto ◽  
Maurizio Evangelista ◽  
◽  
◽  
...  
Keyword(s):  
Acute Treatment ◽  
Treatment Options ◽  
Primary Headache ◽  
Headache Disorder ◽  
Symptomatic Therapy ◽  
Acute Migraine ◽  
Primary Headache Disorder ◽  
Inflammatory Drugs ◽  
Socioeconomic Burden ◽  
Over Time

Migraine is a primary headache disorder associated with a high socioeconomic burden. The first step in effective migraine management, following confirmation of the diagnosis, is patient education: the condition is carefully explained, to ensure that it is properly understood, and realistic expectations are set. The choice of acute treatment has changed over time as the available therapeutic options have increased. Abortive migraine therapy can be either specific (ergot derivatives and triptans) or non-specific (analgesics and non-steroidal anti-inflammatory drugs). Even though acute symptomatic therapy can be optimised, migraine remains a chronic and potentially progressive condition.

Headache

2015 ◽  
Author(s):  
Peter J. Goadsby
Keyword(s):  
Cluster Headache ◽  
Severe Pain ◽  
Primary Headache ◽  
Headache Disorder ◽  
Headache Disorders ◽  
Important Work ◽  
Pain Experience ◽  
Global Impact ◽  
Primary Headache Disorder ◽  
The World

Headache disorders are the dominant cause of neurological disability in the world and the most common reason for neurological referral in any country studied. Yet for much of the first half the twentieth century, research was mired in peripheral mechanistic sideshows. Migraine, the most common disabling primary headache disorder, has been established as primarily a brain problem, with important advances in classification, treatment, and biological understanding. Cluster headache, perhaps the most severe pain experience of humans, has found its nidus in the diencephalon; treatments are evolving and biology being unravelled. Contributions to headache disorders resonate across humanity, so important work here has a global impact for good.

Headache in Sports

2016 ◽  
Author(s):  
Tad Seifert
Keyword(s):  
Primary Headache ◽  
Headache Disorder ◽  
Epidemiological Data ◽  
Return To Play ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Unique Challenge ◽  
Primary Headache Disorder ◽  
Primary Headache Disorders ◽  
Headache Type

The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Sport-related and exercise-related headaches are not uncommon, but there is limited epidemiological data on these types of headaches in athletes. Any primary headache type can occur in the setting of sports. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a genuine concussive injury. Through careful evaluation, the practitioner can distinguish primary headache disorders from posttraumatic headaches following concussion. This chapter reviews primary headache disorders, posttraumatic headaches, and other secondary headache disorders.

scholarly journals Perceived triggers of primary headache disorders: A meta-analysis

Cephalalgia ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 1188-1198 ◽  
Author(s):  
A Brooke Walters Pellegrino ◽  
Rachel E Davis-Martin ◽  
Timothy T Houle ◽  
Dana P Turner ◽  
Todd A Smitherman
Keyword(s):  
Meta Analysis ◽  
Experimental Studies ◽  
Primary Headache ◽  
Headache Disorder ◽  
Assessment Method ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Primary Headache Disorder ◽  
Primary Headache Disorders ◽  
Analytic Review

Objective To quantitatively synthesize extant literature on perceived triggers of primary headache disorders. Methods A meta-analytic review of headache trigger survey studies was conducted. Endorsement rates, assessment method, and headache and sample characteristics were extracted from included articles. Separate random-effects models were used to assess trigger endorsement rates and post-hoc meta-regressions examined potential moderator variables. Results 85 articles from 1958 to 2015 were included, involving 27,122 participants and querying 420 unique triggers (collapsed into 15 categories). Four-fifths (0.81; 95% CI .75 to .86) of individuals with migraine or tension-type headache endorsed at least one trigger. Rates increased with the number of categories queried (OR: 1.18, 1.08–1.30) and year of publication (OR: 1.04, 1.00–1.08). The triggers most commonly endorsed were stress (.58, .53–.63) and sleep (.41, .36–.47). Conclusions Extreme heterogeneity characterizes the headache trigger literature. Most individuals with a primary headache disorder perceive their attacks to be triggered by one or more precipitants, the most common of which are stress and sleep. However, trigger endorsement is influenced by method of assessment. Enhancing methodological consistency and prioritizing experimental studies would improve our understanding of headache triggers.

Emergency Department and Urgent Care use by Patients with Primary Headache Disorder

2007 ◽  
Vol 14 (5 Supplement 1) ◽  
pp. S71-S72
Author(s):  
B. Friedman ◽  
M. Reed ◽  
D. Serrano ◽  
M. Diamond ◽  
R. Lipton
Keyword(s):  
Emergency Department ◽  
Primary Headache ◽  
Headache Disorder ◽  
Urgent Care ◽  
Primary Headache Disorder

scholarly journals Tension-type headache

2019 ◽  
pp. 10-19
Author(s):  
Messoud Ashina ◽  
Med Sci ◽  
Sait Ashina
Keyword(s):  
Tricyclic Antidepressants ◽  
Life Time ◽  
Primary Headache ◽  
Headache Disorder ◽  
Tension Type Headache ◽  
Primary Headache Disorder ◽  
Inflammatory Drugs ◽  
Socio Economic Impact ◽  
Type Headache ◽  
The Individual

