scholarly journals Fundoscopic findings in patients presenting with primary headache disorders.

2019 ◽  
Vol 26 (10) ◽  
pp. 1765-1769
Author(s):  
Bilal Khan ◽  
Khalid Khanzada ◽  
Muhammad Usman Khan ◽  
Sajjad Ullah ◽  
Usman Haqqani

Objectives: To know about the findings on fundoscopic examination in patients complaining of primary headache presenting to the Neurosurgical Outpatient Department (OPD). Study Design: Cross sectional study. Setting: Neurosurgery unit of Govt. Naseer Ullah Babar Memorial Hospital, Kohat Road, Peshawar. Period: December 2016 to December 2017. Materials and Methods: All patients presenting to the Neurosurgical OPD with complaints of headache on whom a fundoscopy was done, were included in the study. The age, gender, duration of symptoms, findings on the fundoscopy, and the need for further studies i.e. CT brain, were noted on a proforma. Any positive findings on fundoscopy were further referred to and evaluated by an ophthalmologist under the slit lamp. All patients with history of recent trauma, focal neurological deficit, and those who had undergone brain imaging were excluded from the study. Consent was taken from all the patients. The data was analyzed by SPSS version 19, and was expressed in the form of tables and charts. Results: A total of 19,000 patients were evaluated in the Neuro-OPD during study period, and 1086 patients were having headache.  Majority of the patients were females with a number of 619 (56.99%), while 447(43.01%) were males. The male to female ratio was approaching 1.38:1. Age range was from 9 to 62 years and the mean age was 37 years. Duration of symptoms was from 20 days to 12 years with a mean duration of 9 months. Positive findings were noted in a minority of patients, 2.5% (n=28); including pappiledema, diabetic and hypertensive changes. Subsequent Brain imaging was done in 93(8.5%) patients, majority of them were on patients' request, and only 7 patients were having an intracranial lesion. Conclusion: A minority of patients with headache without any neurology had intracranial lesion. However, the importance of fundoscopy cannot be overruled, and should be performed in every patient with headache.

Cephalalgia ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 347-354 ◽  
Author(s):  
K Fendrich ◽  
M Vennemann ◽  
V Pfaffenrath ◽  
S Evers ◽  
A May ◽  
...  

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.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jasem Youssef Al-Hashel ◽  
Fathi Abokalawa ◽  
Maram Alenzi ◽  
Raed Alroughani ◽  
Samar Farouk Ahmed

Abstract Background Coronavirus disease-19 is caused by the severe acute respiratory syndrome coronavirus 2 Headache is a common symptom during and after Coronavirus disease-19. We aimed to study headache character in relation to COVID-19. Methods This was a cross-sectional study. Patients who had Coronavirus disease-19, confirmed by reverse transcription polymerase chain reaction technique and presented to the headache clinic within 3 months after the onset of infections were identified to the study. Study included patients diagnosed as primary headache disorders according to The International Classification of Headache Disorders, 3rd edition. Participants were grouped into categories according to having previous or de novo headache. Descriptive data, paired sample t-test and the chi-squared test (X2) were used for statistical analyses of the data. Results A total of 121 patients were included in this study. Their mean age was 35.29 + 9.54 and most of them were females (83.5%). Prior to Coronavirus disease-19 infections, 78 (64.5%) had migraine and 11(9.1%) experienced a tension-type headache while 32 (26.4) reported de novo headache post Coronavirus disease-19. Patient had significant increase in headache days 11.09 ± 8.45 post Coronavirus disease-19 compared with 8.66 ± 7.49 headache days before Coronavirus disease-19 infection (p < 0.006). Post Coronavirus disease-19, the usage of analgesic increased significantly by the patient with migraine (2.31 ± 1.65 vs 3.05 ± 2.09, p = 0.002) while the patient with tension type headache had statistically significant increase in severity (5.556 ± 1.86 vs 7 ± 2.25, p = 0.033) and frequency (7 ± 6.29 vs 12.72 ± 7.96, p = 0.006) of headache attacks. Bi-frontal and temporal headache are the most reported (40.6% each) headache site among de novo headache group. Patients younger than 40 years had longer duration of the headache attack (18.50 ± 16.44 vs 5.5 ± 9.07, p = 0.045) post COVID-19. Male patients compared to females (8.66 ± 1.15 versus 5.93 ± 2.01 p = 0.04) had more severe headache post Coronavirus disease-19. De novo headache resolved within 1 month in most of patients (65.3%). Conclusion Primary headache get worse after Coronavirus disease-19. De novo primary headache is frequent post Coronavirus disease-19 and resolve within 1 month. Headaches related to Coronavirus disease-19 are severe, present as migraine phenotype. Young male patients with Coronavirus disease-19 tend to have worse headache.


