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Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
Occasionally, subdural haematomas can cause focal neurological symptoms (see page 74). They are more common with anticoagulant use, older age and alcohol dependence (probably due to brain shrinkage causing venous stretching). There may not be a history of head trauma. The onset is usually subacute. Headache is commonly associated. There may also be impaired consciousness, confusion and a fluctuating course. The haemorrhage is usually seen on CT scanning. The difficulty may arise between one and three weeks from the onset when the blood may appear isodense to surrounding brain tissue.
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Migraine headaches are usually a moderate or severe unilateral or bilateral throbbing or pulsating headache with associated increased sensitivity to light, noise, or physical movement and may be accompanied by nausea and vomiting. Migraine pain also commonly involves the neck and medial shoulders in addition to the head. The usual duration of a migraine headache is 4 to 72 hours. Up to 25% of migraine headaches may be preceded or accompanied by an aura. The aura is due to neuronal dysfunction that is thought to move through the cortex and is accompanied by decreased regional blood flow (1).
Social context of health and illness
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Thinking point: Imagine having frequent headaches and visiting three practitioners, one who works with a traditional model, one with a medical model and one with a social model. What might each say about the causes of your headaches? What advice might they give you to prevent these headaches?Imagine that 90% of a town is suffering from frequent headaches, and three practitioners, who work with a traditional model, a medical model and a social model, write a piece for a local newspaper. What might each write about the causes of the headaches? What might they say about how to prevent these headaches?
Reductions in acute medication use and healthcare resource utilization in patients with chronic migraine: a secondary analysis of a phase 3, randomized, double-blind, placebo-controlled study of galcanezumab with open-label extension (REGAIN)
Published in Journal of Medical Economics, 2022
Joshua A. Tobin, Shivang Joshi, Janet H. Ford, Russell M. Nichols, Shonda A. Foster, Dustin Ruff, Holland C. Detke, Sheena K. Aurora
Acute medication use for headache was captured in the daily eDiary. The number of migraine headache days per month with acute headache medication use was a prespecified secondary outcome measure based on patients’ eDiary entries. Allowable headache treatments included acetaminophen (paracetamol); nonsteroidal anti-inflammatory drugs (NSAIDs); triptans; ergotamine and derivatives; isometheptene mucate, dichloralphenazone, and acetaminophen combination (Midrin); or combinations thereof. The following medications were allowed with restrictions: (1) opioid and barbiturates no more than 3 days/month and (2) single dose of injectable steroids allowed only once during the study, in an emergency setting. The name and dose of concomitant medications used for the acute treatment of migraine or headache and the use of other pain medications were captured.
Generalized headache among Chinese climacteric women: findings from a prospective cohort
Published in Climacteric, 2021
Y. Gao, R. Tang, J. Li, H. J. Li, J. Lang, G. Liu, S. Lin, R. Chen
In the absence of secondary causes, complaints of pain in the head, which might be a pain located in the head, as over the eyes, at the temples, or at the base of the skull, are here considered generalized headaches. Generalized headaches during menopause vary by type and frequency. Women may experience an improvement, no change, or worsening in headache symptoms amid the menopausal transition6–8. In the absence of secondary causes, migraines predominate among primary headache types9. Other headache types such as cluster headache10,11 and tension-type headache (TTH)12 are reported to be linked to hormonal changes in women. Migraines are reported to be relieved in near two-thirds of patients, while TTH worsened or showed no change in almost 70% of patients in postmenopause12. Migraines in women following oophorectomy were worse than in women undergoing natural menopause. A subgroup of hormone-sensitive women had variable responses to menopausal hormone therapy (MHT)6. Another study found that although headache got better with aging and increasing diastolic blood pressure, prior history of migraine as well as difficulty in stress processing seem to be strong risk factors for severe headaches during menopause and with MHT9. Martin et al. reported that, compared to premenopausal women, perimenopausal women (but not postmenopausal women) had significantly increased risk of high-frequency headache13.
A device review of Relivion®: an external combined occipital and trigeminal neurostimulation (eCOT-NS) system for self-administered treatment of migraine and major depressive disorder
Published in Expert Review of Medical Devices, 2021
Oved Daniel, Roni Sharon, Stewart J. Tepper
Patients with migraine complain of headaches, reported as pain, pressure, or both, as well as associated symptoms such as sensitivity to light and/or sound and nausea. The intensity, frequency, and duration of patients’ symptoms may vary between migraine episodes. The location of the perceived pain may vary as well between episodes, and can be unilateral, bilateral, frontal, posterior, or global [22,23]. Migraine-associated differences in location and fluctuation of severity have been defined as dysregulated sensory thresholds [22]. According to this notion, migraines are characterized by a change in excitability thresholds, which tend to increase or decrease even within the same individual, as a function of the migraine cycle phase. Furthermore, following this variance, stimulation efficacy is optimal when administered in accordance with the current spatial distribution of pain during an episode. Due to this instability, adequate excitation of different locations, such as the right and left sides of the trigeminal nerve branches, requires a separate PNS channel for each location.