scholarly journals Headache in an emergency room in Brazil

2000 ◽  
Vol 118 (3) ◽  
pp. 58-62 ◽  
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.

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.

Headache Prevalence Among Adolescents — The German DMKG Headache Study

Cephalalgia ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 347-354 ◽  
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.

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

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.

The Prevalence of Headache With Emphasis on Tension-Type Headache in Rural Tanzania: A Community-Based Study

Cephalalgia ◽  
2009 ◽  
Vol 29 (12) ◽  
pp. 1317-1325 ◽  
Author(s):  
AS Winkler ◽  
B Stelzhammer ◽  
K Kerschbaumsteiner ◽  
M Meindl ◽  
W Dent ◽  
...  
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Age Group ◽  
Community Based ◽  
The Past ◽  
Rural Tanzania ◽  
Validated Questionnaire ◽  
Northern Tanzania ◽  
Type Headache

The aim of the study was to assess the prevalence of headache with special attention to tension-type headache (TTH) in a rural area in northern Tanzania. A door-to-door study was performed using a standardized and validated questionnaire. A total of 7412 participants were screened. The total headache prevalence during the past year was 12.1%; the overall 1-year prevalence of TTH was 7%; 5% reported episodic TTH and 0.4% chronic TTH. Borderline cases (International Headache Society code 2.3) were described in 1.6%. The prevalence of headache was highest in the 41-50-year-old group in women and in the 61+ age group in men. This is the first account of the prevalence of TTH in a rural Tanzanian population, and shows that headache in general and, more specifically, TTH are prevalent disorders that deserve attention. However, the prevalence of primary headache seems to be lower than in Western countries.

Paranasal Sinus Disease in Children With Headache

2017 ◽  
Vol 32 (12) ◽  
pp. 1014-1017 ◽  
Author(s):  
Ronan J. Vieira Neto ◽  
Karine C. S. Teixeira ◽  
Marilisa M. Guerreiro ◽  
Maria Augusta Montenegro
Keyword(s):  
Disease Control ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Common Finding ◽  
Control Group ◽  
Fisher Exact Test ◽  
Sinus Disease ◽  
Type Headache

Background: Sinus headache is one of the most frequent misdiagnosis given to children with headache. The objective of this study is to evaluate the frequency of sinus disease in children with headache that do not fulfill the criteria for headache attributed to disorder of the nose or paranasal sinuses. Methods: This is a prospective study conducted at the authors’ pediatric neurology clinic. Data from children with headache was evaluated and compared with a disease control group composed of children without history of headache. All patients underwent neuroimaging assessment. Patients with diagnosis of acute infectious sinus disease were excluded from the analysis. The type of headache was classified according to the International Headache Society. Statistical analysis was performed using the Fisher exact test, with a level of significance of .05. Results: A total of 62 patients with headache were evaluated; 24 boys, 38 girls, ages ranging from 3 to 18 years (mean = 9.7 years). Of the patients, 29 had migraine without aura, 4 had frequent episodic tension type headache, 3 had both migraine without aura and frequent episodic tension type headache, 3 had migraine with brainstem aura, 2 had episodic tension type headache, 1 had migraine with aura. In 20 patients the type of headache could not be established. The disease control group had 41 patients; 25 boys, 16 girls, ages ranging from 3 to 17 years (mean = 7.3 years). Sinus abnormalities detected by neuroimaging were present in 12 patients in the headache group and in 11 patients in the disease control group ( P = .469). Conclusion: The authors conclude that sinus abnormalities are a common finding in neuroimaging tests of children with or without headache. Sinus disease disclosed by neuroimaging evaluation should not preclude the diagnosis of migraine or other types of primary headache.

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.

scholarly journals Prednisone for the treatment of withdrawal headache in patients with medication overuse headache: A randomized, double-blind, placebo-controlled study

Cephalalgia ◽  
2012 ◽  
Vol 33 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Kasja Rabe ◽  
Lutz Pageler ◽  
Charly Gaul ◽  
Christian Lampl ◽  
Torsten Kraya ◽  
...  
Keyword(s):  
Rescue Medication ◽  
Medication Overuse ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Type Headache

Purpose To investigate the efficacy of prednisone for treatment of withdrawal headache in patients with medication overuse headache (MOH). Patients and methods In this prospective double-blind, placebo-controlled, parallel designed multicentre trial, 96 consecutive patients with MOH were randomized to withdrawal treatment with either 100 mg prednisone or placebo over 5 days. Patients were enrolled if they met the International Headache Society criteria for MOH and were diagnosed with migraine or episodic tension-type headache as primary headache. Exclusion criteria comprised significant neurological or psychiatric disorders. Withdrawal symptoms, including headache severity and intake of rescue medication, were documented for 14 days after randomization. Results Patients treated with prednisone did not experience fewer hours of moderate or severe headache than patients receiving placebo. However, patients requested less rescue medication within the first 5 days. Conclusions During withdrawal in MOH, prednisone reduces rescue medication without decreasing the severity and duration of withdrawal headache.

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.

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