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1.
Vasc Health Risk Manag ; 18: 685-700, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36082197

RESUMO

Cervical Artery Dissection (CeAD) is a frequent stroke etiology for patients younger than 50 years old. The most common immediate complications related to CeAD are headache and neck pain (65-95%), TIA/ischemic stroke (>50%), and partial Horner's syndrome (25%). The prevailing hypothesis regarding the pathogenesis of sCeAD is that the underlying constitutional vessel wall weakness of patients with sCeAD is genetically determined and that environmental factors could act as triggers. The stroke prevention treatment of CeAD remains controversial, involving anticoagulation or antiplatelet therapy and potentially emergent stenting and/or thrombectomy or angioplasty for selected cases of carotid artery dissection with occlusion. The treatment of headache associated with CeAD depends on the headache phenotype and comorbidities. Radiographically, more than 75% of CeAD cases present with occlusion or non-occlusive stenosis. Many patients demonstrate partial and complete healing, more commonly in the carotid arteries. One-fifth of the patients develop dissecting pseudoaneurysm, but this is a benign clinical entity with an extremely low rupture and stroke recurrence risk. Good recovery is achieved in many CeAD cases, and mortality remains low. Family history of CeAD, connective tissue disorders like Ehlers-Danlos syndrome type IV, and fibromuscular dysplasia are risk factors for recurrent CeAD, which can occur in 3-9% of the cases. This review serves as a comprehensive, updated overview of CeAD, emphasizing etiopathogenesis and management.


Assuntos
Dissecação da Artéria Vertebral , Cefaleia/etiologia , Cefaleia/terapia , Humanos , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Dissecação da Artéria Vertebral/complicações , Dissecação da Artéria Vertebral/terapia
4.
Clin J Sport Med ; 32(5): e457-e460, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36083331

RESUMO

OBJECTIVE: The purpose of this study was to determine the effects of premorbid headache status on vestibular and oculomotor baseline tests in collegiate club athletes. DESIGN: Retrospective case-control study. SETTING: Sport Concussion Laboratory. PATIENTS OR PARTICIPANTS: Collegiate club athletes with a self-reported premorbid headache history (n = 32, 19.50 ± 1.98 years, and 31% women) and age-sex-sport-matched controls (n = 32, 19.56 ± 1.47 years, and 31% women) without a self-reported headache history were included. INTERVENTIONS: Participants were grouped based on a self-reported headache history at baseline. Controls were randomly matched to self-reported headache participants by age, sex, and sport. MAIN OUTCOME MEASURES: Vestibular/ocular motor screen (VOMS) baseline symptoms, symptom provocation, near point of convergence (NPC) distance, and King-Devick (K-D) test time were compared between groups. RESULTS: Athletes with a self-reported headache history at baseline are 3.82 times more likely to have abnormal NPC scores (P = 0.032) and 4.76 times more likely to have abnormal K-D test times (P = 0.014) than those without a headache history. There was no difference in VOMS baseline symptoms or symptom provocation between groups (P > 0.05). CONCLUSIONS: Club collegiate athletes with a headache history were more likely to screen as abnormal during a vestibular/ocular motor function assessment than athletes without a history of headaches. Healthcare professionals should screen for pre-existing headache during baseline concussion assessments before test interpretation. CLINICAL RELEVANCE: A premorbid headache history at preseason baseline assessment may influence vestibular and oculomotor function, and care should be taken when interpreting these individuals' tests.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Adolescente , Atletas , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Estudos de Casos e Controles , Feminino , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Masculino , Testes Neuropsicológicos , Estudos Retrospectivos , Adulto Jovem
6.
Am Fam Physician ; 106(3): 260-268, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36126007