Tension-type headache is the most common primary headache disorder. The life-time prevalence of tension-type headache in general population is between 30 to 78%. Tension-type has the tremendous socio-economic impact on the individual and the society. Unfortunately, it is the least studied primary headache. The pathophysiology of this headache disorder is not fully understood.  The diagnosis of tension-type headache is based on the history, and general and neurological examinations.  Abnormalities in peripheral and central nociceptive nervous systems in combination with environmental and genetic factors may play a role in the pathophysiology of tension-type headache. The pharmacotherapy of episodic tension-type headache is non-specific and includes simple analgesics and nonsteroidal anti-inflammatory drugs. Tricyclic antidepressants are the mainstay in the prophylactic treatment of chronic tension-type headache.

scholarly journals Impact of Primary Headache Disorder on Quality of Life Among School students in Kuwait

2020 ◽  
Author(s):  
Jasem Yousef Al-Hashel ◽  
Raed Alroughani ◽  
Sameera Shuaibi ◽  
Abdelrahman AlAshqar ◽  
Fajer AlHamdan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Middle School Students ◽  
Primary Headache ◽  
Headache Disorder ◽  
Primary Headaches ◽  
Headache Disorders ◽  
School Students ◽  
Primary Headache Disorder ◽  
Primary Headache Disorders

Abstract Background Primary headache disorders have being increasingly reported in younger populations. They can have significant effects on their quality of life and academic achievement and may cause significant distress to their families. Aims and Objectives To assess the burden of primary headache disorder and its impact on the quality of life on school student in Kuwait. Methods A cross-sectional study was conducted among Kuwaiti primary and middle school students of both genders in randomly selected schools located in two governorates in 2018/2019 academic year. Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents was used to assess the impact of primary headaches on the quality of life. Results 1091 questionnaires were completed by primary and middle school students of both genders; of whom 466 students (girls 321 (68.88%) were diagnosed with primary headache disorders with mean age 11.98 + 2.03 years. In the month prior to the survey, the effect of the headache was variable. The students lost a mean of 1.99 + 2.015 days of school while they could not perform their usual activities for a mean of 2.84 + 4.28 days. Their parents lost a mean of 2 + 2.03 days of work because of headaches of their children and parents prohibited 5.7% of the students to engage in any activity due to their headaches. Difficulties in concentrations were reported as never sometimes (39.1%), often (24.8%), and always (26%). Majority of the students (?%) experienced a feeling of sadness ranging from sometimes to always. Most of the students (?%) struggled to cope with the headache and 22.4% were never able to cope. Additionally, 19.4% of students reported they did not want others noticing their headache. Conclusion Primary headache disorder can have a significant impact on the quality of life in children. It can affect their engagement in activities and academic achievement. Implementing strategies to properly manage schoolchildren with primary headaches can have profound effects on their quality of life.

scholarly journals Effectiveness of paranasal air suction on acute migraine using portable air sucker – a randomized, double blind study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. M. R. Bandara ◽  
S. Samita ◽  
A. M. Kiridana ◽  
H. M. M. T. B. Herath
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Sri Lanka ◽  
Primary Headache ◽  
Headache Disorder ◽  
Low Pressure ◽  
Outcome Variable ◽  
Double Blind ◽  
Primary Headache Disorder ◽  
Before And After

Abstract Background Migraine is a primary headache disorder and is the most common disabling primary headache disorder that occurs in children and adolescents. A recent study showed that paranasal air suction can provide relief to migraine headache. However, in order to get the maximum benefit out of it, an easy to use effective air sucker should be available. Aiming to fulfil the above requirement, a randomized, double blind control clinical trial was conducted to investigate the efficacy of a recently developed low–pressure portable air sucker. Methods Eighty-six Sri Lankan school children of age 16–19 years with migraine were enrolled for the study. They were randomly allocated into two groups, and one group was subjected to six intermittent ten-second paranasal air suctions using the portable air sucker for 120 s. The other group was subjected to placebo air suction (no paranasal air suction). The effect of suction using portable air sucker was the primary objective but side of headache, type of headache, and gender were also studied as source variables. The primary response studied was severity of headache. In addition, left and right supraorbital tenderness, photophobia, phonophobia, numbness over the face and scalp, nausea and generalized tiredness/weakness of the body were studied. The measurements on all those variables were made before and after suction, and the statistical analysis was performed based on before and after differences. As a follow–up, patients were monitored for 24-h period. Results There was a significant reduction in the severity of headache pain (OR = 25.98, P < 0.0001), which was the primary outcome variable, and other migraine symptoms studied, tenderness (left) (OR = 289.69, P < 0.0001), tenderness (right) (OR > 267.17, P < 0.0001), photophobia (OR = 2115.6, P < 0.0001), phonophobia (OR > 12.62, P < 0.0001) nausea (OR > 515.59, P < 0.0001) and weakness (OR = 549.06, P < 0.0001) except for numbness (OR = 0.747, P = 0.67) in the treatment group compared to the control group 2 min after the suction. These symptoms did not recur within 24-h period and there were no significant side effects recorded during the 24-h observation period. Conclusion This pilot study showed that low–pressure portable air sucker is effective in paranasal air suction, and suction for 120 s using the sucker can provide an immediate relief which can last for more than 24-h period without any side effects. Trail registration Clinical Trial Government Identification Number – 1548/2016. Ethical Clearance Granted Institute – Medical Research Institute, Colombo, Sri Lanka (No 38/2016). Sri Lanka Clinical Trial Registration No: SLCTR/2017/018. Date of registration = 29/ 06/2017. Approval Granting Organization to use the device in the clinical trial– National Medicines Regulatory Authority Sri Lanka (16 Jan 2018), The device won award at Geneva international inventers exhibition in 2016 and President award in 2018 in Sri Lanka. It is a patented device in Sri Lanka and patent number was SLKP/1/18295. All methods were carried out in accordance with CONSORT 2010 guidelines.

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