primary headache disorders
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2022 ◽  
Vol 7 (4) ◽  
pp. 322-325
Author(s):  
Thomas Mathew ◽  
Shweta Ajay ◽  
B Ramakrishna Goud ◽  
Deepthi Narayan Shanbhag ◽  
Charles J Pallan ◽  
...  

The prevalence of primary headache disorders (PHDs) and their burden has been seldom studied in the rural community setting of a developing country. To study the prevalence of primary headache disorders and their burden in the rural community A door to door survey was done in seven rural villages under Mugalur sub centre area, Sarjapura Primary Health Centre and Anekal taluk, Bangalore district, Karnataka State, south India, for finding the prevalence and burden of PHDs. During the study period of three months, a total of 1255 people were screened in the seven villages. 13.1% (165/1255) of people suffered from PHDs. The population prevalence of migraine without aura was 8.84% (111/1255), tension type headache was 2.86% (36/1255) and chronic migraine was 1.43%(18/1255). The mean number of headache days for all the PHDs was 4.26 (±1.64) days. 66.1% of persons with headache reported minimal or infrequent impact of headache. Among various demographic variables, headache was significantly associated with the female gender and marital status. PHDs are prevalent in the rural communities of developing countries and need urgent attention of primary care physicians, community health departments, governmental agencies and policy makers.


2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Heiko Pohl ◽  
Andreas R. Gantenbein ◽  
Peter S. Sandor ◽  
Jean Schoenen ◽  
Colette Andrée

AbstractPatients with primary headache disorders such as cluster headache cycle between being entirely healthy and almost completely incapacitated. Sick leave or reduced performance due to headache attacks demands flexibility by their social counterparts. The objective of this study is to test the hypothesis that headache patients cause frustration that grows with the times colleagues have to take over their work. In this study, we analysed cluster headache patients’ answers to an online questionnaire. Participants self-reported their number of sick days, the number of days on which leisure activities were missed and whether they felt understood by colleagues and family. We then investigated the correlation between the number of sick days and the proportion of patients feeling understood by colleagues and friends. We found that feeling understood by colleagues and friends decreases with a growing number of sick days. However, when sick days accrue further, this proportion increases again. The number of sick days correlates similarly with both colleagues’ and friends’ understanding. The number of cluster headache patients feeling understood by others decreases with an increasing number of sick days. Their social circles’ frustration with the patients’ failure to meet obligations and expectations are a likely reason. With a growing number of sick days, however, the portion of patients feeling understood rises again despite patients meeting others’ expectations even less. This ‘comprehension paradox’ implies the influence of other factors. We suspect that growing numbers of sick days foster understanding as the disability of the disease becomes increasingly apparent.


Author(s):  
Mr. Bite Rushikesh Vishwanath

Abstract: Headache is an extremely common symptom and collectively headache disorders are among the most common of the nervous system disorders, with a prevalence of 48.9% in the general population.1 Headache affects people of all ages, races and socioeconomic status and is more common in women. Some headaches are extremely debilitating and have significant impact on an individual’s quality of life, imposing huge costs to healthcare and indirectly to the economy in general. Only a small proportion of headache disorders require specialist input. The vast majority can be effectively treated by a primary care physician or generalist with correct clinical diagnosis that requires no special investigation. Primary headache disorders – Headaches, tension headache and cluster headache – constitute nearly 98% of all headaches; however, secondary headaches are important to recognise as they are serious and may be life threatening. This article provides an overview of the most common headache disorders and discusses the red flag symptoms that help identify serious causes that merit urgent specialist referral. The current pathway of headache care in the UK is discussed with a view to proposing a model that might fit well in the financially constrained National Health Service (NHS) and with new NHS reforms. The role of the national society, the British Association for the Study of Headache, and the patient organisations such as Headaches Trust in headache education to the professionals and the general public in shaping headache care in the UK is described. The article concludes by summarising evidence-based management of common headache diagnoses. Keywords: Headache, Headaches, tension headache, cluster headache, medication overuse headache


