Characteristics of posttraumatic headache following mild traumatic brain injury in military personnel in Iran.

OBJECTIVES: The primary goal of this study was to evaluate the incidence and characteristics of posttraumatic headache attributed to mild brain injury in military personnel in Iran within a prospective and observational study design. METHODS: A prospective observational descriptive study was conducted with a cohort of military personnel under military education during a 6-month period at the Military Education Center in Isfahan, Iran. 322 military personnel under education were selected randomly and were given a 13-item mild brain injury questionnaire accompanied with affective disorders and headache questionnaires and were reevaluated after a 3-month interval. RESULTS: A total of 30 (9.3 %) of the 322 military personnel met criteria for a mild brain injury. Among them, 18 personnel (60 %) reported having headaches during the 3-month reevaluation. PTHs defined as headaches beginning within 1 week after a head trauma were present in 5.6 % of military personnel under study during 6 months. In total, 67 % of posttraumatic headaches (PTH) were classified as migrainous or possible migrainous features. Patients with affective disorders such as posttraumatic stress disorder and depression were at a higher risk for developing PTH following mild brain injury (p < 0.05). PTH did not relate to demographic factors such as age or type of trauma. CONCLUSIONS: Posttraumatic headache attributed to mild brain injury is a common disorder in military personnel. Migrainous features are predominant among them in comparison with the general population. PTH is not related to a type of trauma, but has association with affective disorders.

Evaluation of the effect of donepezil on cerebral blood flow velocity in Alzheimer's disease.

OBJECTIVES: To evaluate the effect of Donepezil on cerebral blood flow velocity using non-invasive transcranial Doppler (TCD) sonography. METHODS: This clinical trial was carried out in the Department of Neurology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran from March 2008 to July 2009, on Alzheimer's disease (AD) patients in 2 groups of case and control, each consisting of 11 patients. The case group who received Donepezil medication was examined by TCD before (baseline), after 4 weeks of oral treatment with 5 mg per day Donepezil, and a further 4 weeks of 10mg per day Donepezil, orally. The control group comprised AD patients who did not receive any medications, and were examined by TCD only once. Peak systolic (PSV), end-diastolic (EDV), and mean flow (MFV) velocities of the posterior cerebral artery (PCA) and the middle cerebral artery (MCA) was assessed by TCD. Also, mini-mental state examination (MMSE) was carried out. RESULTS: There were no significant differences between the case and control groups, in terms of age and gender. In the case group, the mean MMSE score reached 20.2 +/- 2.8 from a baseline value of 15.8 +/- 3.3 after 4 weeks of oral treatment with 5 mg/d Donepezil, and reached 20.6 +/- 3.9 after 4 more weeks at 10 mg/d Donepezil. In the MCA, the difference in PSV and MFV values after 4 weeks of treatment with 10 mg/d Donepezil was statistically significant compared with the baseline values. In PCA, the values of MFV and EDV after 4 weeks of treatment with 10 mg/d Donepezil were statistically significant in comparison with the baseline value. CONCLUSION: Donepezil (10 mg/d) increased cerebral blood flow velocity and MMSE score in our AD patients, but more extensive trials are recommended.