Prevalence and impact of headache in undergraduate students in Southern Brazil

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.

Download Full-text

Headache Prevalence Among Adolescents — The German DMKG Headache Study

Cephalalgia ◽

10.1111/j.1468-2982.2007.01289.x ◽

2007 ◽

Vol 27 (4) ◽

pp. 347-354 ◽

Cited By ~ 101

Author(s):

K Fendrich ◽

M Vennemann ◽

V Pfaffenrath ◽

S Evers ◽

A May ◽

...

Keyword(s):

International Headache Society ◽

Primary Headache ◽

Population Based ◽

Cross Sectional Study ◽

Tension Type Headache ◽

Cross Sectional ◽

Primary Headache Disorders ◽

Ihs Criteria ◽

Probable Migraine ◽

Type Headache

This population-based cross-sectional study examined the 3-month prevalence of headache, migraine and tension-type headache (TTH) among adolescents aged 12-15 years in Germany Students ( n = 3324) from 20 schools completed a questionnaire on general and headache-specific pain which included a sociodemographic module. The headache-specific questionnaire complied with the respective revised criteria of the International Headache Society (IHS). 'Modified criteria' changed the item 'duration' in migraine (>30 min instead of >4 h). The overall 3-month prevalence of headache was 69.4% (boys 59.5%, girls 78.9%), with 4.4% of the adolescents suffering from frequent (≥ 14 days/3 months) and severe (grade 8-10 on a 10-point visual analogue scale) headache and 1.4% (boys 0.9%, girls 1.9%) from headache ≥15 days/month. The 3-month prevalence of migraine was 2.6% (boys 1.6%, girls 3.5%) applying strict IHS criteria and 6.9% (boys 4.4%, girls 9.3%) with modified criteria; 12.6% (boys 8.3%, girls 16.7%) suffered from probable migraine, 0.07% fulfilled the criteria for chronic migraine, 4.5% (boys 4.6%, girls 4.3%) suffered from TTH, 0.2% from chronic TTH and 15.7% (boys 14.5%, girls 16.9%) from probable TTH. Headache and migraine were more common in girls than in boys and in teenagers, especially in girls, aiming at higher education. Recurrent headache and primary headache disorders are common complaints among German adolescents, especially among girls.

Download Full-text

Headache in an emergency room in Brazil

Sao Paulo Medical Journal ◽

10.1590/s1516-31802000000300002 ◽

2000 ◽

Vol 118 (3) ◽

pp. 58-62 ◽

Cited By ~ 28

Author(s):

Marcelo Bigal ◽

Carlos Alberto Bordini ◽

José Geraldo Speciali

Keyword(s):

Primary Care ◽

Emergency Room ◽

Care Service ◽

International Headache Society ◽

Tertiary Care ◽

Primary Headache ◽

Tension Type Headache ◽

University Hospital ◽

Type Headache ◽

The University

CONTEXT: When experiencing a headache attack, Brazilian patients usually look for a primary care service, where they are seen by general clinicians. In the town of Ribeirão Preto, these clinicians routinely refer patients to the Emergency Room of the University Hospital. OBJECTIVE: The objective of this study was to evaluate the quality of primary care by analyzing retrospectively the medical records of patients with a complaint of headache seen in this emergency room during the year of 1996. DESIGN: retrospective study. SETTIING: Emergency Room of the Universital Hospital, Ribeirão Preto, São Paulo, reference unit. PARTICIPANTS:1254 patients. The patients who sought the Emergency Room (ER) of the University Hospital of Ribeirão Preto, during the year of 1996 with a complaint of headache were studied retrospectively. MAIN MEASUREMENTS: Etiology, age, diagnosis, secondary cause, laboratory tests. RESULTS: Of the 1254 patients seen (61% women), 1190 (94.9%) were discharged after the administration of parenteral analgesics before they had spent 12 hours in the room. Only 64 (5.1%) patients remained for more than 12 hours. Of the patients who spent less than 12 hours in the room, 71.5% had migraine or tension type headache and did not require subsidiary exams for diagnosis. Of the patients who spent more than 12 hours in the room, 70.3% had secondary headaches. CONCLUSIONS: We conclude the primary care for headache is unsatisfactory in the Ribeirão Preto region. Many patients with primary headache are referred to tertiary care services, indicating the need for the dissemination of the diagnostic criteria of the International Headache Society to general practitioners.

