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Latest & greatest articles for headache
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Efficacy and safety of gastrodin injection for headache: a systematic review and meta-analysis of randomized controlled trials Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any
Headache Outcomes After Treatment of Unruptured Intracranial Aneurysm: A Systematic Review and Meta-Analysis Background and Purpose- While unruptured intracranial aneurysms may be discovered incidentally in the workup of chronic headache, it remains unclear whether their treatment ultimately impacts headache severity. We aim to conduct a systematic review and meta-analysis assessing headache severity after treatment of unruptured intracranial aneurysm. Methods- MEDLINE and EMBASE were (...) systematically reviewed. Results- Data from 7 studies met inclusion criteria (309 nonduplicated patients). The standard mean difference in pre- and post-intervention headache severity was estimated at -0.448 (95% CI, -0.566 to -0.329) under a random effects model. No significant heterogeneity was noted nor was any significant publication bias demonstrated. Conclusions- This is the first systematic review assessing postoperative headache severity following treatment of unruptured intracranial aneurysm. While
Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical (...) questions: (1) In the adult emergency department patient presenting with acute headache, are there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head computed tomography scan performed within 6 hours of headache onset preclude
Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society To provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine.We performed a systematic review of the literature and rated risk of bias of included studies according to the American Academy (...) , acetaminophen (in children and adolescents), and triptans (mainly in adolescents) for the relief of migraine pain, although confidence in the evidence varies between agents. There is high confidence that adolescents receiving oral sumatriptan/naproxen and zolmitriptan nasal spray are more likely to be headache-free at 2 hours than those receiving placebo. No acute treatments were effective for migraine-related nausea or vomiting; some triptans were effective for migraine-related phonophobia
Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society To provide updated evidence-based recommendations for migraine prevention using pharmacologic treatment with or without cognitive behavioral therapy in the pediatric population.The authors systematically reviewed literature from January 2003 (...) to August 2017 and developed practice recommendations using the American Academy of Neurology 2011 process, as amended.Fifteen Class I-III studies on migraine prevention in children and adolescents met inclusion criteria. There is insufficient evidence to determine if children and adolescents receiving divalproex, onabotulinumtoxinA, amitriptyline, nimodipine, or flunarizine are more or less likely than those receiving placebo to have a reduction in headache frequency. Children with migraine receiving
Occipital nerve stimulation for medically refractory chronic cluster headache Occipital nerve stimulation - Health Technology Wales > Occipital nerve stimulation Occipital nerve stimulation Topic Status Incomplete Occipital nerve stimulation for medically refractory chronic cluster headache. Summary Health Technology Wales researchers searched for evidence on the use of occipital nerve stimulation (ONS) for the treatment of medically refractory chronic cluster headaches. Based on the evidence
Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache 1 1 2 Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the 3 Emergency Department With Acute Headache 4 Approved by the ACEP Board of Directors, June 26, 2019 5 6 7 From the American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on 8 Acute Headache: 9 10 Steven A. Godwin, MD (...) Liaison, Clinical Policies Committee and Subcommittee on Acute Headache 50 Rhonda R. Whitson, RHIA, Staff Liaison, Clinical Policies Committee 51 52 53 54 2 ABSTRACT 55 56 This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation 57 and management of adult patients presenting to the emergency department with acute headache. A writing 58 subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer 59
Trial of Galcanezumab in Prevention of Episodic Cluster Headache. Episodic cluster headache is a disabling neurologic disorder that is characterized by daily headache attacks that occur over periods of weeks or months. Galcanezumab, a humanized monoclonal antibody to calcitonin gene-related peptide, may be a preventive treatment for cluster headache.We enrolled patients who had at least one attack every other day, at least four total attacks, and no more than eight attacks per day during (...) a baseline assessment, as well as a history of cluster headache periods lasting at least 6 weeks, and randomly assigned them to receive galcanezumab (at a dose of 300 mg) or placebo, administered subcutaneously at baseline and at 1 month. The primary end point was the mean change from baseline in the weekly frequency of cluster headache attacks across weeks 1 through 3 after receipt of the first dose. The key secondary end point was the percentage of patients who had a reduction from baseline of at least