RESUMO

A detailed history and physical examination can distinguish between key features of a benign primary headache and concerning symptoms that warrant further evaluation for a secondary headache. Most headaches that are diagnosed in the primary care setting are benign. Among primary headache disorders, tension-type headache is the most common, although a migraine headache is more debilitating and likely to present in the primary care setting. Signs such as predictable timing, sensitivity to smells or sounds, family history of migraine, recurrent sinus headache, or recurrent severe headaches with a normal neurologic examination could indicate migraine headache. Evaluating acute headaches using a systematic framework such as the SNNOOP10 mnemonic can help detect life-threatening secondary causes of headaches. Red flag signs or symptoms such as acute thunderclap headache, fever, meningeal irritation on physical examination, papilledema with focal neurologic signs, impaired consciousness, and concern for acute glaucoma warrant immediate evaluation. For emergent evaluations, noncontrast computed tomography of the head is recommended to exclude acute intracranial hemorrhage or mass effect. A lumbar puncture is also needed to rule out subarachnoid hemorrhage if the scan result is normal. For less urgent cases, magnetic resonance imaging of the brain is preferred for evaluating headaches with concerning features. Primary headache disorders without red flags or abnormal examination findings do not need neuroimaging.


Assuntos
Dor Aguda , Transtornos de Enxaqueca , Adulto , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Neuroimagem , Exame Neurológico , Punção Espinal/efeitos adversos
7.
Arq Neuropsiquiatr ; 80(6): 631-633, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35946703

RESUMO

Although neurocognitive dysfunction has been observed after infection by SARS-CoV-2, few studies have detailed these alterations or demonstrated their impact on daily life activities and work. Here, I describe the sequence of events following a mild COVID-19 infection in August 2020 (which now is described as "post-COVID syndrome") and comment on my ensuing limitations associated with cognitive difficulties, headache, fatigue and sleepiness. Furthermore, I discuss the efforts that I have made to recover from my infection since its beginning and the strategies adopted for living with persistent restrictions in terms of cognitive performance.


Assuntos
COVID-19 , Disfunção Cognitiva , Encéfalo , Disfunção Cognitiva/etiologia , Cefaleia/etiologia , Humanos , SARS-CoV-2
8.
Emergencias (Sant Vicenç dels Horts) ; 34(4): 275-281, Ago. 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-205966

RESUMO

Objetivo. Investigar si existen diferencias en las manifestaciones clínicas por consumo de cannabis según la edad, y si estas se modifican en función del sexo o el consumo de etanol. Método. Estudio observacional descriptivo de pacientes atendidos en 11 servicios de urgencias con consumo de can- nabis como motivo de consulta. Se recogieron 11 manifestaciones clínicas y se analizó su frecuencia relativa en fun- ción de la edad mediante curvas spline cúbicas restringidas. Se analizó si existía interacción en el comportamiento etario de cada uno de los síntomas en función del sexo y del consumo de etanol. Resultados. Se analizaron 949 pacientes, edad media 29 años, 74% varones y 39% con coingesta de etanol. Se iden- tificaron tres patrones de síntomas según la edad: estable (vómitos, cefalea, convulsiones, hipotensión), incrementada en edades medias (agresividad-agitación, ansiedad, psicosis, palpitaciones, alucinaciones) y con aumento progresivo con la edad (dolor torácico e hipertensión). En la relación síntoma-edad, la frecuencia de palpitaciones, vómitos y ce- falea tuvo un comportamiento significativamente diferente según el sexo, más constante en hombres y con un incre- mento marcado en edades medias en mujeres. La coingesta de etanol se asoció con más agitación-agresividad (34,0%/23,4%, p < 0,001) y menos palpitaciones (9,8%/15,6%, p = 0,01), ansiedad (20,7%/27,8%, p = 0,01), psico- sis (10,3%/16,6%, p = 0,007) y dolor torácico (3,8%/9,5%, p = 0,001). En cuanto a la relación síntoma-edad, el eta- nol solo modificó significativamente la frecuencia de vómitos y de psicosis. Conclusión. La edad condiciona efectos clínicos diferenciales en algunas manifestaciones agudas de la intoxicación por cannabis que precisa asistencia hospitalaria, y el sexo y el consumo simultáneo de alcohol modifican esta relación entre edad y frecuencia de algunos síntomas. (AU)