Cephalalgia ◽  
2020 ◽  
Vol 40 (13) ◽  
pp. 1422-1431 ◽  
Author(s):  
Rehab Magdy ◽  
Mona Hussein ◽  
Christine Ragaie ◽  
Hoda M Abdel-Hamid ◽  
Ahmed Khallaf ◽  
...  

Objective To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. Methods A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. Results: The majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) ( p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) ( p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) ( p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) ( p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity. Conclusion Healthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.


2017 ◽  
Vol 4 (1) ◽  
pp. 18-22
Author(s):  
Sohail Amir ◽  
Syed Amir Shah ◽  
Khaleeq -Ur- Zaman

OBJECTIVEThe objective of this study was to determine the frequency of dural tear in patients with depressed skull fractures.MATERIAL and MethodThis cross-sectional study was conducted in department of Neurosurgery Pakistan institute of Medical Sciences Islamabad from January 2010 to December 2011. All patients of either gender with depressed skull fracture above one year of age were included in the study. CT brain with bone window done in all patients. Per-operative dura in the region of depressed skull fracture was closely observed for any dural tear. The data collected on pre designed proforma. and analyzed using SPSS version 20.0RESULTSA total of 96 patients were recruited in the study out of which 58(60.4%) were male and 38(39.5%) were female. Male to female ratio was 1.5:1. And mean age was 19.23 + 2.54 years. The most common location of depressed skull fracture was parietal 37(38.5%), followed by frontal in 27(28.1%), 15(15.6%)in temporal region,13(13.5%) in occipital region and only 4(4.1%) located in posterior fossa. Dural tear was present in 33(34.3%) while in 63(65.6%) it was absent. Other finding associated with depressed skull fracture per operatively were extradural hematoma in 16(16%), subdural hematoma in 11(11.4%), contusion in 16(16.6%) and pneumoencephalus was observed in 20(20.8%) cases.CONCLUSIONThe frequency of dural tear in DFS is quite high, so one should be vigilant to identify the defect and repair it properly to minimize post operative complications.


Author(s):  
Al-Amir Bassiouny Mohamed

Abstract Background Headache disorders are rated among the ten most disabling conditions around the world. The primary headache disorders are more common that of secondary headache. The third edition of the International Classification of Headache Disorders (ICHD-III) is considered as a helpful tool for classification and diagnosis of different headache disorders. Methods This is a cross-sectional study that included 500 patients who attended to the headache clinic, between May 2018 and April 2019. Arabic version of headache questionnaire was used to characterize headache, according to ICHD-III. Results Primary headache disorders were found in 89% (most of them is episodic in nature 76.2%), secondary headache disorders in about 10%, and painful cranial neuropathy was present in 0.8%. Primary headache associated with sexual activity was present in 1% of the total number of headache patients, and episodic cluster headache was found in 0.8%. Medication overuse headache (MOH) was the most frequent secondary headache with 2.8% of the total number of headache patients, and when overlaps with chronic migraine or chronic tension type of headache (TTH), the percent was 12.8% and 8.8% respectively. Male to female ratio was 1:3, 3:5, and 1:1 in primary headache, secondary headache, and painful cranial neuropathy respectively. Simple analgesia was the most common abortive therapy (44.8%) while the antidepressants were the most common preventive treatment (17%). Conclusion This study estimates the frequency and characterizes different headache disorders, according to ICHD-III in an outpatient headache clinic at Sohag Governorate, Egypt.


