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Headache Examination

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1. Screening for Insomnia: An Observational Study Examining Sleep Disturbances, Headache Characteristics, and Psychiatric Symptoms in Patients Visiting a Headache Center. (PubMed)

Screening for Insomnia: An Observational Study Examining Sleep Disturbances, Headache Characteristics, and Psychiatric Symptoms in Patients Visiting a Headache Center. Effective treatments for insomnia exist, but few physicians treating headaches have routine methods for screening for insomnia. We sought to 1) describe the migraine characteristics and comorbid conditions that can affect sleep and 2) assess their relationships with positive screens on the Insomnia Severity Index (ISI (...) ).This is a retrospective cross-sectional study of the migraine and sleep characteristics of new patients in our headache center (August 15, 2015-October 28, 2015) who were suspected of having migraines based on the new patient intake questionnaire. The questionnaire included the ISI, questions about headache characteristics, and screens for psychiatric comorbidities. Two tailed t tests and analysis of variance evaluated relationships between headache characteristics, comorbidities, and ISI score.A total of 61 new

2017 Pain Medicine

2. Randomized Controlled Trial Examining the Effects of Balloon Catheter Dilation on "Sinus Pressure" / Barometric Headaches. (PubMed)

Randomized Controlled Trial Examining the Effects of Balloon Catheter Dilation on "Sinus Pressure" / Barometric Headaches. Objective To determine if balloon catheter dilation of sinus ostia affects the severity or frequency of headache among patients who have barometric pressure-related "sinus" headache. Study Design Prospective single-blinded randomized controlled trial. Setting Tertiary care medical center. Subjects and Methods Subjects with a diagnosis of sinus pressure headache without (...) evidence of mucosal thickening on computed tomography were recruited. Subjects were blinded and randomized to undergo balloon dilation of affected sinus ostia (active treatment) or balloon dilation in the nasal cavity (placebo). Two balloon devices were utilized (Acclarent and Entellus) and outcomes compared. Subjects were followed with pre- and postprocedure SNOT-22 scores (Sinonasal Outcome Test-22), HIT-6 scores (Headache Impact Test-6), and medication utilization logs for 6 months. Results

2018 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

3. Neuroimaging of headaches in patients with normal neurological examination: protocol for a systematic review. (PubMed)

Neuroimaging of headaches in patients with normal neurological examination: protocol for a systematic review. Headache disorders (HD) are among the most frequent neurological disorders seen in neurology practice. Because secondary HD are rare, patients' examination is most often unremarkable. However, the will to relieve patients' anxiety and the fear of prosecutions lead to overuse of neuroimaging thus resulting in the discovery of incidental findings (IF) or normal variants that can lead (...) to futile or harmful procedures. Knowing the probability of identifying a potentially clinically significant lesion in patients with isolated headache could facilitate decision-making and reduce health costs. This review aims to determine the prevalence of incidental findings and normal anatomic variants (NAV) on neuroimaging studies performed in patients presenting with headache and normal neurological examination.Studies reporting neuroimaging findings in patients with headache and normal neurological

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2018 BMJ open

4. Barriers to Behavioral Treatment Adherence for Headache: An Examination of Attitudes, Beliefs, and Psychiatric Factors. (PubMed)

Barriers to Behavioral Treatment Adherence for Headache: An Examination of Attitudes, Beliefs, and Psychiatric Factors. Nonpharmacological interventions, such as biofeedback, cognitive behavioral therapy, and relaxation techniques are Level-A evidence-based treatments for headache. The impact of these interventions is often equivalent to or greater than pharmacological interventions, with fewer side effects. Despite such evidence, the rate of participation in nonpharmacological interventions (...) for headache remains low. Once obstacles to optimizing use of behavioral interventions, such as local access to nonpharmacological treatment and primary headache providers are traversed, identification of barriers contributing to low adherence is imperative given the high levels of disability and cost associated with treating headache disorders. In this review of factors in adults associated with underuse of nonpharmacological interventions, we discuss psychological factors relevant to participation

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2018 Headache

5. Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis.

Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis. Patients with acute severe headache, normal neurological examination, and a normal noncontrast head computed tomography (NCCT) may still have subarachnoid hemorrhage, cerebral venous thrombosis (CVT), cervical arterial dissection, or reversible cerebral vasoconstriction syndrome (RCVS). Computed tomography angiography (CTA) is used (...) increasingly in the emergency department for evaluating this, but its added value remains controversial.We retrospectively collected data on the diagnostic yield of CTA in patients with acute severe headache, normal neurological examination, and normal NCCT who received additional CTA in the acute phase in 2 secondary referral centers for vascular neurology. We combined data of our patients with those from the literature and performed a meta-analysis.We included 88 patients from our hospital files and 641

2018 Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

6. Letter to the Editor Regarding "Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis".

Letter to the Editor Regarding "Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis". 29571755 2018 05 28 1532-8511 27 7 2018 Jul Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association J Stroke Cerebrovasc Dis Letter to the Editor Regarding "Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological (...) Examination, and Normal Non Contrast CT: A Meta-Analysis". 2043 S1052-3057(18)30111-3 10.1016/j.jstrokecerebrovasdis.2018.02.049 Malhotra Ajay A Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut. Electronic address: ajay.malhotra@yale.edu. Wu Xiao X Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut. Seifert Kimberly K Department of Radiology and Biomedical Imaging, Yale University School

2018 Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

7. A pilot study examining the effects of priming headache illness schema on attentional engagement towards pain relief medication, in those with high and low medication treatment beliefs. (PubMed)

A pilot study examining the effects of priming headache illness schema on attentional engagement towards pain relief medication, in those with high and low medication treatment beliefs. Few studies have assessed the underlying theoretical components of the Common Sense Model. Past studies have found, through implicit priming, that coping strategies are embedded within illness schema. Our aim was to evaluate the effect priming 'headache' illness schema upon attentional engagement to pain relief (...) medication and to examine the interaction with illness treatment beliefs. Attentional engagement to the pain relief medication ('Paracetamol') was assessed using a 2 (primed vs. control) × 2 (strong belief in medication efficacy vs. weak belief in medication efficacy) design. During a grammatical decision task (identifying verbs/non-verbs), participants were randomised to receive a headache prime or a control. Response latency to the target word, 'Paracetamol' was the dependent variable. 'Paracetamol

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2017 Psychology, health & medicine

8. Tension-type headache

Tension-type headache Tension-type headache - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Tension-type headache Last reviewed: February 2019 Last updated: July 2018 Summary Tension-type headaches can be either episodic or chronic. Stress and mental tension are common triggers. Symptoms include dull, non-pulsatile, bilateral, constricting pain (not severe); pericranial tenderness is common. Unlike migraine (...) , there is no significant nausea, no vomiting, and a lack of aggravation by routine physical activity. Usually responds to simple analgesics; preventative treatments have less evidence for their effectiveness. Non-drug therapies include relaxation, electromyographic biofeedback, cognitive behavioural therapy, and physiotherapy. Definition Tension-type headaches can be either episodic or chronic. They are rarely disabling or associated with any significant autonomic phenomena, thus patients do not usually seek medical

2018 BMJ Best Practice

9. Migraine headache in adults

Migraine headache in adults Migraine headache in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Migraine headache in adults Last reviewed: February 2019 Last updated: October 2018 Summary Migraine is a chronic, genetically determined, episodic, neurological disorder that usually presents in early-to-mid life. Patients complain of intermittent headache and associated symptoms, such as visual disturbance (...) , nausea, vomiting, and sensitivity to light or noise (photophobia and phonophobia). The diagnosis is based on history and physical examination. No laboratory or imaging tests are essential for diagnosis. Treatment approaches involve identification and avoidance of trigger factors, and the use of medication to treat the acute attack or prevent future attacks. There are no clinical trials that identify one migraine therapy (acute therapy or prophylaxis therapy) as superior over others. Triptans