Objectives. To study whether there are age-related differences in the clinical effects of cannabis poisoning and whether any age differences found are also related to sex or coingestion of alcohol. Methods. Descriptive observational study of patients treated in 11 emergency departments for symptoms related to cannabis use. We collected data on 11 clinical manifestations and used a restricted cubic spline model to analyze their relative frequency according to age. We also looked for any interactions between the findings and patient sex or alcohol coingestion. Results. A total of 949 patients were studied. The mean age was 29 years, 74% were males, and 39% had also consumed alcohol. We identified 3 symptom patterns related to age. One set of symptoms (vomiting, headache, convulsions, and hypotension) remained stable across all ages. Manifestations that increased in the middle of the age range studied were agitation and aggressivity, psychosis, palpitations and hallucinations. Chest pain and hypertension increased in older-aged patients. The frequencies of palpitations, vomiting, and headache differed according to sex. These manifestations held constant in males but were markedly higher in young-adult females. Coingestion of alcohol was associated with agitation and aggressivity (in 34.0% vs 23.4%, P < .001), fewer reports of palpitations (in 9.8% vs 15.6%, P = .01), less anxiety (in 20.7% vs 27.8%, P = .01), less psychosis (in 10.3% vs 16.6%, P = .007), and less chest pain (in 3.8% vs 9.5%, P = .001). The only significant interaction between age and alcohol coingestion occurred with respect to vomiting and psychosis. Conclusions. There are age-related differences in the acute clinical manifestations of cannabis poisoning requiring emergency hospital care. Sex and coingestion of alcohol modify the relationship between age and frequency of some manifestations. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Canabinoides , Transtornos Psicóticos , Dor no Peito/diagnóstico , Cefaleia/epidemiologia , Cefaleia/etiologia , Vômito/epidemiologia , Vômito/etiologia , Fatores Sexuais
9.
Medicine (Baltimore) ; 101(34): e30327, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36042651

RESUMO

RATIONALE: Excessive daytime sleepiness (EDS) is a clinical manifestation of various disorders. Here, we report 2 cases of EDS related to Epstein-Barr virus (EBV) encephalitis. PATIENT CONCERNS: Both the patients were elderly men. Case 1 presented with EDS with headache and fever. Case 2 was presented with EDS only. The 2 patients slept normally at night without taking sleeping pill. They were able to get up and go to the toilet and eat by themselves during the day, but they almost slept at other times. DIAGNOSIS: After admission, a lumbar puncture was performed to collect the cerebrospinal fluid, and next-generation sequencing showed that EBV infection was detected. Combined with the patient's head magnetic resonance imaging and clinical features, a diagnosis of EBV encephalitis was made. INTERVENTIONS: Both patients received antiviral therapy. OUTCOMES: Case 1 had a rapid improvement in headache and fever and was discharged from the hospital after the symptoms of EDS gradually improved. In case 2, EDS symptoms gradually improved. Two patients were followed up for 3 months after discharge, and the outcome was good. LESSONS: EDS can also be the main clinical manifestation of viral encephalitis, and we should diagnose and identify it early and treat it promptly.


Assuntos
Distúrbios do Sono por Sonolência Excessiva , Encefalite Viral , Infecções por Vírus Epstein-Barr , Idoso , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/tratamento farmacológico , Distúrbios do Sono por Sonolência Excessiva/etiologia , Encefalite Viral/complicações , Encefalite Viral/diagnóstico , Encefalite Viral/tratamento farmacológico , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/tratamento farmacológico , Cefaleia/etiologia , Herpesvirus Humano 4 , Humanos , Masculino
10.
Folia Neuropathol ; 60(2): 221-227, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35950474