Download Full-text

The need for preventive therapy in primary headaches

Headache Medicine ◽

10.48208/headachemed.2011.10 ◽

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.

Download Full-text

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

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000700007 ◽

2007 ◽

Vol 65 (4b) ◽

pp. 1130-1133 ◽

Cited By ~ 6

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.

Download Full-text

Regional Variations in the Prevalence of Migraine and Tension-Type Headache Applying the new IHS Criteria: The German DMKG Headache Study

Cephalalgia ◽

10.1111/j.1468-2982.2008.01699.x ◽

2009 ◽

Vol 29 (1) ◽

pp. 48-57 ◽

Cited By ~ 50

Author(s):

V Pfaffenrath ◽

K Fendrich ◽

M Vennemann ◽

C Meisinger ◽

K-H Ladwig ◽

...

Keyword(s):

International Headache Society ◽

Epidemiological Studies ◽

Population Based ◽

Tension Type Headache ◽

Regional Variations ◽

Face To Face ◽

German Regions ◽

Ihs Criteria ◽

Probable Migraine ◽

Type Headache

The prevalence of migraine and tension-type headache (TTH) varies considerably with respect to gender, age group and geographic regions. Methodological differences in the assessment and classification of cases are a major cause of this variability across studies, limiting the ability to perform true regional comparisons. We conducted three population-based studies in different German regions and assessed headache prevalence and headache characteristics in face-to-face interviews, applying standardized methods. We analysed the 6-month prevalence of migraine, TTH and their probable subtypes based on the new criteria of the International Headache Society (IHS). Among the 7417 participants in all three regions, the pooled 6-month prevalence of migraine, probable migraine, TTH and probable TTH was 6.75, 4.40, 19.86 and 11.61%, respectively. Despite the application of standardized classification methods, regional variations between 4.39 and 8.00% for migraine and 15.44 and 23.64% for TTH were observed, indicating differences in the local headache burden. Application of the new IHS criteria yielded headache categories that were not mutually exclusive, indicating a need for further discussion about the value of probable headache types in epidemiological studies.

Download Full-text

Changing Headache from Preschool Age to Puberty. A Controlled Study

Cephalalgia ◽

10.1111/j.1468-2982.2007.01277.x ◽

2007 ◽

Vol 27 (4) ◽

pp. 294-303 ◽

Cited By ~ 52

Author(s):

R Virtanen ◽

M Aromaa ◽

P Rautava ◽

L Metsähonkala ◽

P Anttila ◽

...

Keyword(s):

Primary Headache ◽

Tension Type Headache ◽

Preschool Age ◽

Controlled Study ◽

Abdominal Symptoms ◽

Common Location ◽

Headache Type ◽

Type Headache ◽

Pain Localization

The characteristics of disturbing primary headache and the occurrence of headache types were studied by sending a questionnaire to 1132 Finnish families of 6-year-old children. Children with headache in the preceding 6 months and their controls were clinically examined at the ages of 6 and 13. During the follow-up, half of the headaches, classified as migraine at age 6 years, were unchanged and 32% turned into tension-type headache. In children with tension-type headache, the situation was unchanged in 35%, and in 38% of children the headache type had changed to migraine. At preschool age the most common location of headache was bilateral and supraorbital, and at puberty bilateral and temporal. During the follow-up, symptoms concurrent with headache, such as odour phobia, dizziness and balance disturbances became more typical, whereas restlessness, flushing and abdominal symptoms became less marked. The early manifestation of both migraine and tension-type headache predict equally often migraine in puberty with marked changes in concurrent symptoms and pain localization.

Download Full-text

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

Cephalalgia ◽

10.1177/0333102416660533 ◽

2016 ◽

Vol 37 (10) ◽

pp. 947-954 ◽

Cited By ~ 13

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.

