scholarly journals Primary headaches and cognitive disorders — pathophysiologically associated and comorbidity conditions.

Author(s):  
D. A. Iskra ◽  
V. Yu. Lobzin ◽  
S. A. Kalygin

Primary headaches (migraine, tension-type headache and other primary headaches) cause 3% of all disability cases in adult population, fully decrease possibilities of social functioning. Te phenomenon of the central sensitization is one of the fundamental pathophysiological units of primary headaches. NMDA receptors are involved both in initiation and in maintaining of mechanisms of a long-term central sensitization. NMDA activation by glutamate play important role in the initiation of primary headaches. Cognitive impairment development also conducted with NMDA-excitotoxicity due to hyper excitability of NMDA receptors. Tus, it is evident that mechanisms of antinociceptive changes in primary headaches and development of a glutamate excitotoxicity are strongly interdependent. Relationship between somatic symptoms, such as headache in dementia and cognitive symptoms now is represented more widely than just a comorbidity. Te gravity of migraine, tension-type headache and severity of cognitive impairment are strongly connected. Tus, the reliable interrelation between development of primary headache and cognitive decrease is traced, considering a community of pathophysiological mechanisms that has important practical value due to possible correction by NMDA-antagonists. Memantine not only slows the progression of cognitive symptoms in dementia, but also signifcantly influences the frequency and expressiveness of primary headache.

Cephalalgia ◽  
2019 ◽  
Vol 39 (7) ◽  
pp. 883-891 ◽  
Author(s):  
Kati Toom ◽  
Aire Raidvee ◽  
Katri-Helena Allas ◽  
Elina Floria ◽  
Kristiina Juhkami ◽  
...  

Objective To estimate the one-year prevalence of primary headaches, most importantly migraine and tension type headache, but also other primary headaches, in Estonia. Methods A population-based random sample of 2162 subjects in Tartu City and Tartu County were interviewed by telephone or face to face using a previously validated questionnaire. Results Of the 2162 contacted participants, 1215 (56%) fully completed the study. Of these, 502 (41.3%) reported headache during the previous year. The prevalences adjusted by weighting by age, gender, education, marital status and habitat were the following: All headaches 41.0%, all migraine 17.7%, all tension-type headache 18.0%, trigeminal autonomic cephalalgias 0.4%, other primary headaches 2.5%, and chronic headaches 2.7%. Conclusion The 1-year prevalences of primary headache disorders in Estonia are comparable to the previous findings in other European countries.


Cephalalgia ◽  
2013 ◽  
Vol 33 (16) ◽  
pp. 1311-1318 ◽  
Author(s):  
Francesco Margari ◽  
Elisabetta Lucarelli ◽  
Francesco Craig ◽  
Maria G Petruzzelli ◽  
Paola A Lecce ◽  
...  

Background Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.


2011 ◽  
pp. 46-49
Author(s):  
Mario Fernando Prieto Peres ◽  
Daniel Krempel Amado ◽  
André Leite Gonçalves ◽  
Reinaldo Ribeiro ◽  
Jorge Roberto Pagura ◽  
...  

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.


Cephalalgia ◽  
2019 ◽  
Vol 40 (3) ◽  
pp. 299-306
Author(s):  
Torsten Kraya ◽  
Malte Schulz-Ehlbeck ◽  
Philipp Burow ◽  
Stefan Watzke ◽  
Stephan Zierz

Background Headache attributed to ingestion or inhalation of a cold stimulus (HICS), colloquially called ice-cream headache, is a common form of a primary headache in adults and children. However, previous studies on adults are limited due to the small number of patients. Furthermore, most of the subjects in previous studies had a history of other primary headaches. Methods Biographic data, clinical criteria of HICS and prevalence of primary headache were collected by a standardized questionnaire. A total of 1213 questionnaires were distributed; the return rate was 51.9% (n = 629); 618 questionnaires could be analyzed. Results In a cohort of 618 people aged between 17–63 years (females: n = 426, 68.9%), the prevalence of HICS was 51.3% (317 out of 618). There was no difference between men and women (51.3% vs. 51.6%). The duration of HICS was shorter than 30 sec in 92.7%. In the HICS group, localization of the pain was occipital in 17%. Trigemino-autonomic symptoms occurred in 22%, and visual phenomena (e.g. flickering lights, spots or lines) were reported by 18% of the HICS group. The pain intensity, but not the prevalence of HICS, was higher when tension-type headache and migraine or both were present as co-morbid primary headaches (Numeric Rating Scale (NRS) 4.58 and 6.54, p = 0.006). There was no higher risk of participants with migraine getting HICS than for those who did not have migraine (odds ratio = 1.17, 95% confidence interval (CI) 0.75–1.83; p = 0.496). Conclusion The results of this study modified the current criteria for HICS in the ICHD-3 regarding duration and localization. In addition, accompanying symptoms in about one fifth of the participants are not mentioned in the ICHD-3. Neither migraine nor tension-type headache seems to be a risk factor for HICS. However, accompanying symptoms in HICS are more frequent in subjects with another primary headache than in those without such a headache.