Headache Date of origin: 1996 Last review date: 2013 ACR Appropriateness Criteria ® 1 Headache American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Headache Variant 1: Chronic headache. No new features. Normal neurologic examination. Radiologic Procedure Rating Comments RRL* MRI head without and with IV contrast 4 O MRI head without IV contrast 4 O CT head without IV contrast 3 ??? CT head without and with IV contrast 3 ??? CT head with IV contrast 3 ??? MRA head (...) without and with IV contrast 2 O MRA head without IV contrast 2 O Arteriography cervicocerebral 2 ??? CTA head with IV contrast 2 ??? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level Variant 2: Chronic headache with new feature or neurologic deficit. Radiologic Procedure Rating Comments RRL* MRI head without and with IV contrast 8 O MRI head without IV contrast 7 O CT head without IV contrast 7 ??? CT head without and with IV
Intravenous Fluid for the Treatment of Emergency Department Patients With Migraine Headache: A Randomized Controlled Trial The objective of this pilot study is to assess the feasibility and necessity of performing a large-scale trial to measure the effect of intravenous fluid therapy on migraine headache pain.This was a single-center, pilot randomized controlled trial. We randomized adult emergency department migraine headache patients to receive 1 L of normal saline solution during 1 hour
Atraumatic needles reduce headaches following lumbar puncture Atraumatic needles reduce headaches following lumbar puncture Discover Portal Discover Portal Atraumatic needles reduce headaches following lumbar puncture Published on 17 April 2018 doi: Use of atraumatic needles rather than conventional needles for lumbar puncture more than halves the rate of post-procedure headache. Moreover, this improvement does not come at the expense of procedure success rates. Lumbar puncture involves (...) inserting a needle in the lower back into the spinal canal to collect cerebrospinal fluid for diagnosis, or to inject a treatment or anaesthetic into it. A common side effect is a headache, often from leakage of fluid from the puncture. Atraumatic needles leave a smaller puncture. After piercing the skin with an introducer needle, the atraumatic needle is inserted through the introducer. This spreads apart the fibres of the canal lining rather than cutting through it with a conventional needle
Paracetamol is a weak painkiller for regular tension headaches Paracetamol is a weak painkiller for regular tension headaches Discover Portal Discover Portal Paracetamol is a weak painkiller for regular tension headaches Published on 13 September 2016 doi: Paracetamol is only slightly more effective than dummy tablets (placebo) at relieving pain in people who experience regular tension-type headaches. A Cochrane review found that 24 out of 100 people who took paracetamol for regular tension (...) -type headaches were pain free at two hours, compared with 19 out of 100 who took an inactive placebo. There was no difference in risk of side effects between paracetamol and placebo. Paracetamol is a cheap drug that is readily available over-the-counter. Because serious side effects are so uncommon and the “placebo effect” is so strong, this drug could be considered as an option for treating regular tension-type headache for people who find that it helps them. However, clinicians treating regular
34m with fever, headache and myalgias Core IM Hoofbeats: 34M with Fever, Headache and Myalgias – Clinical Correlations Search Core IM Hoofbeats: 34M with Fever, Headache and Myalgias January 16, 2019 15 min read Podcast: | Subscribe: | By Shira Sachs MD, Stephanie Sherman MD, Cindy Fang MD and John Hwang MD || Audio Editing by Richard Chen || Graphic by Amy Ou MD Time Stamps Player three has entered the game! [0:15] Case presentation, part 1 [1:20] First impressions [3:24] Rethinking another (...) to all our listeners for all your support. Now we’re going to pass the mic to Shira and announce our early retirement. CASE PRESENTATION JOHN Yep. As part of our exit clause, I’m going to present Shira’s case. Then you’re in her capable hands. So, Shira’s patient is a previously healthy 34-year-old man presenting with resolved fever and ten days of headache and myalgias. The story he tells is that, ten days ago, he experienced 24-hours of subjective fever and chills. Subsequently, he develops severe
A Randomized Trial of a Long-Acting Depot Corticosteroid Versus Dexamethasone to Prevent Headache Recurrence Among Patients With Acute Migraine Who Are Discharged From an Emergency Department Migraine patients continue to report headache during the days and weeks after emergency department (ED) discharge. Dexamethasone is an evidence-based treatment of acute migraine that decreases the frequency of moderate or severe headache within 72 hours of ED discharge. We hypothesize that intramuscular (...) methylprednisolone acetate, a long-acting steroid that remains biologically active for 14 days, will decrease the number of days with headache during the week after ED discharge by at least 1 day compared with intramuscular dexamethasone.We conducted a randomized, blinded clinical trial comparing intravenous metoclopramide at 10 mg+intramuscular dexamethasone at 10 mg with intravenous metoclopramide at 10 mg+intramuscular methylprednisolone acetate at a dose of 160 mg for patients presenting to 2 different EDs
Occipital nerve stimulation (ONS) for non-migrainous chronic headaches : a systematic review protocol Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web
The differences of the pericranial Total Tenderness Score in patients with migraine, tension-type headache, cervicogenic headache and healthy controls. A systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation