Headache最新文献

{"title":"Impact of perilesional edema on severity of migraine in patients with calcified neurocysticercosis: A prospective evaluation.","authors":"Vishwesh Vishnu Naik, Ravi Uniyal, Ravindra Kumar Garg, Rajesh Verma, Vimal Kumar Paliwal, Hardeep Singh Malhotra, Praveen Kumar Sharma, Neeraj Kumar, Shweta Pandey, Imran Rizvi, Harish Nigam","doi":"10.1111/head.14929","DOIUrl":"10.1111/head.14929","url":null,"abstract":"<p><strong>Objectives: </strong>Recent research has sparked increasing interest in the role of neuroinflammation in the pathogenesis of migraine. We hypothesize that perilesional edema, an imaging marker of inflammation caused by an immune response in the brain parenchyma surrounding calcified neurocysticercosis (NCC), may influence migraine pathophysiology. This study was designed to explore the potential impact of perilesional edema on migraine severity and treatment response.</p><p><strong>Background: </strong>Cranial imaging of patients with primary headache may sometimes reveal calcified lesions indicative of calcified NCC. These lesions were once considered incidental and harmless findings. However, recent studies have shown that such calcifications are more frequently associated with headaches. Some research suggests that patients with calcified brain lesions experience more frequent and severe migraine compared to those without these lesions, though the pathophysiology underlying this association remains unclear.</p><p><strong>Methods: </strong>This single-center, prospective cohort study was conducted at King George Medical University, India, from September 2022 to September 2024. A total of 80 patients with migraine with calcified NCC were enrolled. Cranial magnetic resonance imaging with contrast was used to detect perilesional edema. Patients were divided into two groups based on the presence (Group A) or absence (Group B) of perilesional edema. Both groups were assessed for migraine frequency, severity, and disability using standard scales. They were treated with standard migraine therapy and followed up for 3 months. Statistical analysis was performed to compare migraine characteristics, treatment responses, and disability between the two groups.</p><p><strong>Results: </strong>Perilesional edema was observed in six of the 80 patients (7.5%). At presentation, Group A (those with perilesional edema) experienced more frequent migraine, with a mean (standard deviation [SD]) of 22.5 (4.4) days/month, compared to Group B (those without perilesional edema), which averaged 8.2 (2.7) days/month. The headaches in Group A were also more severe, as indicated by higher median visual analog scale scores (median [interquartile range, IQR] in Group A of 10.0 [8.5-10.0] and 7 [7.0-8.0] in Group B, p < 0.001). Disability scores were significantly higher in Group A, with higher median scores on the Migraine Disability Assessment Scale (median [IQR] score in Group A of 43 [40.5-48.5] and 21.5 [17.0-26.3] in Group B, p < 0.001) and six-item Headache Impact Test (median [IQR] score in Group A of 66 [64.25-71.23] and 57 [54.8-62.0] in Group B, p < 0.001) scales. Although both groups showed improvement over 3 months of treatment, Group A continued to experience greater migraine severity. In Group A, the mean (SD) headache frequency was 22.5 (4.4) at presentation, 14.0 (1.6) at 30 days, 10.7 (1.6) at 60 days, and 9.2 (2.0) at 90 days (p < 0.001). Similarly","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"815-825"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of migraine treatments with reduced ischemic stroke risk: Evidence from two large-scale real-world data analyses.","authors":"Eugene Jeong, Mulubrhan F Mogos, You Chen","doi":"10.1111/head.14918","DOIUrl":"10.1111/head.14918","url":null,"abstract":"<p><strong>Objective: </strong>To compare the risk of ischemic stroke in patients with migraine treated with first-line medications, including valproate, topiramate, metoprolol, timolol, or propranolol, versus those not receiving these treatments, using data from two large electronic health records datasets.</p><p><strong>Background: </strong>The impact of first-line migraine medications on ischemic stroke risk in patients with migraine remains uncertain, highlighting the need for further investigation.