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Association of migraine and stress on academic performance (Abstract)
Get PDFAbstract: Thesis (Doctorate in Neurosciences). Postgraduation in Neuropsychiatry and Behavioral Sciences. Federal University of Pernambuco, Recife, Brazil. 2018. 147 f. Supervisor: Prof. Dr. Marcelo Moraes Valença
Hyperacusis in migraine: pilot project
Get PDFThe stress caused by headache may be related to the development of hearing disorders, such as hyperacusis and phonophobia. Hyperacusis is an unpleasant sensation caused by exposure to a due reduction in your tolerance. Characterized by an increase in sound sensitivity via the auditory pathway and by the ability to hear. However, some few problems can occur, while others can even be from the intensity in case of elevation. Phonophobia is a common symptom and with migration criteria, without a diagnosis of hyperacusis was still little in this context. For this reason, a better understanding of hyperacusis corresponds to a new means for the management and diagnosis of migraine. Keywords: migraine, hyperacusis, phonophobia.The stress caused by headache may be related to the development of hearing disorders, such as hyperacusis and phonophobia. Hyperacusis is an unpleasant sensation caused by exposure to a due reduction in your tolerance. Characterized by an increase in sound sensitivity via the auditory pathway and by the ability to hear. However, some few problems can occur, while others can even be from the intensity in case of elevation. Phonophobia is a common symptom and with migration criteria, without a diagnosis of hyperacusis was still little in this context. For this reason, a better understanding of hyperacusis corresponds to a new means for the management and diagnosis of migraine. Keywords: migraine, hyperacusis, phonophobia
Headache and infections of the central nervous system: neuroradiology
Get PDFHeadache may be a cardinal symptom in a patient with an intracranial infection. Meningitis, meningoencephalitis, empyema, and brain abscess are the most frequent infections of the central nervous system. They are usually accompanied by severe headache, usually acute at onset, accompanied by high temperature, altered level of consciousness, in addition to alterations in the neurologic examination. In this minireview, the authors intend to show and comment on some neuroimaging aspects found during the investigation of patients with a headache caused by an infectious intracranial lesion
Thank you Sjaastad (1928-2022) for everything we learned from you
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Thank you Sjaastad (1928-2022) for everything we learned from yo
Spontaneous intracranial hypotension syndrome presented with sixth cranial nerve palsy: a case report
Get PDFIntroduction
Spontaneous intracranial hypotension (SIH) is a secondary cause of headache often misdiagnosed and underdiagnosed disorder. The main presentation is orthostatic headache. An uncommon symptom is cranial nerve palsy. We described a case of SIH that presented to our service with sixth cranial nerve palsy.
Case Report
Female, 39 years old, no relevant medical past or history of trauma, awoke due intense holocranial headache, associated with vomiting and photophobia, worsening in orthostasis. In the general emergency department, she was release with prescription of analgesics and topiramate, without resolution. After a week, the patient reported diplopia and was referred to our service, a tertiary center. In admission, she kept an intense orthostatic headache and in neurologic examination she presented right sixth nerve palsy, no other deficits. Laboratorial tests were normal, including metabolic and infectious marks. Cerebrospinal fluid (CSF) opening pressure was low (50 mmH2O) and analysis showed elevated protein levels (158mg/dl). MRI showed diffuse pachymeningeal enhancement and venous sinus distension, mainly in superior sagittal venous sinus. CT myelogram detected a spinal CSF leak in transition C1-C2. Initially, performed hydration and bed rest, while patient with partial improvement of headache. An epidural blood patch was then performed using 15ml of autologous blood with compatible contrast and lidocaine. There was complete resolution of pain after the procedure and four weeks later complete resolution of right sixth nerve palsy.
Discussion
According to International Classification of Headaches Disorders, third edition (ICHD-3), the headache attributed to SIH is descripted as a headache has developed in temporal relation to low CSF pressure (<60mm H2O) and/or evidence of CSF leakage on imaging.
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Improvement in the quality of care for patients with headache treated in emergency units in a private hospital network
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Patients with headache complaints are among those who most frequently seek care in emergency units. Unfortunately, the assistance provided to these patients frequently does not reflect the best scientific evidence, compromising clinical results and exposing patients to unacceptable risks and unnecessary procedures. Among these errors, we cite the high rate of prescription of opioids for primary headaches, the excessive number of unnecessary CT scans, high stay rates in emergency units, and high rate of hospital admissions.
Objectives
To evaluate changes in care outcomes after beginning a care protocol in a private hospital network.
Methods
We evaluated all the headache data in the emergence units of Americas Serviços Médicos, a private hospitals network with 18 units distributed in 3 regions of Brazil. Headache was identified in the electronic medical record system through the international code of diseases (CID). The following data were collected: rate of opioids prescription, rate of TC scan, time of stay in emergence room, hospitalization rate, and hospital length of stay. Data were collected in the four months before the protocol (pre-protocol) and in the last four months (post-protocol). Categorical data were evaluated with chi-square and continuous data with unpaired t test.
Results
The data of 9,060 patients in the pre-protocol and 8,828 patients in the post-protocol periods were assessed. The rate of opioids prescription reduced from 19.9% to 18.5% (P=0.0173). The rate of CT scan was 16.75 in pre and post protocol periods P=1). The stay time in emergence room was 227.46±61.07 minutes in the pre and 196±16.11 in the post protocol period (P=0.37). The rate of hospitalization increased from 1,53% in the pre to 2.24% in the post protocol period (P=0.005). The length of hospital stay reduced from 5.9±2.2 in the pre to 3.5±0.6 in...
