RESUMEN
Congenital malformations of the posterior fossa (PF) encompass a wide spectrum of morphological anomalies that arise during embryonic development. This paper provides a narrative review of these most common disorders from a morphological approach based on the division into cystic (Dandy-Walker malformation, Blake's Pouch cyst, mega cisterna magna, arachnoid cyst, and cerebellar vermis hypoplasia) and non-cystic malformations (Joubert syndrome, rhomboencephalosynapsis, and pontocerebellar hypoplasia). The embryogenesis of PF structures is briefly outlined. While magnetic resonance imaging is the preferred modality for evaluation, computerized tomography and ultrasonography serve complementary roles. In conjunction with clinical aspects, specific radiological features, such as cerebellar vermis morphology, Torcular Herophili position, and the presence/absence of mass effect, are highlighted for accurate diagnosis. We also present some typical radiological findings in non-cystic malformations, such as molar tooth sign, diamondshaped fourth ventricle, and dragonfly-shaped cerebellum. This comprehensive review aims to assist radiologists, neuropediatricians, and general neurologists in recognizing and describing PF malformations, thereby facilitating appropriate management strategies.
As malformações congênitas da fossa posterior (FP) abrangem um amplo espectro de anomalias morfológicas que surgem durante o desenvolvimento embrionário. Este artigo fornece uma revisão narrativa desses distúrbios mais comuns a partir de uma abordagem morfológica baseada na divisão em malformações císticas (malformação de Dandy-Walker, cisto da bolsa de Blake, mega cisterna magna, cisto aracnoide e hipoplasia do vermis cerebelar) e não císticas (syndrome de Joubert, rombencefalossinapse e hipoplasia pontocerebelar). A embriogênese das estruturas da FP é brevemente descrita. Embora a ressonância magnética seja a modalidade preferida para avaliação, a tomografia computadorizada e a ultrassonografia desempenham funções complementares. Em conjunto com os aspectos clínicos, características radiológicas específicas, como a morfologia do vermis cerebelar, a posição da torcula Herophili e a presença/ausência de efeito de massa, são destacadas para um diagnóstico preciso. Apresentamos também alguns achados radiológicos típicos de malformações não císticas, como sinal do dente molar, quarto ventrículo em forma de diamante e cerebelo em forma de libélula. Esta revisão abrangente visa auxiliar radiologistas, neuropediatras e neurologistas gerais no reconhecimento e na descrição das malformações da FP, facilitando, assim, estratégias de manejo adequadas.
RESUMEN
OBJECTIVE: To diagnose fibromyalgia in patients with migraine and assess the quality of life of these patients. METHODS: A prospective, cross-sectional study was carried out, comparing groups, in a non-randomized sample, consisting of patients diagnosed with migraine. The sample was evaluated using the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) questionnaires to diagnose fibromyalgia. Quality of life and level of depression were assessed, respectively, using the Headache Impact Test-6 (HIT-6) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: We interviewed 100 patients (5 men and 95 women) diagnosed with migraine, with a mean age of 37.1±11.0 years, ranging from 19 to 64 years. Thirty-four patients (34%) had migraine and fibromyalgia concomitantly. Migraine predominated in females, both in the presence and absence of fibromyalgia. In both groups, there was no difference in headache characteristics. In the group with fibromyalgia, there was a predominance of allodynia and a higher PHQ-9 score (p<0.001). CONCLUSIONS: Patients with migraine are more predisposed to depression when there is an association with fibromyalgia
OBJETIVO: Diagnosticar fibromialgia em pacientes com enxaqueca e avaliar a qualidade de vida desses pacientes. MÉTODOS: Foi realizado um estudo prospectivo, transversal, comparando grupos, em uma amostra não randomizada, composta por pacientes com diagnóstico de enxaqueca. A amostra foi avaliada por meio dos questionários Widespread Pain Index (WPI) e Symptom Severity Scale (SSS) para diagnóstico de fibromialgia. A qualidade de vida e o nível de depressão foram avaliados, respectivamente, por meio do Headache Impact Test-6 (HIT-6) e do Patient Health Questionnaire-9 (PHQ-9). RESULTADOS: Foram entrevistados 100 pacientes (5 homens e 95 mulheres) com diagnóstico de enxaqueca, com idade média de 37,1±11,0 anos, variando de 19 a 64 anos. Trinta e quatro pacientes (34%) apresentavam enxaqueca e fibromialgia concomitantemente. A enxaqueca predominou no sexo feminino, tanto na presença como na ausência de fibromialgia. Em ambos os grupos, não houve diferença nas características da dor de cabeça. No grupo com fibromialgia houve predomínio de alodinia e maior escore no PHQ-9 (p<0,001). CONCLUSÕES: Pacientes com enxaqueca estão mais predispostos à depressão quando há associação com fibromialgia
Asunto(s)
Humanos , Masculino , Femenino , Calidad de Vida/psicología , Fibromialgia/diagnóstico , Depresión/terapia , Cefalea/complicaciones , Salud/clasificaciónRESUMEN
BACKGROUND: Children and adolescents may experience pain in the lower limbs, predominantly at the end of the day or during the night, without any relation to organic disease. These pains are often called "growing pains" (GP) by pediatricians and orthopedists. They are commonly attributed to rapid growth. OBJECTIVE: The aim of this study was to review and characterize GP in children and adolescents as a precursor/comorbidity with migraine. METHODS: The study was of a cross-sectional, prospective, longitudinal cohort, with group comparison. A sample of 100 children/adolescents born to mothers with migraine seen at a headache clinic was recruited in a random order chosen by lot, maintaining the ratio of 1:1 for the group with GP and the controls. Both groups were followed for a period of 5 years. RESULTS: After 5 years of follow-up, 78 patients completed the study, of which 42 were from the GP group and 36 were from the control group. Headache fulfilling the International Classification of Headache Disorders, 3rd edition diagnostic criteria for migraine without aura or probable migraine occurred in 32/42 (76%) of patients with GP and in 8/36 (22%) of controls (p < 0.001). In the sample that initially had "growing pains," these pains persisted in 6/42 (14%) and appeared in 14/36 (39%) of those who were previously asymptomatic (p = 0.026). CONCLUSIONS: Pain in the lower limbs of children and adolescents, commonly referred to as GP by pediatricians and orthopedists, may reflect a precursor or comorbidity with migraine.