2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Muslim Ali Lakhiar ◽  
Abdul Hafeez Bughio ◽  
Ashique Ali Arain ◽  
Manzoor Ali Lakhiar

Objectives: To determine the various patterns of headache presenting to Neurology OPD Liaquat University Hospital Jamshoro/Hyderabad. Study Design: Descriptive, cross-sectional study. Setting: Department of Neurology, Liaquat University of Medical & Health Sciences (LUMHS). Period: July to December 2016. Methods: Data was collected on developed profoma, the same was analyzed on SPSS 22nd version. Results: Out of 238 patients, 61 (25.6%) were male 177 (74.4%) were female patients. Age group distribution of study population ranged from 04 - 65 years with mean age was 31.66 with standard deviation of12.72. Out of 238 patients 170 (71.4%) were diagnosed as primary headache disorders, 56 (17%) were secondary headache while 12 (%) were labeled as cranial neuropathies and facial pains. Migraine without aura 113(65.3%) followed by tension type headache 35(20.2%) were most common primary headache disorder. Among secondary headaches Cervicogenic headache 16(30.2%) was most common cause followed by headache secondary to sinusitis, hypertension and trauma 8(15.1%), 7 (13.2%) and 6(11.3%) respectively. Trigeminal Neuralgia 9 (75.0%) was most common painful cranial neuropathies. Conclusion: Primary as well as secondary headache disorders are most prevalent in female at an age range of 21-40 years with majority of them suffering from migraine followed by tension and Cervical origin respectively.


2021 ◽  
Vol 9 ◽  
pp. 205031212110502
Author(s):  
Delon D Souza ◽  
Sonia Shivde ◽  
Poonam Awatare ◽  
Amrutha Avati ◽  
Saji K John ◽  
...  

Objectives: The prevalence and characteristics of COVID-19-related headaches are not known in Indian patients. We aim to determine the prevalence and characteristics of headache in COVID-19-infected individuals and make a comparison with those without headaches. Methods: This prospective cross-sectional observational study was conducted from 1 October to 31 October 2020. Data were collected using a detailed questionnaire. We compared the data of those with and without headaches to identify the differences between the groups. Results: During the study period of 1 month, among 225 COVID-19-infected patients, 33.8% patients had headaches. The mean age of patients with headache was 48.89 ± 15.19 years. In all, 53.9% were females. In 65.8%, headache occurred at the onset of viral illness; 44.7% described the headache as dull aching; 39.5% had bifrontal headache; and 32.9% had holocranial headache. In total, 78.9% had complete resolution of headache within 5 days. A comparison between those with and without headaches showed that those with headaches were more younger (48.89 ± 15.19 vs 54.61 ± 14.57 years, p = 0.007) and of female gender (41/76(53.9%) vs 41/149 (27.5%), p = 0.001). Primary headache disorders were more common in the headache group. Levels of inflammatory markers such as leukocyte count (7234.17 ± 3054.96 vs 8773.35 ± 5103.65, p = 0.017), erythrocyte sedimentation rate (39.28 ± 23.29 vs 50.41 ± 27.61, p = 0.02) and ferritin (381.06 ± 485.2 vs 657.10 ± 863.80, p = 0.014) were lower in those with headaches. Conclusions: Headaches are a common and early symptom of acute SARS-CoV-2 infection more frequently seen in young females and in those with a history of primary headache disorders. The lower level of inflammatory markers in those with headaches suggests that these headaches are probably due to the local spread of virus through the trigeminal nerve endings, resulting in activation of the trigeminovascular system.


Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.


2021 ◽  
Vol 15 (9) ◽  
pp. 2841-2843
Author(s):  
Muhammad Omer Farooq ◽  
Niaz Ahmed ◽  
Hassan Nadeem ◽  
Kashif Rafi ◽  
Sadia Jabbar ◽  
...  

Objective: To determine the frequency of high MELD score in cirrhotic patients undergoing liver resection due to hepatocellular carcinoma also compare the frequency of mortality in patients with high or low MELD score. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. Duration: 6months i.e. 23 12-2017 to 22-06-2018. Methodology: 75 patients were enrolled. Then blood sample was obtained. Reports assessed and MELD score calculated. Scores were labeled as high or low. Patients underwent liver resection according to BCLC. The mortality was noted. All the collected data was entered and analyzed on SPSS version 22. Results: In this study out of total 75 cases 60 were males and 15 females. The mean age of patients was 39.44±9.76 years, male to female ratio was 4:1. Low MELD class was noted in 45 (60%) cases and high MELD class noted in 30(40%) cases. Mortality occurred in 27(36%) cases. Insignificant difference found between the MELD class with mortality. Conclusion: High MELD score was seen in 40% cirrhotic patients undergoing liver resection due to HCC. Post HCC resection, mortality occurred in 36% patients within three months of surgery. No significant association was found between the mortality and MELD score. Keywords: MELD, Hepatocellular Carcinoma, Mortality, Cirrhosis


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