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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a population-based telephone interview survey of 9,380 Washington County, Maryland, residents 12-29 years of age who reported a headache in the prior year, only 26.7% of women and 13.6% of men had ever sought a physician's advice for a headache problem. Women (13.9%) were more than twice as likely as men (5.6%) to have consulted a doctor for this condition within the previous 12 months. The likelihood of seeking medical care for headache increased with age among women but not men. Married women were more likely to have consulted with a physician for a headache problem than single or divorced women. Men and women consulting a doctor for this disorder within the previous 12 months described recent headaches (within the prior week) that were more severe, of longer duration (women only), and more likely to have migraine characteristics than recent headaches of persons not seeking medical attention. Compared with persons never consulting a physician for a headache problem, men and women who sought medical care had elevated attack rates of certain, probable, and possible migraine and mixed migraine-tension type headaches within the preceding week. Differences in attack rates for migraine and mixed migraine-tension headaches between those who recently and those who more than 12 months ago sought a physician's advice were more striking for men than for women.
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PMID:Headache characteristics associated with physician consultation: a population-based survey. 186 98

In 740 representative normal subjects a diagnostic headache interview and a neurological examination provided the necessary information to classify headache disorders according to the operational diagnostic criteria of the International Headache Society (IHS). Sixteen per cent (n = 119) had migraine, 78% (n = 578) tension-type headache. In migraineurs, pain was of a pulsating quality in 78%, severe in 85%, unilateral in 62%, and aggravated by routine physical activity in 96%. Tension-type headache was of a pressing quality in 78%, mild or moderate in 99%, bilateral in 90%, and 72% had no aggravation by physical activity. The accompanying symptoms of nausea, photo- and phonophobia occurred frequently and were usually moderate or severe in migraine subjects, and if present in subjects with tension-type headache, they were usually mild. Only two subjects had unclassifiable headache. The IHS Classification is thus exhaustive. The criteria may be improved by mandatory demands to the criterion of pain intensity leaving other features of pain as supportive for the diagnosis and by including graded severity of accompanying symptoms. A specific proposal is given.
Cephalalgia 1991 Jul
PMID:A population-based analysis of the diagnostic criteria of the International Headache Society. 188 68

Platelet 5-hydroxytryptamine (5-HT) uptake was measured in asymptomatic headache patients attending a specialist migraine clinic, and in hospital staff who did not suffer from regular or severe headache. Current levels of anxiety and depression were assessed in all subjects using the Hospital Anxiety and Depression (HAD) scale and their possible influence on the uptake kinetics taken into account during the analysis of results. The Michaelis-Menten constant (Km) was significantly raised in common migraine and tension headache compared with controls (p less than 0.001 and p less than 0.01, respectively), but not in classical migraine or cluster headache. The increase remained significant after adjusting for differences in age, sex, presence of anxiety or depression (HAD sub-scale score greater than or equal to 8), drug intake during the week before testing, time elapsed since last attack and time of assay (am or pm). No differences were observed between patients and controls in the maximal rate of uptake (Vmax) or platelet count, and previous reports of a reduction in Vmax in patients experiencing attack within 5 days prior to testing could not be confirmed. The cause and significance of an increased Km are not clear, but plasma factors acting as competitive inhibitors for the uptake site or an alteration in the configuration of the uptake site are possible explanations. If confirmed, the shared biochemical abnormality may suggest that common migraine and tension headache have a common pathogenesis.
Cephalalgia 1991 Jul
PMID:Kinetics of platelet 5-hydroxytryptamine uptake in headache patients. 188 70

Alexithymia is a new term which usually means "no words for mood" and used to describe a disorder where patients have difficulty in expressing feelings in words. Such patients therefore express emotions in somatic terms. We have selected headache as a symptom to test the term Alexithymia. A group of thirty patients with the complaint of persistent headache of more than 6 months duration, without any organic pathology or neurological disease entity was taken. This study concludes that Alexithymic traits are not necessarily more prominent in those having psychophysiological symptoms specially tension headache. It also shows that we should not accept any new concept evolved in West without testing it in our own conditions.
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PMID:Alexithymia in Karachi. 190 32

Twenty-one tension headache sufferers and 21 control subjects were exposed to a series of psychological stressors and an ischemic pain task, involving a tourniquet around the arm. Compared to control subjects, headache patients showed higher heart rates and evidence of more prolonged vasoconstriction in the hands and the ear lobe. No between-group differences in EMG were found, however. Headache patients rated the tourniquet as more painful than did control subjects, and described themselves as more anxious, angry, and depressed. The pattern of results is consistent with the interpretation that headache patients are emotionally and autonomically hyperreactive to pain and to psychological stress.
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PMID:Stress reactivity and perception of pain among tension headache sufferers. 201 90