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study using data from Vanderbilt University Medical Center (VUMC) and the All of Us Research Program. Cases were patients with a primary ischemic stroke diagnosis after their first migraine diagnosis, while controls had no ischemic stroke following their initial migraine diagnosis.</p><p><strong>Results: </strong>In the VUMC database, 356 cases and 15,231 controls were identified; the All of Us database included 256 cases and 6590 controls. Propranolol was the only medication significantly associated with a reduced risk of ischemic stroke in female patients with migraine (VUMC: adjusted odds ratio [aOR] 0.55, 95% confidence interval [CI] 0.33-0.86, p = 0.013; All of Us: aOR 0.41, 95% CI 0.19-0.77, p = 0.010), particularly in those with migraine without aura (VUMC: aOR 0.53, 95% CI 0.29-0.90, p = 0.027; All of Us: aOR 0.28, 95% CI 0.10-0.62, p = 0.006). The Cox model showed lower ischemic stroke rates in propranolol-treated female patients with migraine at 10 years in the VUMC data (adjusted hazard ratio [aHR] 0.45, 95% CI 0.24-0.83; p = 0.011, log-rank p < 0.001) and 10 years in the All of Us data (aHR 0.29, 95% CI 0.09-0.87; p = 0.048, log-rank p = 0.003).</p><p><strong>Conclusions: </strong>Among various migraine treatments, propranolol was notably associated with a significant reduction in ischemic stroke risk among female patients with migraine, particularly those without aura. These findings suggest a potential dual benefit of propranolol in managing migraine and reducing stroke risk, highlighting the need for further prospective studies to confirm these results and potentially inform clinical practice.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"802-814"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Afterimage duration differs for migraine with or without aura.","authors":"Florian Rimmele, Julia Teuber, Britta Müller, Simeon Giesen, Johannes Drescher, Jörg Scheidt, Uwe Walter, Peter Kropp, Tim P Jürgens","doi":"10.1111/head.14934","DOIUrl":"10.1111/head.14934","url":null,"abstract":"<p><strong>Background: </strong>It is controversial to what extent afterimages, as distinct visual phenomena, are altered in patients with migraine and whether they have a specific role in migraine pathophysiology.</p><p><strong>Objective: </strong>The aim of this cross-sectional study was to investigate the duration of afterimages in patients with migraine, migraine with aura (MwA), and migraine without aura (MwoA), compared to healthy controls (HCs).</p><p><strong>Methods: </strong>Adults with migraine, MwA, and MwoA, diagnosed according to The International Classification of Headache Disorders, third edition criteria and HCs without relevant headache history were included. Initially, factors affecting the experimental setting of testing afterimage latency were determined. Then, afterimage duration was measured in the two study groups (MwA and MwoA) and the HC group. Patient characteristics, intraocular pressure, and relevant comorbid conditions, as well as scales on depressive symptoms (nine-item Patient Health Questionnaire) and headache-specific psychosocial impairment (six-item Headache Impact Test) were recorded. Lastly, the role of different stimulus colors, as well as habituation effects after repeated stimulation, were investigated.</p><p><strong>Results: </strong>The main study included 174 participants (40 with MwA, 53 with MwoA, and 81 HCs). The duration of the afterimage in patients with MwA was significantly longer than in HCs, at a mean (standard error of the mean [SEM]) of 12.6 (2.6) versus 5.5 ( 0.3) s (p = 0.035), while there was no significant difference between patients with MwoA (mean [SEM] 7.7 [1.6] s; p = 0.510) and HCs. There was also no significant effect of stimulus color on afterimage latency (mean [SEM] red: 8.9 [1.2] s and black: 8.4 [1.2] s).</p><p><strong>Conclusion: </strong>We found significantly longer afterimage duration in patients with MwA compared to both HCs and patients with MwoA. Furthermore, partially selective stimulation of retinal rods and cones by different stimulus colors had no effect on afterimage duration suggesting a relevant subcortical and/or cortical modulation in migraine aura with increased excitability.