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Headache in Pregnancy

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281. Migraine Headache (Overview)

31, 2019 Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD Share Email Print Feedback Close Sections Sections Migraine Headache Overview Practice Essentials Migraine is a complex disorder characterized by recurrent episodes of headache, most often unilateral and in some cases associated with visual or sensory symptoms—collectively known as an aura—that arise most often before the head pain but that may occur during or afterward (see the image below). Migraine is most common (...) be felt anywhere around the head or neck Pain builds up over a period of 1–2 hours, progressing posteriorly and becoming diffuse Headache lasts 4–72 hours Nausea (80%) and vomiting (50%), including anorexia and food intolerance, and light-headedness Sensitivity to light and sound Features of migraine aura are as follows: May precede or accompany the headache phase or may occur in isolation Usually develops over 5–20 minutes and lasts less than 60 minutes Most commonly visual but can be sensory, motor

2014 eMedicine.com

282. Cluster Headache (Overview)

, they should be instructed to avoid high altitudes. For patient education resources, see the , as well as , , , , and . Previous References Goadsby PJ. Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol . 2002 Aug. 1(4):251-7. . Matharu M. Cluster headache. Clin Evid (Online) . 2010 Feb 9. 2010: . . The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Holle D, Obermann M, Katsarava Z. The electrophysiology of cluster (...) headache. Curr Pain Headache Rep . 2009 Apr. 13(2):155-9. . Mendizabal JE, Umana E, Zweifler RM. Cluster headache: Horton's cephalalgia revisited. South Med J . 1998 Jul. 91(7):606-17. . Lodi R, Pierangeli G, Tonon C, et al. Study of hypothalamic metabolism in cluster headache by proton MR spectroscopy. Neurology . 2006. 66(8):1624-6. . Kudrow L. Cluster headache: diagnosis and management. Headache . 1979 Apr. 19(3):142-50. . Rozen TD, Fishman RS. Female cluster headache in the United States of America

2014 eMedicine.com

283. Headache: Pediatric Perspective (Treatment)

for migraine in children at a headache clinic. Cephalalgia . 1995 Oct. 15(5):404-9. . Headache Classification Committee of the IHS. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia . 1988. 8 Suppl 7:1-96. . Lima MM, Padula NA, Santos LC, Oliveira LD, Agapejev S, Padovani C. Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD (...) , an excessive tendency exists to attribute headaches to this problem. Previous References Chakravarty A, Mukherjee A, Roy D. Migraine pain location: how do children differ from adults?. J Headache Pain . 2008 Dec. 9(6):375-9. . Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Hämäläinen ML, Hoppu K, Santavuori PR. Effect of age on the fulfilment of the IHS criteria

2014 eMedicine.com

284. Headache, Children (Treatment)

for migraine in children at a headache clinic. Cephalalgia . 1995 Oct. 15(5):404-9. . Headache Classification Committee of the IHS. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia . 1988. 8 Suppl 7:1-96. . Lima MM, Padula NA, Santos LC, Oliveira LD, Agapejev S, Padovani C. Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD (...) , an excessive tendency exists to attribute headaches to this problem. Previous References Chakravarty A, Mukherjee A, Roy D. Migraine pain location: how do children differ from adults?. J Headache Pain . 2008 Dec. 9(6):375-9. . Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Hämäläinen ML, Hoppu K, Santavuori PR. Effect of age on the fulfilment of the IHS criteria

2014 eMedicine.com

285. Headache, Migraine (Treatment)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

286. Cluster Headache (Treatment)

to medications. Narcotics may expedite transformation of episodic CH to chronic CH. Previous References Goadsby PJ. Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol . 2002 Aug. 1(4):251-7. . Matharu M. Cluster headache. Clin Evid (Online) . 2010 Feb 9. 2010: . . The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Holle D, Obermann M, Katsarava Z. The electrophysiology of cluster headache. Curr Pain Headache Rep (...) Headache Foundation. 2004. . [Guideline] Beithon J, Gallenberg M, Johnson K, et al. Diagnosis and Treatment of Headache. Institute for Clinical Systems Improvement. Available at . Accessed: March 31, 2014. Calhoun AH, Peterlin BL. Treatment of cluster headache in pregnancy and lactation. Curr Pain Headache Rep . 2010 Apr. 14(2):164-73. . Giraud P, Chauvet S. Cluster headache during pregnancy: case report and literature review. Headache . 2009 Jan. 49(1):136-9. . Tfelt-Hansen P. Acute pharmacotherapy

2014 eMedicine.com

287. Migraine Headache (Treatment)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

288. Migraine Headache: Neuro-Ophthalmic Perspective (Treatment)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

289. Pathophysiology and Treatment of Migraine and Related Headache (Treatment)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

290. Pathophysiology and Treatment of Migraine and Related Headache (Overview)

== processing > Migraine Headache Updated: Jan 31, 2019 Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD Share Email Print Feedback Close Sections Sections Migraine Headache Overview Practice Essentials Migraine is a complex disorder characterized by recurrent episodes of headache, most often unilateral and in some cases associated with visual or sensory symptoms—collectively known as an aura—that arise most often before the head pain but that may occur during or afterward (see the image (...) and ocular area, but the pain may be felt anywhere around the head or neck Pain builds up over a period of 1–2 hours, progressing posteriorly and becoming diffuse Headache lasts 4–72 hours Nausea (80%) and vomiting (50%), including anorexia and food intolerance, and light-headedness Sensitivity to light and sound Features of migraine aura are as follows: May precede or accompany the headache phase or may occur in isolation Usually develops over 5–20 minutes and lasts less than 60 minutes Most commonly