2007 ◽  
Vol 65 (4b) ◽  
pp. 1130-1133 ◽  
Author(s):  
Facundo Burgos Ruiz Jr ◽  
Márcia Silva Santos ◽  
Helen Souto Siqueira ◽  
Ulisses Correa Cotta

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Salah A. Abdo ◽  
Mohammed Amood AL-Kamarany ◽  
Karem H. Alzoubi ◽  
Mohamed T. Al-Maktari ◽  
Abdulrhman H. Al-Baidani

Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen.Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004).Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH) was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH) was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P<0.05), while between primary headache and sex was not (P>0.05). In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL). 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist) regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%). Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45%) were unknown agents.Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.


Cephalalgia ◽  
2016 ◽  
Vol 37 (10) ◽  
pp. 947-954 ◽  
Author(s):  
Roberto Torriero ◽  
Alessandro Capuano ◽  
Rosanna Mariani ◽  
Roberto Frusciante ◽  
Samuela Tarantino ◽  
...  

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.


2020 ◽  
Vol 5 (2) ◽  
pp. 539
Author(s):  
Restu Susanti

<p><em>Headache is one of the most common symtomps which cause patients consult a neurologist. Primary headache is headache without other underlying diseases. Primary headaches can be divided into migraine headaches, tension</em><em> </em><em>types-headache, trigeminal autonomic cephalalgias, and other types of headaches. Sex differences play a role in the perception of headache. Theories regarding hormonal, the number of pain-sensitive points, subjectivity, and psychosocial factors are mostly related to the differences of migraine and TTH pathophysiology between women and men.</em></p>


2020 ◽  
Vol 3 ◽  
pp. 251581632095177
Author(s):  
Pawan Ojha ◽  
Vikram Aglave ◽  
Suranjana Basak ◽  
Jayendra Yadav

Introduction: A better understanding of etiology might improve poor outcomes of trochlear headaches (TRHs). Aims: To study clinical spectrum, etiology, and therapeutic response of TRH. Methods: Fifty-three TRH patients seen in a single center between 2015 and 2020 were included, excluding Trigeminal Autonomic Cephalalgia (TAC). Results: Mean age was 36.45 years (range 11–85 years), with 77.35% being females. Twenty-five patients had continuous trochlear headache (CTRH) and 28 episodic trochlear headache (ETRH). Tension-type headache (TTH) occurred in 9 ETRH patients and 24 of 25 CTRH patients, and migraine-like headaches occurred in 19 ETRH patients and 8 CTRH (trochlear migraine) patients. Prior history of headaches was noted in 22 of 28 ETRH and 11 of 25 CTRH patients. Twenty-eight responded to migraine/TTH prophylaxis, 25 being nonresponders (partial/no response). Fourteen of 25 nonresponders, 4 of 28 responders (4 of 4 secondary and 5 of 9 idiopathic trochleitis (IT), 3 of 9 primary TRH (PTRH), and 6 of 28 ETRH) had autoantibodies, that is, 11 antinuclear antibodies (ANAs) and 7 antithyroid antibodies. Ten of 14 (71.42%) antibody-positive nonresponders improved with immunosuppressants including steroids/hydroxychloroquine and only 11 required local injections. Finally, 38 patients had good response, 13 partial, and 2 no response. The etiology and refractoriness of IT can be attributed to underlying autoimmunity and a minor contribution by primary headaches, vice versa being the case for PTRH and ETRH. Refractory TRHs should be evaluated for underlying autoimmunity and primary headaches. Conclusion: Identification and treatment of underlying autoimmunity and primary headaches can help improve outcome of TRH.


CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 32-37
Author(s):  
Daniel P. Greenfield ◽  
Subramanian Hariharan

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.


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