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"756-763"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing blood pressure changes and hypertension-related outcomes in patients with migraine treated with erenumab: A systematic review and meta-analysis.","authors":"Luana Miyahira Makita, Rafael de Freitas de Kleimmann, Rafael Reis de Oliveira, Henrique Alexsander Ferreira Neves, Angela Maria Sandini Corso, Vinícius Salles Alves, Giovana Schlichta Adriano Kojima, Aishwarya Koppanatham, Pedro André Kowacs, Elcio Juliato Piovesan","doi":"10.1111/head.14921","DOIUrl":"10.1111/head.14921","url":null,"abstract":"<p><strong>Objectives/background: </strong>We aimed to systematically review and summarize evidence on the effects of erenumab on systemic blood pressure (BP) in patients with migraine (International Prospective Register of Systematic Reviews ID: CRD42024571056). US Prescribing Information for erenumab was updated to include the potential risk of hypertension, although randomized trials did not link it previously. The association of this monoclonal antibody with an elevated vascular risk remains uncertain.</p><p><strong>Methods: </strong>Embase, PubMed, and the Cochrane databases were searched up to June 18, 2024 for studies examining the impact of erenumab on BP in patients with migraine. I² statistics and prediction intervals (PIs) were applied to assess heterogeneity, and sensitivity and subgroup analyses were used to explore it. Data were collected using mean difference (MD) or proportion of events. The risk of bias of the included studies was assessed with the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>Systolic (MD = 0.86, 95% confidence interval [CI] = -1.02 to 2.73, p = 0.370, I² = 63%) and diastolic (MD = 1.33, 95% CI = -0.05 to 2.72, p = 0.060, I² = 69%) BP measures did not significantly differ between after and before erenumab treatment. This lack of significant difference persisted at 3 and 12 months. The leave-one-out technique did not change heterogeneity. The proportion of participants presenting worsening BP appears to be 22.04% (95% CI = 11.12-38.98, PI = 0.54-93.60), with 56.40% corresponding to nonhypertensive individuals at baseline. The incidence of patients starting antihypertensive medications during the study was 3.96% (95% CI = 1.30-11.42, PI = 0.02-90.04), of which 62.88% corresponded to nonhypertensive patients at baseline.</p><p><strong>Conclusion: </strong>We did not find an association of erenumab with significant increases in systemic BP. There is a considerable degree of fragility in the current evidence available. The decision to prescribe erenumab, especially for patients with multiple comorbidities and risk factors for hypertension, must be made weighing the risks and benefits. Further studies are needed to confirm these findings.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"871-882"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of acute SARS-CoV-2 infection on headache pattern in patients with migraine: A novel Bayesian analysis.","authors":"Jiunn-Tyng Yeh, Yen-Feng Wang, Yi-Shiang Tzeng, Shih-Pin Chen, Li-Ling Hope Pan, Shuu-Jiun Wang","doi":"10.1111/head.14911","DOIUrl":"10.1111/head.14911","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze headache and migraine dynamics around severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.</p><p><strong>Background: </strong>Headache is a common symptom of SARS-CoV-2 infection, which caused the coronavirus disease 2019 (COVID-19) pandemic. However, the daily changes in headache patterns in patients with migraine during the infection are unclear.</p><p><strong>Methods: </strong>This study is a post hoc and retrospective study of patients with migraine and documented COVID-19 diagnoses and headache diaries from a large prospective migraine cohort that consecutively enrolls eligible patients. Patients' characteristics, headache and migraine patterns, and vaccination data were retrieved. Change points in daily headache or migraine rates of this cohort were identified from 28 days before (day -28) to 28 days after (day 28) the infection. We calculated and compared the weekly headache and migraine days of individual patients during pre-infection, infection, and post-infection periods based on the change points. We further categorized patients into those with increased headache days and those without to investigate if vaccinations affected the headache patterns by comparing the pre- and post-infection headache days.