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Differentiation between Call Fleming syndrome and nervous system vasculitis
Get PDFIntroductionCall Fleming syndrome is a reversible cerebral vasoconstriction syndrome of idiopathic etiology that causes thunderclap headache. It is a condition with a good prognosis, but clinically and radiologically similar to other diseases, such as nervous system vasculitis.
Objectives To bring clinical, radiological and laboratorial aspects of Call Fleming Syndrome and nervous system vasculitis and provide the differentiation of both.
MethodologyThe research is an integrative review, carried out in June 2022, using the SciElo and Pubmed databases. From the keywords: Call-Fleming syndrome) AND (Diagnosis), (Case report), (Radiology), the clinical, laboratorial and radiological profile of the Call-Fleming Syndrome was traced while the keywords (Nervous System) AND (Vasculitis) AND (Diagnosis), (Case report), (Radiology) were used to CNS vasculitis. Then, from case reports, radiology articles and laboratory analyses, the diseases in question were compared in terms of similarities and differences.
ResultsBoth pathologies are similar from a clinical point of view: they are frequent causes of thunderclap headache, a sudden and severe headache that reaches its maximum intensity within 1 minute. Some patients with Call-Fleming Syndrome may present several neurological deficits, the more frequents in case reports are hemiparesis, hemianopia, and loss of balance. The disease has a limited course that lasts from 1 to 3 months, however, its main complications are hemorrhages and cerebral infarction. The age group affected in the reported cases ranges from 10 to 76 years and there is a slight predominance of cases in women. (To see the complete abstract, please, check out the pdf)
Analysis of sleep, pain and anxiety correlation in individuals with TMD: an analytic transversal study
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Temporomandibular disorder (TMD) is a pathology of the stomatognathic system, considered the main cause of non-dental orofacial pain. Several signs and symptoms are present in the face from this pathology, and among them, there is the possibility of pain in the joint and associated regions.
Pain is defined by International Association Study of Pain as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Although it relates to adaptive processes, it can cause adverse effects on social and psychological function and well-being, influenced to different degrees by biological, psychological and social factors. Individuals with chronic pain, further to the pains, have oscillation in their emotional behaviors and sleep disturbances.
The anxiety and depression in the pathogenesis of temporomandibular disorders have been investigated since the entry of Research Diagnostic Criteria (RDC) for TMD in 1992, approached in Axis II of this instrument. Studies indicate that the health of the individual and quality of life are influenced negatively by the pain and/or for the stress caused by TMD, which can compromise daily activities, cognitive and affective balance, the physical activities and sleep.
As shown above, TMD is considered an important health problem nowadays, and is also important to consider the psychological aspects related to it and the impacts on the quality of the individuals affected by this disorder.
Objective
The aim of this study is to analyze the correlation of sleep, pain and anxiety in individuals with TMD.
Methods
This work is a cross-sectional study that uses data from research realized in Federal University of Pernambuco (UFPE), approved by the Ethics and Research Committee and labeled under the number 81287.9.0000.5208...
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Rocky Mountain spotted fever, an underdiagnosed cause of headache
Get PDFIntroductionRocky Mountain spotted fever is a tick-borne rickettsiosis. The main clinical signs and symptoms are fever, severe headache, rashes and myalgia. Endothelium tropism can lead to vasculitis, thrombosis, and hemorrhage. In addition, the disease can generate neurological impairment through meningoencephalitis, characterized by holocranial headache. It is considered difficult to diagnose and underreported because nonspecific signs and it is commonly confused with dengue.
Objectives To analyze the epidemiology of spotted fever in São Paulo (state) between 2010 and 2020.
MethodologyThe work is a descriptive cross-sectional study that statistically analyzes the cases of spotted fever in São Paulo between 2010 and 2020 through data obtained by the Information System of Notifiable Diseases (SINAN). The proportions of spotted fever cases were calculated according to: sex, age group, race/color, infection environment, confirmation criteria and evolution. The correlation coefficient between human development index (HDI) and that of the reporting city and mortality was estimated. The number of inhabitants and HDI were from the latest IBGE (Brazilian Institute of Geography and Statistics) census in 2010.
ResultsThere are 869 cases were confirmed (representing 44% of the country\u27s cases), of which 324 are from the metropolitan region of Campinas. The correlation coefficient between HDI and deaths is 0.06 and the average HDI of the cities is 0.79. (To see the complete abstract, please, check out the PDF)
A dor de cada dia: saúde dos estudantes antes e durante a pandemia da COVID-19
No full textFor 4 years, our team has been monitoring the physical and mental complaints of Federal University of Paraíba (UFPB) students, mainly those from the healthcare field. We have verified oscillations in headache complaints and other psycho-emotional symptoms during this period. In 2022, perhaps as a result of the impacts of the Covid-19 pandemic, complaints of headache and anxiety were above 70%. This public, today, demands integral care appropriate to their socio-cultural reality. We warn about the importance of local diagnosis and respective offer of appropriate social support to each reality to foster, care and accompany these communities.Há 4 anos, nossa equipe acompanha as queixas físicas e mentais dos alunos da UFPB, principalmente da área da saúde. Verificamos oscilações nas queixas de cefaléia e outros sintomas psicoemocionais nesse período. Em 2022, talvez em decorrência dos impactos da pandemia de COVID-19, as queixas de cefaléia e ansiedade ficaram acima de 70%. Esse público, hoje, demanda atendimento integral adequado à sua realidade sociocultural. Alertamos para a importância do diagnóstico local e respetiva oferta de apoio social adequado a cada realidade para acolher, cuidar e acompanhar estas comunidades