Asunto(s)
Trastornos Migrañosos , Dolor , Adolescente , Niño , Humanos , Estudios Transversales , Cefalea , Trastornos Migrañosos/diagnóstico , Estudios ProspectivosRESUMEN
Introduction: Propranolol was the first non-selective beta-adrenergic blocker to be developed. Initially it was used in the treatment of cardiovascular diseases, but since the 60's it has been used in the prevention of migraine. Objective: The objective of this study was to know the history of propranolol and its use as a migraine prophylactic. Methods: This study was an integrative literature review using articles with historical data on propranolol, from its origin in cardiology to its indication in the preventive treatment of migraine. Results: Propranolol was described in 1962 for the treatment of cardiovascular diseases. In the same decade, it was prescribed for the preventive treatment of migraine and, recently, included in the consensus of the Brazilian Headache Society. Conclusion: Although propranolol was initially synthesized for the treatment of heart disease, it has proved to be an effective drug in preventing migraine attacks
Introdução: O propranolol foi o primeiro bloqueador beta-adrenérgico não seletivo a ser desenvolvido. Inicialmente era utilizado no tratamento de doenças cardiovasculares, mas desde a década de 60 tem sido utilizado na prevenção de enxaquecas. Objetivo: O objetivo deste estudo foi conhecer a história do propranolol e seu uso como profilático para enxaqueca. Métodos: Este estudo foi uma revisão integrativa da literatura utilizando artigos com dados históricos sobre o propranolol, desde sua origem na cardiologia até sua indicação no tratamento preventivo da enxaqueca. Resultados: O propranolol foi descrito em 1962 para o tratamento de doenças cardiovasculares. Na mesma década, foi prescrito para o tratamento preventivo da enxaqueca e, recentemente, incluído no consenso da Sociedade Brasileira de Cefaleia. Conclusão: Embora o propranolol tenha sido inicialmente sintetizado para o tratamento de doenças cardíacas, provou ser um medicamento eficaz na prevenção de crises de enxaqueca
RESUMEN
Introduction: Headache is as old as the emergence of man on earth. A classification for headaches has been suggested for many centuries. After the invention of writing, numerous words were created to designate different types of headache. Objective: The objective of this review was to discuss the historical and etymological aspects of the terms "migrânea" and "enxaqueca". Methods: This study was an integrative review using articles with historical data on the etymology of the terms "migrânea" and "enxaqueca" and their evolution over the years. Results: The terms "migrânea" and "enxaqueca" have Greek and Arabic origins, respectively. Both describe a neurological syndrome characterized by headache and other associated symptoms. Usually, sufferers of this disease are more familiar with the term "enxaqueca" and confuse it with headache, while health professionals prefer the term "migrânea". Conclusions: After so many years that the term "migrânea" has been used, it would be a step backwards to use the term "enxaqueca" again, especially because "migrânea" has been adopted by young neurologists, including those from other specialties.
Introdução:A dor de cabeça é tão antiga quanto o surgimento do homem na terra. Uma classificação para dores de cabeça tem sido sugerida há muitos séculos. Após a invenção da escrita, inúmeras palavras foram criadas para designar diferentes tipos de dor de cabeça. Objetivo: O objetivo desta revisão foi discutir os aspectos históricos e etimológicos dos termos "migranânea" e "enxaqueca". Métodos: Este estudo foi uma revisão integrativa utilizando artigos com dados históricos sobre a etimologia dos termos "migranânea" e "enxaqueca" e sua evolução ao longo dos anos. Resultados: Os termos "migranânea" e "enxaqueca" têm origem grega e árabe, respectivamente. Ambos descrevem uma síndrome neurológica caracterizada por dor de cabeça e outros sintomas associados. Normalmente, quem sofre desta doença conhece mais o termo "enxaqueca" e confunde-o com dor de cabeça, enquanto os profissionais de saúde preferem o termo "migranânea". Conclusões: Depois de tantos anos de uso do termo "migranânea", seria um retrocesso usar novamente o termo "enxaqueca", até porque "migranânea" tem sido adotada por jovens neurologistas, inclusive de outras especialidades.
RESUMEN
BACKGROUND: Headache is as old as human history and has been able to report, and the first descriptions were found in Greece and Mesopotamia. OBJECTIVE: Our objective was to know the date of the first description of ICHD-3 headaches, with their respective author. METHODS: We searched for articles that addressed the historical aspects of primary and secondary headaches and painful cranial neuropathies. RESULTS: Twenty-seven different headaches were analyzed according to the occurrence of their first description, with the respective author and country of origin. CONCLUSIONS: The knowledge of the first description of ICHD-3 headaches, with their respective author, showed us how and when the different headaches appeared over the years.