</p><p><strong>Results: </strong>A total of 463 patients, 370 (79.9%) females, with an age (mean ± standard deviation) of 41.5 ± 11.9 years, were enrolled. A total of 26,391 diary days were analyzed. The change-point algorithm identified changes in headache rates on day -4 (95% credible interval: -5.0, -1.2) and day 12 (95% credible interval: 7.6, 17.0). For migraine attacks, the change points were day -2 (95% credible interval: -4.9, -0.8) and day 11 (95% credible interval: 7.6, 17.2). After the grouping based on these change points, we found that the weekly headache days (mean ± standard error of the mean) increased from 1.5 ± 0.1 days during pre-infection to 1.8 ± 0.1 days during acute infection and recovered to 1.6 ± 0.1 days after infection. The weekly migraine days increased from 1.0 ± 0.1 day to 1.3 ± 0.1 days during acute infection and recovered to 1.1 ± 0.1 days. Female patients and those older than 40 had more abrupt changes in headache and migraine patterns. There was no impact of vaccinations on the headache pattern regardless of the type or dose of the vaccinations or the intervals between the last vaccination and the COVID-19 diagnosis.</p><p><strong>Conclusion: </strong>We demonstrated that the headache and migraine rates among individuals with migraine escalated during the early stage of SARS-CoV-2 infection and returned to baseline along with systemic viral clearance.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"745-755"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspareunia and pelvic pain in women with chronic migraine: A retrospective, observational analysis.","authors":"Liza Smirnoff, Leon S Moskatel","doi":"10.1111/head.14905","DOIUrl":"10.1111/head.14905","url":null,"abstract":"<p><strong>Background: </strong>Dyspareunia and pelvic pain are commonly comorbid conditions with migraine, with chronic migraine potentially contributing to the exacerbation of sexual dysfunction and pain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of female patients seen at the Stanford Headache Clinic between January 1, 2022, and March 24, 2024, for the management of chronic migraine for dyspareunia and pelvic pain and stratified for comorbidities related to both conditions.</p><p><strong>Results: </strong>Patients with chronic migraine were overall found to be at higher likelihood of having a comorbid pelvic pain condition after adjusting for age, race-ethnicity, and marital status (adjusted odds ratio [aOR] 2.46; 95% confidence interval [CI]: 2.17-2.79, p < 0.001), with interstitial cystitis (aOR 3.04; 95% CI: 1.98-4.66, p < 0.001), vaginismus (aOR 2.51; 95% CI: 1.29-4.88, p = 0.007), dyspareunia (aOR 1.97; 95% CI: 1.57-2.49, p < 0.001), and vulvodynia (aOR 1.88; 95% CI: 1.04-3.40, p = 0.036) all increased in the chronic migraine population. Furthermore, conditions that are commonly comorbid with migraine, such as irritable bowel syndrome, fibromyalgia, and mood disorders, independently contributed to increased risk of pelvic pain conditions and dyspareunia.</p><p><strong>Conclusions: </strong>Conditions that cause pelvic pain and sexual dysfunction in women are disproportionally common in women with chronic migraine and may contribute to disability and difficulties in interpersonal relationships. Early screening for disorders of pelvic pain in patients with chronic migraine and appropriate referrals can improve the quality of life of these patients.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"764-769"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low serum 25-hydroxyvitamin D levels in migraine are not related to headache frequency: A case-control study in patients with high-frequency/chronic migraine.","authors":"Marina Haro, Gabriel Gárate, José Luis Hernández, José Manuel Olmos, María Muñoz, Vicente González-Quintanilla, Julio Pascual","doi":"10.1111/head.14901","DOIUrl":"10.1111/head.14901","url":null,"abstract":"<p><strong>Background: </strong>Serum 25-hydroxyvitamin D (25[OH]D) concentrations have been shown to be low in patients with migraine, but results are controversial regarding the current role of vitamin D in migraine severity. Using a case-control design, we aimed to evaluate serum 25(OH)D levels in a group of females with high-frequency episodic migraine/chronic migraine (HF/CM) and analyze its association with headache frequency and serum calcitonin gene-related peptide (CGRP) levels.