In an initial attempt to examine relationships between family functioning and chronic headache disorders, the present study examined: a) family structure characteristics, b) family functioning, and c) family pain modeling. Subjects completed an assessment battery consisting of several measures of family functioning. Analyses showed that migraine sufferers (N = 42) as compared to headache-free controls (N = 59) were more likely to describe their families as emphasizing clear organization, structure, rules, and overall control, but less likely to encourage emotional expression. No differences were found between tension headache subjects (N = 43) and headache-free controls. While only an initial exploration of the importance of family characteristics in chronic headache, these results suggest that there are important differences in headache subjects' (particularly migraine) reports of family environment and functioning.
Headache 1991 Jan
PMID:The role of family structure, functioning, and pain modeling in headache. 201 66

In modification of a method published by Schoenen et al., early (ES 1) and late (ES 2) exteroceptive suppression periods elicited by perioral electrical trigeminus-stimulation during teeth-clenching were recorded with surface electrodes over the temporalis muscles. 29 patients with chronic tension headache, 20 with migraine, 7 patients with combined tension headache and migraine and 19 controls were examined. Duration of the late suppression period for the mean of three single shocks was highly significantly reduced in chronic tension headache sufferers and patients with combined tension headache and migraine when compared with migraine cases or controls. These results are in agreement with those of Schoenen et al. EMG analysis of temporalis late exteroceptive suppression is a helpful diagnostic method in primary headache. The reduction of ES 2 in chronic tension headache sufferers might suggest a deficient activation or excessive inhibition of the motoric trigeminus nucleus by pontobulbar inhibitory neurons which receive a strong input from limbic and nociceptive structures.
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PMID:[EMG analysis of exteroceptive suppression of temporal muscle activity in tension headache]. 203 7

About half of the aneurysm patients admitted to neurosurgical departments experience warning symptoms in the form of minor bleeding episodes days or even several months before a major haemorrhage occurs. Headache is the most common symptom of this warning leak, occurring in 9 out of 10 patients. The onset of headache is sudden and is unusual in severity and location, being unlike any headache the patient has otherwise experienced. It is frequently accompanied by transient nausea, vomiting, visual disturbances or meningism. Medical advice may be sought by the patient but all too often the diagnostic importance of a warning headache is missed. It is misinterpreted as attacks of migraine, tension headache, the 'flu, sinusitis, or a "sprained neck". A more vigilant attention to the presence of a warning headache probably offers the greatest opportunity for altering the otherwise serious natural history of aneurysmal subarachnoid haemorrhage. If a warning headache is suspected, lumbar puncture is the examination of choice, once CT scanning has ruled out an intracranial mass lesion.
Cephalalgia 1991 Feb
PMID:Headache as a warning symptom of impending aneurysmal subarachnoid haemorrhage. 203 71

This paper presents the results of two studies. In the first, 20 tension headache subjects were evaluated in both a headache and non-headache state on bilateral trapezius and unilateral frontalis electromyographic activity during six positions: standing, bending from the waist, rising, sitting with back unsupported, sitting with back supported, and prone. Results indicated no effect of headache state on either measure. In a second study, 11 of the tension headache sufferers in Study One and 11 age-matched controls were compared on the same measures (controls were assessed two times, with a one-week duration separating evaluations). Results indicated a diagnosis by position interaction, with post-hoc tests revealing the muscle activity of tension headache sufferers to be considerably higher during the prone position than that of non-headache controls. Non-significant trends were found when examining the data for clinically significant abnormalities (90% of the headache sufferers were found to have significant clinical abnormalities).
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PMID:Effect of movement and position on muscle activity in tension headache sufferers during and between headaches. 204 52

Forty-one recurrent tension headache sufferers were randomly assigned to either cognitive-behavioral therapy (administered in a primarily home-based treatment protocol) or to amitriptyline therapy (with dosage individualized at 25, 50, or 75 mg/day). Cognitive-behavioral therapy and amitriptyline each yielded clinically significant improvements in headache activity, both when improvement was assessed with patient daily recordings (56% and 27% reduction in headache index, respectively), and when improvement was assessed with neurologist ratings of clinical improvement (94% and 69% of patients rated at least moderately improved, respectively). In instances where differences in treatment effectiveness were observed (headache index, somatic complaints, perceptions of control of headache activity), cognitive-behavioral therapy yielded somewhat more positive outcomes than did amitriptyline. Neither treatment, however, eliminated headache problems.
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PMID:A comparison of pharmacological (amitriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches. 207 23


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