RESUMO

Despite high prevalence of cerebrovascular stroke, headache attributed to ischemic strokes is often undertreated and overlooked. The aim is to detect the relation of a post-stroke headache to cerebrovascular pathology and changes in hemodynamics through a high-resolution duplex ultrasound examination. The present study was a case-control study conducted among 239 patients, who presented with an acute ischemic stroke. Patients were sub-divided into two groups: group I included patients with headache attributed to ischemic stroke (cases) and group II included headache-free stroke patients (controls). History consisted of headache characteristics and risk factors. Clinical and radiological examination were preformed to detect the type of stroke. Ultrasound duplex examination of extra-cranial and intra-cranial cerebrovascular system was carried for both groups. Group I included 112 patients (mean age, 57.66 ±6.59 years), and group II included 127 patients (mean age 57.73 ±7.89 years). Post-stroke headache was more frequent in patients with posterior circulation infarction (58%). Post-stroke headache was reported within 7 days post-stroke in 61.6% of patients. Pre-stroke headache was an independent predictor for post-stroke headache occurrence (OR = 28.187, 95% CI: 6.612-120.158%, p < 0.001). Collateral opening and various degrees of intra-cranial vascular stenosis were strong predictors of headache occurrence (OR = 25.071, 95% CI: 6.498-96.722%, p < 0.001). In conclusion, post-stroke headache is a common phenomenon, especially in patients with pre-stroke headache, history of old stroke, posterior circulation infarction, and large artery disease. This headache was of moderate-intensity with clinical characteristics of tension-type. Intra-cranial cerebrovascular pathological changes including opening of collateral channels and variable degrees of stenosis of cerebrovascular systems were implicated in the production of that headache.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Isquemia Encefálica/complicações , Estudos de Casos e Controles , Circulação Cerebrovascular , Constrição Patológica/complicações , Cefaleia/epidemiologia , Cefaleia/etiologia , Hemodinâmica , Humanos , Infarto/complicações , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações
11.
J Headache Pain ; 23(1): 96, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941545

RESUMO

OBJECTIVE: To investigate whether persistent post-traumatic headache attributed to mild traumatic brain injury (TBI) is associated with more pronounced pericranial tenderness and lower pressure pain thresholds (PPTs) in the head and neck region, compared with healthy controls. METHODS: Patients with persistent post-traumatic headache (n = 100) and age- and gender-matched healthy controls (n = 100) were included between July 2018 and June 2019. Total tenderness score (TTS) was used to assess pericranial tenderness by bilateral manual palpation in eight muscles or tendon insertions. Summation was then used to calculate a TTS from 0 to 48 based on individual right- and left-sided scores; higher TTS score indicated more pronounced pericranial tenderness. PPTs were examined in m. temporalis and m. trapezius (upper and middle part) using an electronic pressure algometer that applies increasing blunt pressure at a constant rate. RESULTS: The TTS score was higher in patients with persistent post-traumatic headache (median, 21; IQR, 12-31), compared with healthy controls (median, 10; IQR, 6-17; P < .001). PPTs were lower in patients with persistent post-traumatic headache than in controls in both the left-sided m. temporalis (mean ± SD, 157.5 ± 59.9 vs. 201.1 ± 65.2; P < .001) and right-sided m. temporalis (mean ± SD, 159.5 ± 63.8 vs. 212.3 ± 61.9; P < .001). Furthermore, patients with persistent post-traumatic headache also had lower left- and right-sided PPTs in the upper as well as middle part of m. trapezius, compared with healthy controls; all P values were .05 or less. CONCLUSIONS: Among patients with persistent post-traumatic headache, pericranial tenderness was more pronounced and PPTs in the head and neck region were lower than in healthy controls free of headache and mild TBI. Further research is needed to better understand the involvement of pericranial myofascial nociceptors in the disease mechanisms underlying post-traumatic headache.