Download Full-text

Diagnosis and Clinical Management of Headaches

CNS Spectrums ◽

10.1017/s1092852900012153 ◽

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.

Download Full-text

Use of MPV and MPV/Plt Ratio in the Differentiation of Migraine and Tension-Type Headache

Acta Haematologica Polonica ◽

10.2478/ahp-2018-0003 ◽

2018 ◽

Vol 49 (1) ◽

pp. 15-19

Author(s):

Ersin Kasim Ulusoy

Keyword(s):

Large Scale ◽

International Headache Society ◽

Primary Headache ◽

Tension Type Headache ◽

Healthy Control Group ◽

Control Group ◽

Neurology Clinic ◽

Healthy Control ◽

And Gender ◽

Type Headache

AbstractPurposeMean platelet volume (MPV) is an indicator of platelet (Plt) function and activation. The purpose of this study is to demonstrate whether MPV and MPV/Plt ratio, indicators of Plt activation, are increased in migraine patients, compared to tension-type headache (TTH) and healthy control groups, in our large-scale study, and whether these two primary headache types with unknown pathophysiology may be differentiated by using MPV and MPV/Plt ratio.Materials and methodsEighty patients diagnosed with migraine as per the 2004 diagnosis criteria of the International Headache Society (IHS), 80 patients with TTH who have applied to the Neurology Clinic of our hospital, and 80 healthy subjects who have applied to the Family Practice Clinic and Blood Bank were enrolled in this study. MPV and MPV/Plt ratio in both patients of similar age and gender who were diagnosed with migraine as well as in the TTH group and healthy control group were compared.FindingsThe MPV/Plt ratio was 0.046±0.008 in migraine patients, 0.037±0.009 in patients with TTH, and 0.036±0.009 in the healthy control group. This difference was statistically significant (p<0.05). The cutoff value of MPV/Plt ratio for differentiating migraine and TTH was 0.037. The sensitivity of this value was 92.5%, while specificity was 55%.Conclusion We have demonstrated that the most commonly confused primary headache types may be differentiated by using MPV and MPV/Plt ratio, and therefore, the disability caused by migraine and unsuitable, unnecessary, and long-term drug therapies may be avoided in patients.

Download Full-text

Markers of endothelial function in migraine patients: Results from a bi-center prospective study

Cephalalgia ◽

10.1177/0333102414564890 ◽

2014 ◽

Vol 35 (10) ◽

pp. 877-885 ◽

Cited By ~ 4

Author(s):

Marlene Fischer ◽

Charly Gaul ◽

Hind Shanib ◽

Dagny Holle ◽

Lorin Loacker ◽

...

Keyword(s):

Endothelial Function ◽

Cluster Headache ◽

Primary Headache ◽

Tension Type Headache ◽

Healthy Controls ◽

Headache Disorders ◽

Endothelial Markers ◽

Primary Headache Disorders ◽

Significant Difference ◽

Type Headache

Background Numerous studies suggest an increased vascular risk in patients with migraine, in particular in those with aura. A possible link between both conditions might be a dysfunction of the vascular endothelium. This observational study analyzed the endothelial markers angiopoietin-1, angiopoietin-2, Tie-2, sFlt-1 and NT-proBNP for the first time in migraineurs, patients with other primary headache disorders and healthy controls. Methods Patients with episodic migraine with and without aura, episodic cluster headache, tension-type headache and healthy controls were included. Blood samples were obtained during migraine attacks and headache-free periods in migraineurs, in and out of bout in cluster headache and during headache-free periods in tension-type headache and healthy individuals to analyze markers of endothelial function. Results No significant difference in endothelial markers between migraine, other headache disorders and healthy controls was detected. There was no significant difference between migraine attacks and headache-free intervals. Additionally, no distinction could be found between migraine with and without aura. Discussion The endothelial markers analyzed do not display a characteristic pattern in different headache disorders especially migraine compared to healthy controls. The novel findings of our study indicate that factors other than endothelial dysfunction seem to be responsible for the at least statistical association of migraine with vascular disease.

Download Full-text