Headaches, quality of life, and academic performance in schoolchildren and adolescents.

BACKGROUND: Just a few studies to date have focused on headaches, quality of life, and academic performance in children. OBJECTIVE: Determine the effect of headaches on the life of schoolchildren and the association between headaches and academic performance. METHODS: We conducted a cross-sectional study. One hundred and ninety-five students from an elementary school were randomly selected out of 355 students aged from 10 to 15 years old. Semi-structured interview, the Pediatric Quality of Life Inventory Version 4.0, the Children's Depression Inventory, and the State-Trait Anxiety Inventory were used. The variables relating to academic performance were obtained by consulting the academic records. RESULTS: Prevalence of headaches: headache: 97.3% (179/184); migraine: 51% (94/184); tension-type headache: 33% (61/184); primary stabbing headache: 7.6% (14/184); unclassified headaches: 5.4% (10/184). Migraine (relative risk: 3.11; 95% confidence interval: 1.54-6.30) and more severe headaches (relative risk: 7.93; 95% confidence interval: 2.65-23.7) were associated with lower quality of life (P < .01; multivariate logistic regression). More severe headaches were associated with lower grades in school (P < .01; multiple linear regression). Variables relating to headaches were not associated with "failing the school year" (P > .05; chi-square test and Fisher's exact test). CONCLUSION: Headaches were found to be associated with lower quality of life and poor academic performance.

The risk of headache attributed to surgical treatment of intracranial aneurysms: a cohort study.

OBJECTIVES: The aim of this study was to assess the risk of headache in patients undergoing surgical treatment of intracranial aneurysms. BACKGROUND: The risk of the post-craniotomy headache has never been studied. METHODS: Patients with intracranial aneurysm, who were consecutively admitted to the Hospital da Restauração, Brazil, from May 2009 to October 2010, were interviewed before they underwent surgical or non-surgical treatment of the aneurysms. The patients were followed for 4 months after intervention. The International Headache Society criteria for post-craniotomy headache were used after surgery and adapted for headache after embolization (maximum intensity of pain on the same side of the aneurysm). We also used the Headache Impact Test, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale. RESULTS: Of 101 patients enrolled, 53 patients underwent craniotomy and 48 patients embolization. The surgery group was younger and had fewer women. The incidence of headache was 28/51 cases (54.9%) after surgery and 12/47 cases (25.5%) after embolization (relative risk = 2.15; 95% confidence interval [CI] 1.24-3.72). The incidence of persistent headache was not different between the 2 groups. The only risk factor for headache after the intervention was craniotomy (odds ratio = 2.6; 95% CI 1.1-6.7) and for persistent headache was anxiety prior to treatment (odds ratio = 8.5; 95% CI 1.7-42.3). The headache after treatment was not associated with the risk of anxiety or depression after the intervention. CONCLUSIONS: Patients who underwent craniotomy had an increased risk of headache after treatment of intracranial aneurysms. The incidence of persistent headache after 3 months was higher among patients who had anxiety before the intervention.

Headaches and academic performance in university students: a cross-sectional study.

OBJECTIVES: To estimate the 1-year prevalence of headache, its repercussion and its association with the academic performance of university students. METHODS: Cross-sectional study. Three hundred eighty students were randomly selected out of the 1718, 90.5% of them were interviewed. A semi-structured interview, the Headache Impact Test (HIT-6) and the Hospital Anxiety and Depression Scale were used. The variables related to academic performance: absenteeism, performance coefficient and number of failures in disciplines, were obtained by consulting the academic records. RESULTS: Three hundred forty-four students were interviewed. The headache prevalence was 87.2%. Migraine prevalence was 48.5%. Tension-type headache prevalence was 42.4%. During the 3 months prior to the interview, 8.7% sought emergency services, 30.8% missed class, and 30.8% had a reduction in their productive capacity because of headache. HIT-6: substantial/severe impact = 49%. Multiple linear regressions have shown that serious/very serious-impact headaches are significantly related to greater number of discipline failure and absenteeism. There was no association between student grades and headaches. CONCLUSION: A high prevalence of headache in the studied population was verified. A high headache impact on a student's life was associated with worse academic performance.