Cephalalgia ◽  
2021 ◽  
pp. 033310242110600
Author(s):  
Isa Amalie Olofsson ◽  
Katrine Falkenberg ◽  
Jes Olesen ◽  
Thomas Folkmann Hansen

Introduction In the general population 4% have never experienced a headache. Freedom from headache could be due to distinctive protective mechanisms or a lack of environmental risk factors for headache. Isosorbide-5-mononitrate is an organic nitrate which in the body is metabolised to nitric oxide. The nitric oxide pathway plays a crucial role in the primary headaches. We hypothesized that people who are free from headache are protected by distinctive mechanisms in the nitric oxide pathway. Methods We performed an observer blinded case-control study using nitric oxide to provoke a headache. 32 headache free male participants and 26 randomly selected male controls received 60 mg Isosorbide-5-mononitrate orally on the study day. Participants fill out a headache diary with headache intensity and characteristics until 12 hours after administration of Isosorbide-5-mononitrate. Primary endpoint were areas under the curve of headache intensity score. Results All 58 participants completed the study. There was no significant difference in headache incidence, headache intensity score or migraine-like attack between headache free participants and controls. Conclusion We show that men who have never experienced a headache develop a headache when provoked with Isosorbide-5-mononitrate. This indicates that freedom from headache in men is not related to the nitric oxide pathway which is involved in the primary headache disorders.


2021 ◽  
Author(s):  
Martin Ruttledge ◽  
Gregor Broessner ◽  
Astrid Gendolla ◽  
Els Hollanders

Abstract Background: There is an unmet need for the correct diagnosis of primary headache disorders, such as migraine, in primary care. Misdiagnosis is associated with suboptimal management of patients, and it is now widely accepted internationally that better diagnostic support is needed for general practitioners (GPs). In this study, we describe the development of a short, patient-directed questionnaire and supporting documents that aim to help with the diagnosis of headache disorders in primary care. We have also prepared patient feedback material and collected preliminary input from patients, but the main aim of this report is to invite comment and debate on the use of the questionnaire in real-life clinical practice.Methods: This questionnaire was developed over 18 months using the clinical experience of the authors, current literature review and the International Classification of Headache Disorders (ICHD), 3rd edition, for migraine, tension-type headache, cluster headache and medication-overuse headache. The questionnaire and two supporting documents will hopefully assist the GP to make a correct diagnosis. A patient survey was used to gather feedback from a small number of patients, and based on these comments, the questionnaire and the supporting documents were modified and updated.Results: Feedback gathering was attempted in Austria, Germany, Switzerland, Ireland and Spain, but was only possible in Austria due to the COVID-19 pandemic restrictions. From the 18 patients who participated, 17 responded about how easy or difficult the questionnaire was to complete, with 14/17 (82%) being able to complete the questionnaire easily on their own. Overall, the patients found the questionnaire averagely helpful in reminding them of and communicating their headache triggers, symptoms and behaviour changes; on a scale of 1–5, with 1 being very helpful and 5 being not helpful at all, the mean scores were 2.8 and 2.7 (n=18), respectively. Conclusions: This questionnaire and associated documents were developed with a view to helping GPs to make an accurate headache diagnosis quickly in primary care. Following feedback from patients, updates have been made, including changes to reduce the time it takes to complete the questionnaire. Next steps include wider validation and feedback from primary care physicians.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Isa Amalie Olofsson ◽  
Jeppe Hvedstrup ◽  
Katrine Falkenberg ◽  
Mona Ameri Chalmer ◽  
Henrik Winther Schytz ◽  
...  