2018 BMJ Best Practice

10. Assessment of acute headache in children

, especially if the pattern has persisted for a long period. May also occur in secondary headache, as with intermittent elevation in intracranial pressure. Chronic progressive headache A gradual increase in headache. Suggestive of an expanding intracranial lesion. Of children with brain tumours, 62% have headache prior to diagnosis, and 98% have at least one neurological symptom or abnormality on examination. The Childhood Brain Tumor Consortium. The epidemiology of headache among children with brain tumor (...) Assessment of acute headache in children Assessment of acute headache in children - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of acute headache in children Last reviewed: February 2019 Last updated: June 2018 Summary Headaches are common in children, increasing in incidence from early childhood to adolescence. They account for 0.7% to 1.3% of all paediatric emergency department visits. Kan L

2018 BMJ Best Practice

11. Migraine headache in adults

Migraine headache in adults Migraine headache in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Migraine headache in adults Last reviewed: February 2019 Last updated: October 2018 Summary Migraine is a chronic, genetically determined, episodic, neurological disorder that usually presents in early-to-mid life. Patients complain of intermittent headache and associated symptoms, such as visual disturbance (...) , nausea, vomiting, and sensitivity to light or noise (photophobia and phonophobia). The diagnosis is based on history and physical examination. No laboratory or imaging tests are essential for diagnosis. Treatment approaches involve identification and avoidance of trigger factors, and the use of medication to treat the acute attack or prevent future attacks. There are no clinical trials that identify one migraine therapy (acute therapy or prophylaxis therapy) as superior over others. Triptans

2018 BMJ Best Practice

12. Migraine headache in children

excluded. Diagnosis is difficult in young children because the condition is defined by subjective symptoms. History and exam presence of risk factors age >2 years gradual onset of headache normal physical examination aura nausea and/or vomiting visual disturbance phonophobia occipital headache, ataxia, diplopia, blurred vision, vertigo, and tinnitus unilateral motor or sensory signs and headache ptosis generalised seizure positive family history of migraine chocolate, cheese, and citrus fruits stress (...) Migraine headache in children Migraine headache in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Migraine headache in children Last reviewed: February 2019 Last updated: May 2018 Summary Migraine has a high prevalence in children (10%) and is a significant source of morbidity. Careful consideration of the broad differential diagnosis is important when evaluating a child with headache. The expectations

2018 BMJ Best Practice

13. Protocol for a comparison of therapies for cluster headache systematic review, updated meta-analysis, and network meta-analysis of medication effect by class (acute and preventative) and by headache subtype (episodic and chronic)

Protocol for a comparison of therapies for cluster headache systematic review, updated meta-analysis, and network meta-analysis of medication effect by class (acute and preventative) and by headache subtype (episodic and chronic) 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 (...) will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration of index ischemia (linear); stem cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8 studies per subgroup is required. ">Subgroup analyses A sensitivity analysis is conducted to assess the impact of decisions taken in the review process on the meta-analysis outcome. These decisions may have been made in various

2019 PROSPERO

14. Prevalence and risk factors of migraine, tension headache and other primary headache in Asia: a systematic review and meta-analysis

Prevalence and risk factors of migraine, tension headache and other primary headache in Asia: a systematic review and meta-analysis 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 (...) into the relationship between study characteristics (e.g. species, sex or drug class or dose) and effect size. They should be considered hypothesis-generating. Ideally, a threshold describing the number of studies per subgroup required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration

2019 PROSPERO

15. 34m with fever, headache and myalgias

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

2019 Clinical Correlations

16. Headache

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 (...) Summary of Literature Review Introduction/Background The cause or type of most headaches can be determined by procuring a careful history and performing a physical examination while focusing on the warning signals that prompt further diagnostic testing. In the absence of worrisome features in the history or examination, the task is then to diagnose the primary headache syndrome based on the clinical features. If atypical features are present or the patient does not respond to conventional therapy