Assuntos
Concussão Encefálica , Cefaleia Pós-Traumática , Cefaleia do Tipo Tensional , Cefaleia/etiologia , Humanos , Dor , Limiar da Dor/fisiologia , Cefaleia Pós-Traumática/etiologia , Cefaleia do Tipo Tensional/complicações
12.
BMC Health Serv Res ; 22(1): 1016, 2022 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948960

RESUMO

BACKGROUND: The COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic. METHODS: From January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states. RESULTS: In total, 2132 individuals participated. 52.3% experienced a PPE-induced headache. Usual onset time was between 2-3 h, lasting up to 1 h after PPE removal. The most common localization was in temporal and frontal regions. Headache usually occurred 2 to 3 days per week with an average pain score of 5.04 ± 1.80 points. Higher risk was associated with discomfort/pressure OR = 11.55, heat stress OR = 2.228, skin conditions OR = 1.784, long PPE use (duration 10-12 h) OR = 2,18, headache history prior PPE use OR = 1.207. Out of 52.3% respondents with PPE-induced headache, 45.5% developed de novo headache, whereas 54.5% had headache history. Statistically significant differences of PPE-induced headache between respective groups included severity (4.73 vs 5.29), duration (≥ 6 h 6.7% vs 8.2%), accompanying symptoms (nausea (19.3% vs 25.7%), photophobia (19.1% vs 25.7%), phonophobia (15.8% vs 23.5%), osmophobia (5.3% vs 12.0%)) and painkiller use (43.0% vs 61.7%). CONCLUSIONS: Over half of the medical personnel reported headache while using PPE. The risk was higher in individuals with headache history, increased duration of PPE use and discomfort while using PPE. Predisposed individuals reported PPE-induced headache which persisted longer, was more intense and debilitating than in the respondents with de novo headache.


Assuntos
COVID-19 , Equipamento de Proteção Individual , COVID-19/epidemiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Pessoal de Saúde , Humanos , Corpo Clínico , Pandemias , Fatores de Risco , Inquéritos e Questionários
13.
Headache ; 62(8): 1007-1018, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36018057

RESUMO

OBJECTIVE: To assess headache response and patient perception of improvement after computed tomography (CT)-guided fibrin glue occlusion of cerebrospinal fluid-venous fistulas (CVFs) in a large sample size and with a long clinical follow-up. BACKGROUND: CVFs are an increasingly identified type of spinal leak in patients with spontaneous intracranial hypotension (SIH), and CT-guided fibrin glue occlusion has been introduced as a treatment option in a prior small series. METHODS: Retrospective case series review of medical records from a single institution was performed for all patients with CVFs that were treated with CT-guided fibrin glue occlusion between August 2018 and April 2022 in an outpatient or inpatient setting. Pre- and posttreatment Headache Impact Tests (HIT-6) were administered to patients, and a change in scores was evaluated. In some patients, pretreatment HIT-6 tests were not obtained prior to the fibrin glue procedure, and the patient was asked to fill out the pretreatment test based on personal recall of their symptoms prior to treatment. Patients completed a Patient Global Impression of Change (PGIC) scale after treatment. Pre- and posttreatment brain imaging was compared using Bern SIH scores. RESULTS: Thirty-five patients (19 females, 16 males; mean age 60 years) with CVFs treated with CT-guided fibrin glue occlusion met the inclusion criteria. Mean pretreatment and posttreatment HIT-6 scores were 64.7 ± 10.2 and 43.4 ± 9.9 (p < 0.001), respectively. The posttreatment HIT-6 questionnaires were completed on average 10.3 months after treatment, and 20 patients filled out the pretreatment HIT-6 form after their treatment. The mean PGIC score was 6.1 ± 1.3. Mean pretreatment and posttreatment Bern SIH scores were 5.9 ± 2.5 and 1.5 ± 1.5 (p < 0.001), respectively. CONCLUSIONS: We report a large series of patients who underwent CT-guided fibrin glue occlusion of CVFs. We showed that headache scores decreased after treatment, and the majority of patients had high PGIC scores. Posttreatment brain MRIs also showed improved Bern SIH scores.


