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  • 1
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Thirty-eight patients with “chronic daily” headache and ergotamine and/or analgesics abuse according to the criteria proposed by the international Headache Society were re-investigated 5 years after inpatient drug withdrawal. At the end of the observation period, 19 patients (50.0%) had their headaches on only 8 days per month or less, 18 patients (47.4%) were free of symptoms or had only mild headaches. A close correlation was found between the frequency of headache and the duration of drug abuse, as well as between the intensity of headache and the number of tablets taken per month. Frequency and intensity of headache had changed within the first 2 years after withdrawal, but remained stable afterwards. Fifteen patients (39.5%) reported on recurrent drug abuse. Patients with migraine showed a tendency towards a better prognosis compared to patients with tension-type headache or with combined migraine and tension-type headache. The results of this study highlight the long-term efficacy of inpatient drug withdrawal in patients with headache and ergotamine and/or analgesics abuse.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to investigate whether the IHS criteria for migraine and tension-type headache depend on gender. Among 409 children and adolescents with recurrent idiopathic headache seen at a university outpatient clinic, girls had significantly more often migraine with aura. Also, there was a trend towards a higher frequency of tension-type headache in girls. In migraine, aggravation of headache by physical activity and occurrence of aura symptoms were more common in females, whereas vomiting and phonophobia occurred more often in males. In tension-type headache, females more often reported mild intensity of headache. All other criteria were similar in both sexes. Age influenced the expression of some of the accompanying symptoms in the various types of migraine, but had only minimal influence on other diagnostic criteria of migraine and tension-type headache in females as well as in males. Our study suggests that the frequency of migraine (except that of migraine with aura) is similar among girls and boys, that tension-type headache may occur more often in girls, and that gender has some influence on the IHS criteria for migraine, but almost no influence on those of tension-type headache.
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  • 3
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : Blackwell Science Ltd
    Cephalalgia 16 (1996), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sigmund Freud, the famous Viennese founder of psychoanalysis, suffered from recurrent episodes of severe headache. Autobiographic and biographic data make it evident that he had migraine. Freud’s theoretical approaches to pain in general and to migraine in particular are discussed. Initially, Freud’s theories on the etiopathogenesis of pain and migraine focused on neurophysiological hypotheses which are of historical interest. They were replaced by psychodynamic hypotheses which are still important for our current understanding of pain and headache. These psychodynamic pain theories are reviewed and their importance for headache research is discussed.
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  • 4
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : Blackwell Science Ltd
    Cephalalgia 15 (1995), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Over 3 years we evaluated two patients, an adolescent and a child, with migraine-like headache and ischemic stroke. Based on our clinical observations and on liter: review of migraine and stroke in the pediatric age group, we believe that the criteria of migrainous infarction outlined by the International Headache Society (IHS) could be occasionally too restrictive Therefore, we suggest subclassifying migrainous infarction into: (i) “definite”, referring to the patient: ischemic stroke fulfills all the IHS criteria, (ii) “possible”, referring to ischemic strokes which I 1 some, but not all, criteria. This subclassification of migrainous infarction may be relevant in cal practice and in human research studies.
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  • 5
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We investigated whether the criteria for idiopathic headache published by the International Headache Society (IHS) are useful in childhood and adolescence and compared the diagnoses according to this classification with those of Vahlquist. We used a semi-structured questionnaire to examine a total of 437 children and adolescents referred consecutively to a headache outpatient clinic. Twenty-eight of 437 patients were excluded because of symptomatic or unclassifiable headache. Of 409 patients with idiopathic headache, 70.4% had definite migraine or tension-type headache (IHS 1.1, 1.2, 2.1, 2.2), 20.5% had a migrainous disorder (IHS 1.7) and 9.1% had headache of the tension-type not fulfilling the criteria (IHS 2.3). In the differential diagnosis of migraine and tension-type headache the intensity of pain, aggravation of headache by physical activity, nausea and vomiting were the most important features. The quality of pain, photo- and phonophobia were less helpful and location least important. The duration of migraine attacks was less than 2 h in 19.0% of the migraine patients. In general, the diagnostic criteria of migraine were highly specific but less sensitive, and those of tension-type headache highly sensitive but less specific. The agreement between IHS criteria and those of Vahlquist was marked (kappa = 0.57). We conclude that the IHS criteria are useful for classifying headache in children and adolescents referred to a headache outpatient clinic. A forthcoming modification of the IHS criteria should consider a reduction of the minimum duration of migraine attacks from 2 h to I h and should try to increase the sensitivity of the criteria for migraine and the specificity of the criteria for tension-type headache.
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  • 6
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : American Association for the Study of Headache/Blackwell Science Ltd
    Cephalalgia 14 (1994), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied in vivo the influence of flunarizine on dopamine D2 receptors and investigated whether dopamine D2 receptor blockade is involved in its antimigraine action. Eleven migraine patients, treated with flunarizine, 10 mg per day, underwent single photon emission computer tomography (SPECT) using [123I] labeled iodobenzamide, a ligand with high affinity and high specificity for D2 receptors. There was a reduction of the dopamine D2 receptor binding potential in all patients compared to age-matched controls. The efficacy of flunarizine in migraine prophylaxis failed to correlate with the degree of the dopamine D2 receptor blockade. The antimigraine action of flunarizine may not involve antidopaminergic mechanisms.
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  • 7
    ISSN: 1432-1920
    Keywords: Key words Virchow-Robin spaces ; Magnetic resonance imaging ; Childhood migraine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Virchow-Robin spaces (VRS) are pia-lined extensions of the subarachnoid space which surround penetrating arteries as they enter the brain on its surface. Using high-resolution MRI, which shows small penetrating arteries, we studied a possible association of accentuated VRS in children with tension-type headache (TTH) or migraine. We studied 58 children aged 3–14 years (mean 10.8 years) with a clinical diagnosis of migraine (31) or TTH (27), who underwent cerebral MRI, and 30 headache-free patients of the same age (mean 10.2 years) and 30 adult migraineurs with postpubertal onset of symptoms, who served as controls. The images were reviewed for structural abnormalities in the regions of the small penetrating arteries. Accentuated VRS were found in 61 % of the children with migrainous headaches and in 22 % of children of those with TTH. Prominent VRS were seen in 27 % of the control children and in only 13 % of the adults. Small infarcts and gliosis were rare in children with or without headache, but were seen in 30 % of the adult migraineurs. Our findings show that accentuated VRS are significantly more common in children with migraine than in those with TTH or headache-free controls. Detection of accentuated VRS may therefore enhance differential diagnosis of primary headaches in children, contributing to an improvement in management.
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