Cephalalgia Reports最新文献

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Erenumab for chronic cluster headache: A case report Erenumab治疗慢性丛集性头痛1例
Cephalalgia Reports Pub Date : 2020-08-31 DOI: 10.1177/2515816320947713
F. Riederer, A. Wenner
{"title":"Erenumab for chronic cluster headache: A case report","authors":"F. Riederer, A. Wenner","doi":"10.1177/2515816320947713","DOIUrl":"https://doi.org/10.1177/2515816320947713","url":null,"abstract":"The preventive treatment for cluster headache is often limited by a lack of efficacy or side effects. Calcitonin gene-related peptide (CGRP) has been implicated in the pathophysiology of cluster headache. Galcanezumab, a monoclonal antibody against calcitonin gene-related peptide (CGRP), significantly reduced the frequency of episodic cluster headache attacks. We report the case of a 38-year-old woman with chronic refractory cluster headache and comorbid migraine who received erenumab in 4 repeated doses of 70 mg subcutaneously over 25 weeks. Attack frequency decreased from three attacks per day to several attacks per week. Erenumab seemed to be highly effective in the prevention of cluster headache attacks in this patient. We suggest that randomized control trials should be performed.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320947713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47356989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Failure to identify underlying autoimmunity and primary headache disorder might be the reasons for refractoriness of trochlear headaches 未能识别潜在的自身免疫和原发性头痛障碍可能是滑车头痛顽固性的原因
Cephalalgia Reports Pub Date : 2020-08-28 DOI: 10.1177/2515816320951770
P. Ojha, V. Aglave, Suranjana Basak, J. Yadav
{"title":"Failure to identify underlying autoimmunity and primary headache disorder might be the reasons for refractoriness of trochlear headaches","authors":"P. Ojha, V. Aglave, Suranjana Basak, J. Yadav","doi":"10.1177/2515816320951770","DOIUrl":"https://doi.org/10.1177/2515816320951770","url":null,"abstract":"Introduction: A better understanding of etiology might improve poor outcomes of trochlear headaches (TRHs). Aims: To study clinical spectrum, etiology, and therapeutic response of TRH. Methods: Fifty-three TRH patients seen in a single center between 2015 and 2020 were included, excluding Trigeminal Autonomic Cephalalgia (TAC). Results: Mean age was 36.45 years (range 11–85 years), with 77.35% being females. Twenty-five patients had continuous trochlear headache (CTRH) and 28 episodic trochlear headache (ETRH). Tension-type headache (TTH) occurred in 9 ETRH patients and 24 of 25 CTRH patients, and migraine-like headaches occurred in 19 ETRH patients and 8 CTRH (trochlear migraine) patients. Prior history of headaches was noted in 22 of 28 ETRH and 11 of 25 CTRH patients. Twenty-eight responded to migraine/TTH prophylaxis, 25 being nonresponders (partial/no response). Fourteen of 25 nonresponders, 4 of 28 responders (4 of 4 secondary and 5 of 9 idiopathic trochleitis (IT), 3 of 9 primary TRH (PTRH), and 6 of 28 ETRH) had autoantibodies, that is, 11 antinuclear antibodies (ANAs) and 7 antithyroid antibodies. Ten of 14 (71.42%) antibody-positive nonresponders improved with immunosuppressants including steroids/hydroxychloroquine and only 11 required local injections. Finally, 38 patients had good response, 13 partial, and 2 no response. The etiology and refractoriness of IT can be attributed to underlying autoimmunity and a minor contribution by primary headaches, vice versa being the case for PTRH and ETRH. Refractory TRHs should be evaluated for underlying autoimmunity and primary headaches. Conclusion: Identification and treatment of underlying autoimmunity and primary headaches can help improve outcome of TRH.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320951770","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48239193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Development of new or worsening headache after cochlear implant activation: A hypothesis-generating pilot study of incidence, timing, and clinical factors 人工耳蜗激活后新发或恶化头痛的发展:一项关于发病率、时间和临床因素的假设产生的初步研究