Assuntos
Fístula , Hipotensão Intracraniana , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Cefaleia/diagnóstico por imagem , Cefaleia/etiologia , Cefaleia/terapia , Humanos , Hipotensão Intracraniana/diagnóstico por imagem , Hipotensão Intracraniana/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
15.
Medicine (Baltimore) ; 101(31): e29920, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35945769

RESUMO

There is insufficient evidence on SARS-CoV-2 induced neurological effects. Studies on CNS involvement during COVID-19 in children are limited. This study aims to identify and manage the neurological signs and symptoms in COVID-19-infected pediatric patients during follow up and plan future follow-ups. Children diagnosed COVID-19 and hospitalized in the pediatric pandemic services, between March 18, 2020, and June 18, 2021, were included in the study. Children with underlying neurological disease were excluded from the study. Patient data retrieved from hospital files and medical records. Children divided into 2 groups, 1 and 2, based on the presence or absence of neurological findings. A total of 243 children received follow-ups in the pandemic wards, 35 (14.4%) of these patients had neurological findings. Major neurological manifestations were headache (n:17, 7%), seizure (n:4, 1.6%), and anosmia/hyposmia (n:17, 7%). The number of boys (n:13, 37.1%) was smaller than the number of girls (n:22, 62.9%) in Group 1. Group 1 showed higher blood leukocyte, lymphocyte, thrombocyte, AST, LDH, d-dimer values. Anosmia/hyposmia occurred more often in girls, anosmia and headache occurred more often over 9 years of age. Pulmonary and hematologic involvement was more common in children with anosmia and headache. Our study is one of the few studies on neurological involvement in COVID-19 in children. To the best of our knowledge, there is limited data on these subjects in the literature.


Assuntos
COVID-19 , Doenças do Sistema Nervoso , Anosmia , COVID-19/complicações , Criança , Feminino , Cefaleia/etiologia , Humanos , Masculino , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/etiologia , SARS-CoV-2 , Convulsões/complicações
16.
BMC Public Health ; 22(1): 1533, 2022 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-35953857

RESUMO

BACKGROUND: Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China. METHODS: PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test. RESULTS: Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors. CONCLUSION: The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients' neurological recovery and quality of life.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Feminino , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Fatores de Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia
17.
Otolaryngol Clin North Am ; 55(3S): e1-e8, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35987560

RESUMO

Otolaryngologists will frequently encounter patients with head and facial pain. The headache may be a primary disorder or a symptom of a secondary pathology. Understanding diagnostic criteria and the autonomic and otologic manifestations of primary headaches is imperative for accurate diagnosis and treatment. This article summarizes key points in the issue "Comprehensive Management of Headache for the Otolaryngologist" and can be used as a cursory reference.


Assuntos
Cefaleia , Otorrinolaringologistas , Dor Facial/diagnóstico , Cefaleia/diagnóstico , Cefaleia/etiologia , Cefaleia/terapia , Humanos
18.
Otol Neurotol ; 43(9): e1045-e1048, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36026590

RESUMO

OBJECTIVES: The main objective was to describe the nystagmus observed during benign paroxysmal vertigo (BPV) of childhood, which is one of the criteria included in the three versions of the International Classification of Headache Disorders that has never been specified. The secondary objectives were to emphasize the usefulness of a mobile phone to record nystagmus and discuss the physiopathology of this nystagmus. PATIENT: A 6-year-old boy complained of approximately 30 to 50 vertigo attacks, most of them lasting around 1 minute, during a 6-month period. INTERVENTION: Otoneurologic history and examination, audiovestibular exploration, and brain imaging were performed between the attacks. Video recording by the parents' mobile phone and video electroencephalography recording during a 1-day hospitalization were performed during the episodes. MAIN OUTCOME MEASURE: Analysis of seven video recordings performed by the parents and four during a 1-day hospitalization, as well as follow-up. RESULTS: The assessment between the attacks confirmed the diagnosis of BPV according to International Classification of Headache Disorders criteria. Video recordings constantly demonstrated a strong left horizontal nystagmus present at fixation in all direction of gaze, enhanced in left gaze. This nystagmus was associated with a rightward body deviation. CONCLUSION: The clinical presentation was more consistent with a peripheral vestibular deficit than with a central disorder. We encourage video recording of their child by the parents because it will help both to define the ictal nystagmus and to understand the underlying pathophysiology. The latter is discussed and is probably more complex than initially thought in BPV.