Abstract Background Headache affects 90–99% of the population. Based on the question “Do you think that you never ever in your whole life have had a headache?” 4% of the population say that they have never experienced a headache. The rarity of never having had a headache suggests that distinct biological and environmental factors may be at play. We hypothesized that people who have never experienced a headache had a lower general pain sensitivity than controls. Methods We included 99 male participants, 47 headache free participants and 52 controls, in an observer blinded nested case-control study. We investigated cold pain threshold and heat pain threshold using a standardized quantitative sensory testing protocol, pericranial tenderness with total tenderness score and pain tolerance with the cold pressor test. Differences between the two groups were assessed with the unpaired Student’s t-test or Mann-Whitney U test as appropriate. Results There was no difference in age, weight or mean arterial pressure between headache free participants and controls. We found no difference in pain detection threshold, pericranial tenderness or pain tolerance between headache free participants and controls. Conclusion Our study clearly shows that freedom from headache is not caused by a lower general pain sensitivity. The results support the hypothesis that headache is caused by specific mechanisms, which are present in the primary headache disorders, rather than by a decreased general sensitivity to painful stimuli. Trial registration Registered at ClinicalTrials.gov (NCT04217616), 3rd January 2020, retrospectively registered.


2021 ◽  
pp. 874-883
Author(s):  
Mark A. Whealy ◽  
F. Michael Cutrer

Primary headache disorders are those in which the headache is the primary feature of the disorder and is not otherwise explained by a structural, genetic, or metabolic cause. This chapter reviews the clinical features, diagnosis, and treatment of common primary headache disorders, including migraine, tension-type, and chronic daily headaches. Migraine usually starts during adolescence, and 90% of patients with migraine have their first attack by age 40 years. In childhood, there is a slight male predominance, but after puberty, a 3:1 female predominance is established. The highest reported prevalence of migraine is in patients who are 30 to 39 years old.


2021 ◽  
pp. 892-900
Author(s):  
Amaal J. Starling ◽  
David W. Dodick

In the evaluation of a patient with headache, the first task is to differentiate between a secondary headache and a primary headache. This step is essential because secondary causes of headache may require vastly different evaluation and treatment than primary headache disorders. Thunderclap headache (TCH) is an acute, severe headache with an abrupt onset, reaching maximum intensity in less than 1 minute. TCH is a neurologic emergency and should immediately prompt an urgent evaluation for a secondary headache.


2021 ◽  
pp. 884-891
Author(s):  
Juliana H. VanderPluym ◽  
Rashmi B. Halker Singh

Primary headache disorders are those in which the predominant clinical feature is headache that is not caused by or attributed to another disorder. This chapter reviews the common primary headache disorders of migraine, tension-type headache, and chronic daily headache. The present chapter reviews less common primary headache disorders, such as trigeminal autonomic cephalalgias and headaches with certain triggers. A careful history, physical examination, and additional testing are often necessary to rule out a secondary cause.


Cephalalgia ◽  
2021 ◽  
pp. 033310242110456
Author(s):  
Steffen Naegel ◽  
Julia Zeller ◽  
Anders Hougard ◽  
Christopher Michael Weise ◽  
Stefan Zuelow ◽  
...  

Objective To identify grey matter alterations in patients suffering new daily persistent headache to enrich the pathophysiological concept of this rare headache disorder characterised by a distinct, clearly remembered onset and its instant chronification. Method Magnetic resonance-based voxel-based and surface-based morphometry was used to investigate 23 patients suffering from new daily persistent headache and 23 age- and gender-matched healthy controls with 1.5 Tesla MRI. Independent statistical analysis was performed at three sites using statistical parametric mapping, as well as FSL(FMRIB Software Library)-based approaches. Results No grey matter changes were detected using this sophisticated and cross-checked method. Conclusion The absence of structural brain changes in patients with new daily persistent headache contribute to the recent discussion regarding structural alterations in primary headache disorders in general and does not provide evidence for grey matter changes being associated with the pathophysiology of new daily persistent headache. Future research will have to determine the underlying pathophysiological mechanisms of this disorder.


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