</p><p><strong>Methods: </strong>Serum 25(OH)D levels were measured in 97 females with HF/CM (age 48.9 ± 9.4 years) and 146 healthy females (47.4 ± 8.1 years). Participants taking vitamin D supplements were excluded. Serum concentrations of 25(OH)D were determined by electrochemiluminescence (Roche, Germany), and CGRP levels were measured by enzyme-linked immunosorbent assay (Abbexa, UK).</p><p><strong>Results: </strong>Mean 25(OH)D levels in females with HF/CM (median [interquartile range] 19.0 [13.0-24.5] ng/mL) were below the values considered for insufficiency or deficiency and significantly lower than controls (25.0 [19-29.8] ng/mL; p < 0.0001). Fifty (51.5%) patients with HF/CM had levels below 20 ng/mL. There was no significant association between vitamin D levels and monthly headache days (Spearman's rank correlation coefficient [rho]: -0.086; p = 0.404) or with serum α (rho: 0.114; p = 0.267) and β-CGRP (rho: 0.113; p = 0.276) levels. Serum 25(OH)D levels in females with HF/CM with a minimum daily sunlight exposure were significantly higher than those without (23.0 [15.0-26.0] ng/mL vs. 14.0 [10.0-20.0] ng/mL; p < 0.001). Females with HF/CM who performed exercise had higher, albeit not significant, plasma 25(OH)D levels than those who did not (21.0 [15.5-28.0] ng/mL vs. 16.5 [12.0-24.0] ng/mL; p = 0.059).</p><p><strong>Conclusions: </strong>Serum concentrations of 25(OH)D were low in many patients with HF/CM. Because there was no correlation with migraine frequency or serum CGRP levels, this deficiency seems to be a direct consequence of the migraine impact. Our data do not support either a relationship of 25(OH)D levels with migraine severity or the use of vitamin D supplements as a specific migraine treatment, although further studies are needed.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"863-870"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Headache characteristics in acromegaly: Only a secondary disorder?","authors":"Giada Giuliani, Denise Costa, Chiara Pellicano, Patrizia Gargiulo, Camilla Virili, Vittorio Di Piero, Marta Altieri","doi":"10.1111/head.14927","DOIUrl":"10.1111/head.14927","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the characteristics and nature of headache in a population of patients with acromegaly.</p><p><strong>Background: </strong>Headache is frequently described by patients with pituitary adenomas. Although it is mainly considered a secondary disorder, it can persist despite effective therapy for pituitary disease. A proper description of headache according to the subtype of pituitary adenoma is not available in literature. In this light, we aimed to analyze headache characteristics in a population of patients with acromegaly.</p><p><strong>Methods: </strong>In this registry-based retrospective cohort study, headache features were collected through a structured telephone interview. The clinical picture of each patient was classified according to the third edition of the International Classification of Headache Disorders criteria. We carefully investigated the time course and the relationship of headache with acromegaly.</p><p><strong>Results: </strong>Out of 39 enrolled patients, 27 (69%) reported headache. Six patients (15%) fulfilled secondary headache criteria, with complete headache resolution after acromegaly treatment. In all, 21 patients (54%) met the criteria for a primary headache: fourteen had episodic migraine, four had chronic migraine, and three had tension-type headache. No trigeminal autonomic cephalalgias were observed. The presence of primary headache significantly reduced the time to diagnosis of acromegaly (mean [standard deviation] 2.1 [2.5] vs. 4.3 [3.5] years, p = 0.007). The occurrence of primary headache was similar in patients with macroadenoma compared to patients with microadenoma (14 [67%] vs. 7 [33%], χ² = 0.591, p = 0.400), while its course was not significantly influenced either by the acromegaly treatment (p = 0.670) or the achievement of biochemical control (p = 0.490).</p><p><strong>Conclusion: </strong>Secondary headache was found only in a small percentage of our patients. Most of them had a primary headache with a high prevalence of migraine, suggesting that acromegaly might act as a trigger for this disorder. Considering the potentially disabling nature, primary headaches in patients with acromegaly require careful evaluation and personalized management.