Which patients with headache do not seek medical attention?

OBJECTIVES: To evaluate why patients do not discuss their headaches with their doctors and to compare these patients with those who seek medical assistance for headache. METHOD: Cross-sectional study. A total of 200 consecutive patients attended by family doctors had their complaints registered. Those with headaches were interviewed. A semi-structured questionnaire, Headache Impact Test and Hospital Anxiety and Depression Scale were used. RESULTS: Fifty-two percent had headaches. Ten percent sought medical assistance for headache, 11% already had received some form of medical assistance for headache. There was no association between headache disability and seeking a doctor for headache. Patients that did not seek a doctor for headache had a higher prevalence of tension-type headache (59.6% vs. 22.1%; P < .01), a lower prevalence of migraine with aura (32.3% vs. 40.5%; P < .01), headache intensity (5.4 vs. 6.8; P = .01) and frequency (4.2 × 7.4 days/month; P < .01). Fifty-two percent of them needed preventive treatment. Most of them did not seek a doctor because their headaches were mild or received relief from painkillers. CONCLUSIONS: Patients who did not seek medical assistance for headache had more tension-type headache, less migraine with aura, lower headache intensity and frequency, but the same headache disability. Most of them needed preventive treatment and did not seek doctors because their headache was mild or received relief from painkillers.

The long-term effect of craniotomy on temporalis muscle function.

OBJECTIVE: The objective of this study was to evaluate jaw movements and the masticatory muscle in patients who underwent craniotomy for treatment of cerebral aneurysm. STUDY DESIGN: Descriptive study. RESULTS: There were 71 patients evaluated between 4 and 6 months after craniotomy, by means of a systematized approach. Their mean age was 45.3 years. Thirty-four (47.9%) patients complained of headache during dental evaluation. Twenty (28.2%) patients reported pain during normal jaw movements. There was a correlation between pain complaints and jaw movements during dental examinations (P = .03). Patients with postcraniotomy headache had more masticatory muscle tenderness on palpation than those without post-craniotomy headache (P < .02). Jaw protrusion was worse than the reference values (P < .01). CONCLUSIONS: Headache was the complaint in 47.9% of the sample. Jaw movement was statistically a pain-precipitating factor. Patients who suffered from postcraniotomy headache had more masticatory muscle tenderness. There were functional jaw limitations.

SUNCT syndrome associated with pituitary tumor: case report.

For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. He presented a stabbing and intense daily pain located in the left pre-auricular and temporal regions. Each of these intense pain attacks lasted around one minute and presented a frequency of two to eight times per day. The pain was associated with ipsilateral lacrimation, conjunctival injection and rhinorrhea. MRI revealed a pituitary tumor with little suprasellar extent. The subjects serial assays of prolactin, GH, TSH and ACTH were within normal levels. Following transsphenoidal hypophysectomy, with complete removal of the tumor, the subject no more presented pain. The pathological diagnosis was non-secreting adenoma. Fourteen months after the surgery, he remains symptom-free.

SUNCT syndrome associated with pituitary tumor: case report

O paciente relatado neste artigo apresentou uma condição clínica compatível com síndrome SUNCT (cefaléia de curta duração, unilateral, neuralgiforme com hiperemia conjuntival e lacrimejamento). Ele referia dor diária, intensa, em facada, localizada na região pré-auricular e temporal esquerdas. Cada ataque de dor permanecia por cerca de um minuto, com freqüência de duas a oito vezes por dia. A dor se acompanhava de lacrimejamento ipsolateral, congestão conjuntival e rinorréia. A RM mostrou um tumor de hipófise com pouca extensão suprasselar. Dosagens de prolactina, GH, TSH e ACTH estavam em níveis normais. Foi então submetido a hipofisectomia transesfenoidal com remoção completa do tumor após o que a dor cessou completamente. O diagnóstico anátomo-patológico foi adenoma não secretor. Quatorze meses após a cirurgia, o paciente permanecia livre de dor.