Cephalalgia Reports Pub Date : 2020-08-24 DOI: 10.1177/2515816320951820
Nina Riggins, Ricky Chae, M. Levin, Annika Ehrlich, Henna Sawhney, Colleen Polite, P. Goadsby
{"title":"Development of new or worsening headache after cochlear implant activation: A hypothesis-generating pilot study of incidence, timing, and clinical factors","authors":"Nina Riggins, Ricky Chae, M. Levin, Annika Ehrlich, Henna Sawhney, Colleen Polite, P. Goadsby","doi":"10.1177/2515816320951820","DOIUrl":"https://doi.org/10.1177/2515816320951820","url":null,"abstract":"The objectives of the study are to investigate the incidence of new or worsening headache after cochlear implant (CI) surgery and activation and to determine whether there are predictors of associated headache. We performed a cross-sectional survey of patients who had CI surgery. The frequency and severity of headache, onset of headache relative to surgery and device activation, medication use, family history, headache triggers, and accompanying cranial autonomic symptoms were recorded and analyzed. Thirty-seven subjects were enrolled. In the time period after CI surgery but before CI activation, none reported a new headache and four (11%) reported a worsening headache. After CI activation, six (16%) developed new headache and five (14%) developed worsening headache. These 11 subjects also experienced a significantly higher mean of 6.3 headache days/month following CI activation (p < 0.009). Providers should be aware that new or worsening headache can be reported following CI activation, although not immediately following CI surgery.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320951820","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48036214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Early use of acute medication for preventing migraine attacks: Results from a diary-based cohort study 早期使用急性药物预防偏头痛发作:基于日记的队列研究结果
Cephalalgia Reports Pub Date : 2020-08-12 DOI: 10.1177/2515816320944928
S. Termini, C. Wöber, W. Brannath
{"title":"Early use of acute medication for preventing migraine attacks: Results from a diary-based cohort study","authors":"S. Termini, C. Wöber, W. Brannath","doi":"10.1177/2515816320944928","DOIUrl":"https://doi.org/10.1177/2515816320944928","url":null,"abstract":"Background: Treating migraine attacks early may improve outcome. The aim of this analysis was to investigate whether certain premonitory symptoms could be indicators for taking acute medication. Methods: We analyzed 3-month diary data recorded by 271 patients with episodic migraine and looked at all migraine-free intervals. For investigating the interaction between acute medication and neck discomfort associated with sensitivity to lights, noises, or odors, we used a marginal structural model and a Cox regression analysis adjusted for moderate or severe headache. Results: The patients (mean age 43 ± 15.4 years, 88% women) recorded a total of 20,219 diary days without migraine. In the marginal structural model analysis, the risk for occurrence of a migraine attack on the subsequent day was reduced when acute medication was used in the presence of neck discomfort associated with sensitivity to lights (hazard ratio 0.4; 95% confidence interval 0.2–0.7), noises (0.4; 0.3–0.7), or odors (0.2; 0.1–0.4). The marginal structural model showed lower risk of migraine attacks than the Cox regression analysis adjusted for moderate or severe headache in the majority of the cases. Conclusion: Migraine attacks may be prevented when acute medication is used in the presence of neck discomfort associated with sensitivity to lights, noises, or odors. The results of this study may stimulate further prospective trials.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320944928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42522393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can the effects of the mitochondrial DNA mutations found in Leber’s hereditary optic neuropathy be protective against the development of cluster headache in smokers? 在Leber遗传性视神经病变中发现的线粒体DNA突变是否能预防吸烟者丛集性头痛的发生?