2014 eMedicine.com

291. Headache, Migraine (Overview)

31, 2019 Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD Share Email Print Feedback Close Sections Sections Migraine Headache Overview Practice Essentials Migraine is a complex disorder characterized by recurrent episodes of headache, most often unilateral and in some cases associated with visual or sensory symptoms—collectively known as an aura—that arise most often before the head pain but that may occur during or afterward (see the image below). Migraine is most common (...) be felt anywhere around the head or neck Pain builds up over a period of 1–2 hours, progressing posteriorly and becoming diffuse Headache lasts 4–72 hours Nausea (80%) and vomiting (50%), including anorexia and food intolerance, and light-headedness Sensitivity to light and sound Features of migraine aura are as follows: May precede or accompany the headache phase or may occur in isolation Usually develops over 5–20 minutes and lasts less than 60 minutes Most commonly visual but can be sensory, motor

2014 eMedicine.com

292. Pathophysiology and Treatment of Migraine and Related Headache (Follow-up)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

293. Headache, Migraine (Follow-up)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

294. Headache: Pediatric Perspective (Follow-up)

for migraine in children at a headache clinic. Cephalalgia . 1995 Oct. 15(5):404-9. . Headache Classification Committee of the IHS. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia . 1988. 8 Suppl 7:1-96. . Lima MM, Padula NA, Santos LC, Oliveira LD, Agapejev S, Padovani C. Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD (...) , an excessive tendency exists to attribute headaches to this problem. Previous References Chakravarty A, Mukherjee A, Roy D. Migraine pain location: how do children differ from adults?. J Headache Pain . 2008 Dec. 9(6):375-9. . Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Hämäläinen ML, Hoppu K, Santavuori PR. Effect of age on the fulfilment of the IHS criteria

2014 eMedicine.com

295. Migraine Headache: Neuro-Ophthalmic Perspective (Follow-up)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

296. Migraine Headache (Follow-up)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine.com

297. Headache, Children (Follow-up)

for migraine in children at a headache clinic. Cephalalgia . 1995 Oct. 15(5):404-9. . Headache Classification Committee of the IHS. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia . 1988. 8 Suppl 7:1-96. . Lima MM, Padula NA, Santos LC, Oliveira LD, Agapejev S, Padovani C. Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD (...) , an excessive tendency exists to attribute headaches to this problem. Previous References Chakravarty A, Mukherjee A, Roy D. Migraine pain location: how do children differ from adults?. J Headache Pain . 2008 Dec. 9(6):375-9. . Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Hämäläinen ML, Hoppu K, Santavuori PR. Effect of age on the fulfilment of the IHS criteria

2014 eMedicine.com

298. Cluster Headache (Follow-up)

to medications. Narcotics may expedite transformation of episodic CH to chronic CH. Previous References Goadsby PJ. Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol . 2002 Aug. 1(4):251-7. . Matharu M. Cluster headache. Clin Evid (Online) . 2010 Feb 9. 2010: . . The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Holle D, Obermann M, Katsarava Z. The electrophysiology of cluster headache. Curr Pain Headache Rep (...) Headache Foundation. 2004. . [Guideline] Beithon J, Gallenberg M, Johnson K, et al. Diagnosis and Treatment of Headache. Institute for Clinical Systems Improvement. Available at . Accessed: March 31, 2014. Calhoun AH, Peterlin BL. Treatment of cluster headache in pregnancy and lactation. Curr Pain Headache Rep . 2010 Apr. 14(2):164-73. . Giraud P, Chauvet S. Cluster headache during pregnancy: case report and literature review. Headache . 2009 Jan. 49(1):136-9. . Tfelt-Hansen P. Acute pharmacotherapy

2014 eMedicine.com

299. Pediatrics, Headache (Treatment)

for migraine in children at a headache clinic. Cephalalgia . 1995 Oct. 15(5):404-9. . Headache Classification Committee of the IHS. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia . 1988. 8 Suppl 7:1-96. . Lima MM, Padula NA, Santos LC, Oliveira LD, Agapejev S, Padovani C. Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD (...) , an excessive tendency exists to attribute headaches to this problem. Previous References Chakravarty A, Mukherjee A, Roy D. Migraine pain location: how do children differ from adults?. J Headache Pain . 2008 Dec. 9(6):375-9. . Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia . 2004. 24 Suppl 1:9-160. . Hämäläinen ML, Hoppu K, Santavuori PR. Effect of age on the fulfilment of the IHS criteria

2014 eMedicine Emergency Medicine

300. Headache, Migraine (Treatment)

the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older. Users hold the device with both hands to the back of the head and press a button to release a pulse of magnetic energy that stimulates the occipital cortex. The recommended daily usage of the device is not to exceed one treatment in 24 hours. [ , ] Approval for the Cerena TMS was based on a randomized study of 201 patients (...) with moderate to strong migraine headaches, in which 39% of the patients using the device were pain-free 2 hours following its use, relative to 22% of control patients (therapeutic gain: 17%). [ , ] At 24 hours, nearly 34% of patients treated with the device were pain-free, compared with 10% of the control group. Contraindications and precautions regarding the use of the Cerena TMS include the following [ , ] : Do not use for patients with any metal in the head, neck, or upper body that is attracted

2014 eMedicine Emergency Medicine

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