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"826-834"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of primary stabbing headache: A meta-analysis.","authors":"Aleksander Osiowski, Maksymilian Osiowski, Dominik Taterra","doi":"10.1111/head.14915","DOIUrl":"10.1111/head.14915","url":null,"abstract":"<p><strong>Objectives/background: </strong>This study was undertaken to assess the prevalence of primary stabbing headache (PSH) among adult patients seeking medical attention for headache in a clinic-based setting. PSH is a primary headache disorder and is one of the representatives of indomethacin-responsive cephalalgias. The epidemiology of PSH in adult patients assessed for headache in a tertiary care setting remains not well established.</p><p><strong>Methods: </strong>PubMed, Embase, MEDLINE, and ScienceDirect databases were thoroughly searched for observational studies published between January 1, 1988, and August 9, 2024, that reported the relative frequency of PSH among adult patients evaluated for headache in a clinic-based setting. The Meta-Analysis of Observational Studies in Epidemiology guidelines were strictly followed by the study's design. Risk of bias was assessed using the Joanna Briggs Institute Checklist for Studies Reporting Prevalence Data. The study's protocol was preregistered on PROSPERO (ID: CRD42024573776).</p><p><strong>Results: </strong>Of the initial 1153 records, 15 articles (n = 35,904 individuals) met all of the eligibility criteria. Most of the studies revealed a low risk of bias. The prevalence of PSH among adult patients evaluated for headache in a tertiary care setting was 1.6% (95% confidence interval [CI] = 0.7-3.4, 95% prediction interval [PI] = 0.00-0.29), with substantial heterogeneity (I² = 98.42) noted across the studies. PSH was diagnosed more often in females than in males (1.6%, 95% CI = 0.8-3.2, 95% PI = 0.00-0.18 vs. 0.5%, 95% CI = 0.2-1.1, 95% PI = 0.00-0.06). The mean age at onset of PSH was 41.6 years (SD = 13.7), and the mean delay time of diagnosis was 64.6 months (SD = 73.9).</p><p><strong>Conclusion: </strong>Our results showed that PSH is a rare headache disorder among adults evaluated for headache in a clinic-based setting. Moreover, PSH is typically diagnosed in the early fourth decade of life and predominantly in females.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"883-891"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occipital neuralgia as an initial manifestation of atypical Lemierre syndrome: A case report.","authors":"Akira Hanazono, Keita Yasuda, Atsuyoshi Nagata, Toshiharu Kitamura, Masashiro Sugawara","doi":"10.1111/head.14876","DOIUrl":"10.1111/head.14876","url":null,"abstract":"<p><p>Lemierre syndrome is a life-threatening but treatable septic thrombosis of the internal jugular vein (IJV) derived from a craniocervical bacterial infection. Metastatic septic embolization is common. However, diagnostic delay and poor prognosis remain a problem, largely due to the diverse clinical presentations and unclear symptomatology of Lemierre syndrome. In contrast, occipital neuralgia is a common disease typically treated with symptomatic therapy in emergency settings, as most cases are not life-threatening. The present case involved a 70-year-old female with Lemierre syndrome stemming from Streptococcus anginosus infection originating in sinusitis or periodontitis. The onset was characterized by headache with typical occipital neuralgia, a severe trigger point in the posterior neck ipsilateral to the infected IJV, and reduced sensation of the C2 nerve root area. Given the anatomical relationship of the cranial venous emissary system into the posterior cervical venous plexus, the case highlights the potential for the neighboring occipital nerve to be directly involved in Lemierre syndrome. Interestingly, despite Lemierre syndrome typically arising from pharyngeal bacterial infections and infected IJV located in the \"anterior\" neck, many prior case reports have described \"occipital\" or \"posterior\" pain at the head or neck. History taking and physical examination remain essential to identify the causes of these posterior/occipital symptoms, since imaging investigations, as in this case, often fail to identify them. Early recognition of occipital neuralgia as a potential initial symptom of Lemierre syndrome could lead to earlier diagnosis and treatment, potentially improving patient outcomes.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"897-901"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}