Cephalalgia Reports Pub Date : 2020-07-29 DOI: 10.1177/2515816320939571
T. Rozen
{"title":"Can the effects of the mitochondrial DNA mutations found in Leber’s hereditary optic neuropathy be protective against the development of cluster headache in smokers?","authors":"T. Rozen","doi":"10.1177/2515816320939571","DOIUrl":"https://doi.org/10.1177/2515816320939571","url":null,"abstract":"Is it possible that some mitochondrial DNA (mtDNA) mutations enhance the risk of developing a headache disorder while other mutations actually confer a protective effect? Mitochondrial disorders have been linked to migraine but very rarely to cluster headache (CH). The true pathogenesis of CH is unknown but a linkage to cigarette smoking is irrefutable. Leber’s hereditary optic neuropathy is a syndrome of bilateral vision loss that typically manifests in a patient’s 20s and 30s, is male predominant, and its sufferers are heavy smokers and heavy drinkers. Tobacco exposure is so linked to the condition that only smokers appear to develop vision loss while nonsmokers remain unaffected carriers of their mutations. In essence, the Leber’s hereditary optic neuropathy population is the CH population but at present there have been no reported cases of CH in this mitochondrial subgroup. Thus, could the effects of the mtDNA mutations found in Leber’s hereditary optic neuropathy, which involve complex I of the electron transport chain, actually confer a protective effect against the development of CH? This article will delve into this theory.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320939571","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44000865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Efficacy and safety of galcanezumab for prevention of migraine headache in Japanese patients with episodic migraine: A phase 2 randomized controlled clinical trial galcanezumab预防日本发作性偏头痛患者偏头痛的有效性和安全性:一项2期随机对照临床试验
Cephalalgia Reports Pub Date : 2020-07-02 DOI: 10.1177/2515816320932573
F. Sakai, Akichika Ozeki, V. Skljarevski
{"title":"Efficacy and safety of galcanezumab for prevention of migraine headache in Japanese patients with episodic migraine: A phase 2 randomized controlled clinical trial","authors":"F. Sakai, Akichika Ozeki, V. Skljarevski","doi":"10.1177/2515816320932573","DOIUrl":"https://doi.org/10.1177/2515816320932573","url":null,"abstract":"Objective: This study was designed to assess the efficacy and safety of galcanezumab in comparison with placebo for the prevention of migraine in Japanese patients with episodic migraine. Methods: In this double-blind, placebo-controlled study, which was conducted over 6 months, randomized adult patients received subcutaneous injections of galcanezumab (120 mg n = 115, 240 mg n = 114) or placebo (n = 230) once monthly. The primary endpoint was the overall mean change from baseline in the number of monthly migraine headache days. The key secondary outcome measures were response rates (≥50%, ≥75%, and 100%); the Migraine-Specific Quality-of-Life Questionnaire Role Function-Restrictive score; monthly migraine headache days requiring acute treatment; and Patient Global Impression of Severity (PGI-S). Results: The mean change from baseline in monthly migraine headache days over months 1–6 was significantly (p < 0.001) greater for the 120-mg galcanezumab dose (−3.60 days) and the 240-mg galcanezumab dose (−3.36 days) compared with placebo (−0.59 days). Both the 120-mg and 240-mg doses of galcanezumab were superior compared with placebo for each of the key secondary endpoints except for PGI-S (only the 240-mg dose was superior). The most commonly reported treatment-emergent adverse events were local injection-site reactions; erythema, swelling, pruritus, and pain were more commonly reported by patients who were treated with galcanezumab than those treated with placebo. Conclusion: The number of monthly migraine headache days was reduced with both doses of galcanezumab, and both doses were safe and well tolerated in Japanese patients with episodic migraine.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320932573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43704470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
Neck treatment compared to aerobic exercise in migraine: A preference-based clinical trial 颈部治疗与有氧运动治疗偏头痛的比较:一项基于偏好的临床试验
Cephalalgia Reports Pub Date : 2020-06-10 DOI: 10.1177/2515816320930681
K. Luedtke, W. Starke, Karolin von Korn, T. Szikszay, A. Schwarz, A. May