2019 American College of Radiology

17. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

help the reader better understand how the results may be applied to the individual patient. This can assist the 176 clinician in applying the recommendations to most patients but allows adjustment when applying to patients at the 177 extremes of risk (Appendix C). 178 This policy is not intended to be a complete manual on the evaluation and management of adult patients 179 with acute headache but rather a focused examination of critical issues that have particular relevance to the current 180 (...) literature exists to answer the 190 critical questions addressed in this policy. 191 Scope of Application. This guideline is intended for physicians working in EDs who are evaluating 192 nontraumatic patients with acute onset headache and nonfocal neurologic examination findings. 193 Inclusion Criteria. This guideline is intended for acute adult nontraumatic headaches. 194 Exclusion Criteria. This guideline is not intended for patients with chronic headaches or pediatric, 195 pregnant, or trauma patients

2019 American College of Emergency Physicians

18. Effectiveness of Oxygen and Other Acute Treatments for Cluster Headache: Results From the Cluster Headache Questionnaire, an International Survey. (PubMed)

or older.Large international surveys of cluster headache are rare, as are examinations of treatments and side effects in older cluster headache patients. This article presents data from the Cluster Headache Questionnaire, with respondents from over 50 countries and with the vast majority from the United States, the United Kingdom, and Canada.This internet-based survey included questions on cluster headache diagnostic criteria, which were used as part of the inclusion/exclusion criteria for the study, as well (...) Effectiveness of Oxygen and Other Acute Treatments for Cluster Headache: Results From the Cluster Headache Questionnaire, an International Survey. To assess the effectiveness and adverse effects of acute cluster headache medications in a large international sample, including recommended treatments such as oxygen, commonly used medications such as opioids, and emerging medications such as intranasal ketamine. Particular focus is paid to a large subset of respondents 65 years of age

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2019 Headache

19. Psychosocial and Demographic Characteristics of Children and Adolescents With Headache Presenting for Treatment in a Headache Infusion Center. (PubMed)

medications used and treatment setting, which may occur in the emergency room, as an inpatient admission, or, less often, in an outpatient infusion center. The paucity of research on the treatment of status migrainosus is a limitation to treatment effectiveness.The objective of the study was twofold. First, we sought to examine the demographic characteristics of children and adolescents accessing our outpatient infusion center for prolonged headache. Second, we sought to determine whether any demographic (...) Psychosocial and Demographic Characteristics of Children and Adolescents With Headache Presenting for Treatment in a Headache Infusion Center. Approximately 10% of pediatric patients have recurrent headaches, with migraine being the most common headache type. If untreated, migraine may progress to status migrainosus, a debilitating condition of prolonged duration, high pain severity, and significant disability. There is high variability in the treatment of status migrainosus including

2019 Headache

20. TEMPORARY REMOVAL: Letter to the Editor: Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review by Rubio-Ochoa et al. (2015). (PubMed)

TEMPORARY REMOVAL: Letter to the Editor: Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review by Rubio-Ochoa et al. (2015). 26934859 2016 12 29 2018 12 02 1532-2769 23 2016 06 Manual therapy Man Ther Letter to the Editor: Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review by Rubio-Ochoa et al. (2015). e7-8 10.1016/j.math.2016.01.006 S1356-689X(16)00007-2 Castien René F RF Department of General (...) , Vrije Universiteit, Amsterdam, The Netherlands. eng Letter Comment 2016 01 29 Scotland Man Ther 9610924 1356-689X IM Man Ther. 2016 Feb;21:35-40 26423982 Man Ther. 2016 Jun;23:e9 27026112 Headache Humans Physical Examination Post-Traumatic Headache diagnosis Spinal Diseases diagnosis 2016 01 11 2016 01 14 2016 3 4 6 0 2016 3 5 6 0 2016 12 31 6 0 ppublish 26934859 S1356-689X(16)00007-2 10.1016/j.math.2016.01.006

2016 Manual therapy

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