Assuntos
Transtornos da Cefaleia , Nistagmo Patológico , Vestíbulo do Labirinto , Vertigem Posicional Paroxística Benigna/complicações , Criança , Cefaleia/diagnóstico , Cefaleia/etiologia , Transtornos da Cefaleia/complicações , Humanos , Masculino , Nistagmo Patológico/etiologia , Gravação em Vídeo
19.
J Headache Pain ; 23(1): 101, 2022 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-35962348

RESUMO

BACKGROUND: The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group. METHODS: Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale. RESULTS: The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04-2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in migraine patients compared to controls were fatigue (OR = 1.662, 95%CI = 1.064-2.596, P-value = 0.025), anosmia/hyposmia (OR = 2.06, 95%CI = 1.164- 3.645, P-value = 0.012), cacosmia (OR = 2.663, 95%CI = 1.145-6.195, P-value = 0.019), depression (OR = 2.259, 95%CI = 1.284- 3.975, P-value = 0.004), anxiety (OR = 3.267, 95%CI = 1.747- 6.108, P-value ≤ 0.001), insomnia (OR = 2.203, 95%CI = 1.298- 3.739, P-value = 0.003), and headache (OR = 3.148, 95%CI = 1.616-6.136, P-value = ≤ 0.001).While there was no statistically significant difference between migraine patients and controls regarding the post-COVID-19 functional status score (P-value = 0.102). The pattern of post-COVID-19 headache was reported as chronic headache transformation in 17.6% of the migraine group, with the median intensity rate being 5.5 and IQR (3-7). In the control group, 14% experienced chronic headache attributed to systemic viral infection with a median intensity rate of 2 and IQR (2-5), while 12% experienced a new daily persistent headache with a median intensity of 5 and IQR (1-6). CONCLUSION: The study highlighted the importance of follow-up migraine patients upon recovery from COVID-19 infection, being more vulnerable to post-COVID-19 symptoms.


Assuntos
COVID-19 , Transtornos de Enxaqueca , COVID-19/complicações , Estudos de Casos e Controles , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , SARS-CoV-2 , Sobreviventes
20.
Headache ; 62(8): 1046-1052, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36005277

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccine-related side effects are a key concern with the emergence of various types of vaccines in the market. We aimed to assess the frequency and characteristics of headache following different types of COVID-19 vaccines. METHODS: Fully vaccinated people were recruited by a convenience sample through an online survey from September 1 to December 1, 2021. Detailed analysis of headache following vaccination was investigated. Participants with a history of pre-existing headaches were telephone interviewed by a neurologist to ascertain the type of headache. RESULTS: A total of 1372 participants participated (mean age 32.9 ± 11.1). The highest frequency of headache was reported with the adenoviral vector type (302/563, 53.6%), followed by mRNA vaccines (129/269, 48%) and then the inactivated type (188/540, 34.8%). Recipients of the adenoviral vector type had a significantly longer latency between vaccination and the headache onset (median 8 h [5:12]) than recipients of the inactivated type (median 4 h [2:8], p < 0.001). Headache intensity was significantly higher with the adenoviral vector type (median 6 [5:8]) than with the inactivated type (median 5 [4:7], p < 0.001). Adenoviral vector vaccines would increase the likelihood of headache by 2.38 times more than inactivated vaccines (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.83-3.04, p < 0.001). Female sex and thyroid disease were significantly associated with headache related to COVID-19 vaccines (OR 1.52, 95% CI 1.16-1.99; OR 3.97, 95% CI 1.55-10.2, respectively). CONCLUSION: Recipients of the COVID-19 vaccine should be counseled that they may experience headaches, especially after the adenoviral vector type. However, the intensity of such headache is mild to moderate and can resolve within a few days. Based on the current study design and the potential recall bias, these results may not be generalizable and should be preliminary.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Cefaleia , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Feminino , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Inquéritos e Questionários , Adulto Jovem
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