{"title":"Neck treatment compared to aerobic exercise in migraine: A preference-based clinical trial","authors":"K. Luedtke, W. Starke, Karolin von Korn, T. Szikszay, A. Schwarz, A. May","doi":"10.1177/2515816320930681","DOIUrl":"https://doi.org/10.1177/2515816320930681","url":null,"abstract":"Objectives: The main objective of this study was to compare the effectiveness of aerobic exercise with physiotherapy. A second objective was to evaluate whether patients with pain referred to the head during manual palpation will benefit more from physiotherapy than patients with local or no pain. Methods: A total of 103 patients with migraine received physiotherapy (n = 79) or supervised aerobic exercise (n = 24) according to their preference as an add-on treatment. Both groups had the same contact time with a specialized physiotherapist. The primary outcome measure was headache frequency during the 4 weeks after the intervention. Eighty-seven patients were analyzed at the primary end point (n = 69 in the physiotherapy group; n = 18 in the aerobic exercise group). A follow-up assessment was conducted 3 months after the final intervention. Results: During the initial assessment of the upper cervical spine, 17 patients reported no pain, 45 local pain, and 25 referred pain to the head. Patients in the physiotherapy group had a mean reduction of 1.8 days (standard deviation (SD) 6.07), while patients in the aerobic exercise group had a mean reduction of 1.2 days (SD 4.27) at the primary end point. This difference was not statistically significant (p = 0.8). The largest improvement was noted in the group that showed referred pain to the head and received physiotherapy (2.13 days (SD 7.82)). Only patients in the physiotherapy group reported a subjectively perceived general improvement. Conclusions: Patients had a strong preference for physiotherapy. Both groups showed small reductions in headache frequency. Effects were superior after physiotherapy but not statistically significant. Patients with pain referred to the head responded best to a physiotherapy intervention.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320930681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43452849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Characteristics of migraine patients with Migraine Disability Assessment (MIDAS) scores in real-world clinical practice 偏头痛患者的特征与偏头痛功能障碍评估(MIDAS)评分在现实世界临床实践中的应用
Cephalalgia Reports Pub Date : 2020-06-02 DOI: 10.1177/2515816320928463
V. Chia, A. Bogdanov, A. Yusuf, L. Kallenbach
{"title":"Characteristics of migraine patients with Migraine Disability Assessment (MIDAS) scores in real-world clinical practice","authors":"V. Chia, A. Bogdanov, A. Yusuf, L. Kallenbach","doi":"10.1177/2515816320928463","DOIUrl":"https://doi.org/10.1177/2515816320928463","url":null,"abstract":"Background: Better understanding of migraine treatment in US clinical practice could be facilitated by availability of Migraine Disability Assessment (MIDAS) questionnaire results collected in routine care. We present results for migraine patients with MIDAS collected in routine clinical practice through an electronic medical record (EMR) system that presented the MIDAS questionnaire as an electronic form during the patient office encounter. The purpose of this retrospective observational study was to gain better understanding of migraine disability and migraine treatment patterns in US real-world clinical practice. Methods: In this EMR database study, patients were required to have 12 months baseline time for review of patient and clinical characteristics. Adult patients with documentation of migraine with subsequent MIDAS questionnaire data collected between March 2017 and September 2018 were included. Based on MIDAS responses patients were categorized into grade I—little or no disability, grade II—mild disability, grade III—moderate disability, and grade IV—severe disability. Results: This study included 2731 migraine patients with MIDAS results. Overall, 2309 (84.5%) were female with an average age of 46.7 years. Distribution by disability grade was 1161 (42.5%) little or no disability, 424 (15.5%) mild disability, 477 (17.5%) moderate disability, and 669 (24.5%) severe disability. Compared to overall, a larger proportion of patients with severe disability had baseline treatment with acute (71.3% vs. 67.6%) or preventive medications (70.4% vs. 62.0%) and to be on 3+ acute (9.4% vs. 7.0%) or 3+ preventive therapies (17.0% vs. 14.5%). Conclusion: Availability of MIDAS results in usual care provides additional insight into migraine care.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320928463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47528068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Methylation analysis of NPTX2 and SH2D5 genes in chronic migraine: A case–control study 慢性偏头痛患者NPTX2和SH2D5基因甲基化分析:一项病例对照研究
Cephalalgia Reports Pub Date : 2020-05-07 DOI: 10.1177/2515816320923592
