1,721,030 research outputs found
Chronic paroxsysmal hemicrania (CPH) and hemicrania continua: transition from one stage to another
No full textTwo female patients, one suffering from CPH in non-remitting form, and the other from hemicrania continua, in the pre-chronic (non-continuous) stage are described. Both were followed through transitions to other stages: the CPH patient was followed from the non-remitting stage to a longlasting remission, and lastly back to another chronic stage. Indomethacin was effective in all the symptomatic stages. The hemicrania continua patient was followed from the non-continuous to the continuous stage. Indomethacin was effective in both stages. These observations provide further evidence that the non-chronic and chronic ("remitting" and "non-remitting") stages of CPH belong together. The same seems to apply to the two stages of hemicrania continua, the "continuous" and the "non-continuous" stages
Cervicogenic headache: a real headache.
Full text linkAlthough theories regarding headache originating in the neck have existed for more than 150 years, the term "cervicogenic headache" originated in 1983. Early descriptions pinpoint the characteristic symptoms as dizziness, visual disturbances, tinnitus, and "posterior" headache, conceivably as a consequence of arthrosis, infliction upon the vertebral artery, or with a "migrainous" background and occurring in "advanced age." Cervicogenic headache (mean age of onset, 33 years) displays a somewhat different picture: unilateral headache, starting posteriorly, but advancing to the frontal area, most frequently the main site of pain; usually accompanied by ipsilateral arm discomfort, reduced range of motion in the neck, and mechanical precipitation of exacerbations (eg, through external pressure upon hypersensitive, occipital tendon insertions). Treatment options in treatment-resistant cases include cervical stabilization operations and extracranial electrical stimulation. In a personal, population-based study of 1,838 individuals (88.6% of the population), a prevalence of 2.2% "core" cases was found.
PMID: 2112543
Hemicrania continua: a possible symptomatic case, due to mesenchymal tumor.
No full textThe case of a 28-year old woman with headache resembling hemicrania continua (HC) is described. Since her childhood she had a history of right-sided, side-locked, painful headache attacks, with increasing attack frequency during the last two years, each attack lasting around 24 hours. There were only a few "migrainous" symptoms and signs, thus no photo- and phono-phobia and no vomiting. Only occasionally did she have slight nausea. The clinical picture as well as the complete indomethacin effect suggested a case of HC. However, the indomethacin effect faded away after > 2 months. At that time, a CT scan revealed a tumor in the right sphenoidal bone involving the clinoid process and the base of the skull. A biopsy of the tumor during craniectomy showed a mesenchymal tumor, and the patient was considered inoperable (April, 1989). After cytostatic treatment, she is back in full time work; the headache disappeared and it still has not recurred after approximately 2 years of observation. Neuroradiological investigation should, therefore, be included in the work-up of patients with HC. At the present stage of knowledge, neuroradiological investigations should probably also be included when faced with a typical clinical picture
Chronic paroxysmal hemicrania: a case report. Long-lasting remission in the chronic stage
No full textIn a 38-year-old woman who had had CPH since the middle 1960s and had been successfully treated with indomethacin (dosage usually within the limits of 50-175 mg/day) for approximately 10 years, the requirement for indomethacin was gradually reduced to nought in the spring of 1985. She was then pain-free without indomethacin for almost 1 1/2 years. In the late fall of 1986 she had a 3-week exacerbation. In recent months, she again seems to have a slowly increasing, although clearly fluctuating, indomethacin requirement. Long-lasting remissions may thus appear even in the chronic stage. The remission could be a spontaneous one or it could in some way be related to the protracted indomethacin treatment; the authors favour the former possibility. The recurrence of symptoms after a while shows that the attack-generating potential has not been permanently extinguished by indomethacin
A piroxicam derivative partly effective in chronic paroxysmal hemicrania and hemicrania continua
No full textPiroxicam beta-cyclodextrin has recently been observed to be equal to, or even possibly to be superior to, indomethacin (mainly with regard to side effects) in a single case of hemicrania continue. Piroxicam beta-cyclodextrin, 20 to 40 mg per day, was, accordingly, tried in six patients with chronic paroxysmal hemicrania and six patients with hemicrania continua with a previously proven response to indomethacin. The study was conducted over a period of 3 weeks and in an open fashion. A placebo effect is considered to be negligible in these disorders. In such a comparison, piroxicam beta-cyclodextrin seemed inferior to indomethacin, in particular in chronic paroxysmal hemicrania
Chronic paroxysmal hemicrania and hemicrania continua : recent advances on clinical pictures and instrumental findings
No full textThe sweating anomaly in cluster headache. Further observations on the underlying mechanism
No full textWe describe a patient with a typical history of cluster headache for more than 18 years. During the first approximately 10 years of his disease, the pain was right-sided, and pupillometric and evaporimetric measurements indicated a sympathetic deficiency on this same side. However, for the next greater than 6 years, his pain was consistently left-sided, although the signs of sympathetic dysfunction still were more marked on the right side. This was also true for the findings obtained during the interictal period and for the heating test performed within an attack. The implications of this interesting case are discussed. The view that two separate lines of symptom production lead to the pain and the autonomic phenomena seems to be supported by this case history. The cluster headache syndrome may also be a bilateral disorder, with only the weight of balance pointing one way or the other. Finally, the autonomic test results of this patient could reflect an autonomic "scar" in the previous headache side
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