Sara Pérez Pereda, María Toriello Suárez, Vicente González Quintanilla, A. Oterino
{"title":"Methylation analysis of NPTX2 and SH2D5 genes in chronic migraine: A case–control study","authors":"Sara Pérez Pereda, María Toriello Suárez, Vicente González Quintanilla, A. Oterino","doi":"10.1177/2515816320923592","DOIUrl":"https://doi.org/10.1177/2515816320923592","url":null,"abstract":"Background: Methylation of two CpG sites related to neuronal pentraxin II protein (NPTX2) and SH2 domain containing 5 protein (SH2D5), corresponding to two neuroplasticity genes, has been associated to headache chronification. We aimed to investigate the epigenetic modification of these two genes in chronic migraine (CM). Methods: We conducted a case–control study in which the DNA of 305 age- and sex-matched subjects classified according to the International Classification of Headache Disorders version beta (ICHD-III β) in CM (109), episodic migraine (EM; n = 98), and healthy controls (HC; 98) was analyzed. Real-time quantitative methylation-specific PCR was performed using specific methylation primers for two representative CpG sites within these genes. Results: We found no significant differences in methylation level between CM, EM, and HC in the first exon of the NPTX2 gene nor in the 5′ upstream region of the SH2D5 gene. Methylation level in the first exon of the NPTX2 showed a low correlation with age (r = 0.266; p < 0.005). Conclusion: We did not find methylation level differences in analyzed regions related to NPTX2 and SH2D5 in our CM sample. Despite the potential relevance of neuroplasticity genes in headache chronification, we conclude that CM is a more heterogeneous clinical diagnosis than desired and that an epigenetic marker remains elusive.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320923592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42567900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Isolated headache and its association with characteristics and outcome of cerebral venous sinus thrombosis 孤立性头痛及其与脑静脉窦血栓形成的特点和转归的关系
Cephalalgia Reports Pub Date : 2020-04-18 DOI: 10.1177/2515816320919961
Banafsheh Shakibajahromi, A. Borhani-Haghighi, H. Vardanjani, Mehrnaz Ghaedian, F. Feiz, A. Safari, Etrat Hooshmandi, A. Mowla
{"title":"Isolated headache and its association with characteristics and outcome of cerebral venous sinus thrombosis","authors":"Banafsheh Shakibajahromi, A. Borhani-Haghighi, H. Vardanjani, Mehrnaz Ghaedian, F. Feiz, A. Safari, Etrat Hooshmandi, A. Mowla","doi":"10.1177/2515816320919961","DOIUrl":"https://doi.org/10.1177/2515816320919961","url":null,"abstract":"We aimed to evaluate the clinical characteristics and outcome, hospital stay, and intracranial hemorrhage (ICH) development of patients with cerebral venous sinus thrombosis (CVST) who presented with isolated headache. In a retrospective study, consecutive patients with a definite diagnosis of CVST referred to Namazi hospital (Shiraz University of Medical Sciences) from 2012 to 2016 were included. Clinical, radiological, and prognostic characteristics and outcome on discharge (using modified Rankin Scale (mRS)) were compared between the CVST patients who presented with isolated headache and other CVST patients through univariate analyses. The associations of isolated headache with poor outcome (mRS > 2), presence or development of ICH, and duration of hospital stay were assessed through multivariable analyses. Of the 174 patients, 45 (26.0%) presented with isolated headache. Presence of isolated headache was more frequent in men (p value = 0.048) and patients with thrombophilia (p value = 0.040). Lateral sinus involvement was more common in patients with isolated headache (p value = 0.005). After adjustment for other variables, the isolated headache was significantly associated with shorter hospital stay (odds ratio (OR): 0.85, confidence interval (CI): 0.73–0.99) and lower risk of early ICH (OR: 0.314, CI: 0.132–0.749). Although poor outcome was significantly less frequent in patients with isolated headache on univariate analysis (p value < 0.001), this association was not significant in multivariable analysis (OR: 0.324, CI: 0.035–2.985). CVST patients with isolated headache had lower ICH events and shorter hospital stay. CVST should be considered as a possible differential diagnosis in certain patients who present only with headache, particularly those with diffuse progressive headache, or underlying provocative conditions.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320919961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43701681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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