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

Tension-type headaches, the most prevalent form of headache, are differentiated as being either episodic or chronic. The episodic form is a physiologic response to stress, anxiety, depression, emotional conflicts, fatigue, or repressed hostility. Treatment focuses on the use of over-the-counter or prescribed simple analgesics for pain relief. Successful treatment of the chronic form depends on recognition of depression or persistent anxiety states. Primary care physicians can effectively manage most of these patients with nonhabituating anxiolytic or antidepressant medications; however, referrals for psychotherapy may be required in some cases. When tension-type headaches occur in children and adolescents, the physician must explore the patient's family and social relationships as well as school performance. In addition to nonhabituating drug therapies, family counseling and biofeedback may be helpful. In coexisting migraine and tension-type headaches, nonhabituating analgesics may be used for the relief of acute pain; the use of ergotamine and triptans should be restricted to relief of the hard or sick headache. Tricyclic antidepressants or monoamine oxidase inhibitors are the gold standards for prophylaxis, although the selective serotonin reuptake inhibitors may be indicated in less severe cases. Several forms of biofeedback have also proved effective. Nonetheless, some patients with this form of headache may require psychiatric treatment for severe depression.
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PMID:Tension-type headache. 1068 86

Tension-type headache is now the term used to describe headaches that have previously been grouped under various ill-defined headings such as 'tension headache', 'stress headache' and 'muscle contraction headache'. Tension-type headaches are characterized by pain that is mild or moderate in severity, bilateral in distribution, pressing or tightening in quality, and unaccompanied by major systemic disturbance or neurological signs. While many people have mild, infrequent tension-type headaches which they do not regard as an illness, a minority have chronic and often daily symptoms. Here we review the management of tension-type headaches in adults.
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PMID:Management of tension-type headache. 1069 10

Tension type headache in both its forms, episodic and chronic, is the most common type of headache experienced by the population. The headache attack or the prevention of new crises may be treated with pharmacological as well as non-pharmacological measures. This study included 5,490 patients from out-patient clinics and medical offices covering various regions of Brazil. Approximately 95% of the subjects had episodic tension type headache, while 5% had chronic tension type headache. The majority of the patients presented with crisis of moderate intensity (62.19%). In 5,419 patients a tension type headache crisis was treated with acetaminophen 1000 mg and caffeine 130 mg. In 93.98%, onset of relief occurred within 2 hours of taking the medication. In 77.61%, complete reversion of the crisis occurred within 2 hours. Good/excellent efficacy ratings were achieved in 61.93%/37.80% of the cases according to the physician's assessment and in 48.51%/40.29% according to the patients' assessment. Adverse events, commonly gastrointestinal manifestations, were reported by 5.57% of the patients. This is a Brazilian study of the efficacy and safety of the combined use of acetaminophen-caffeine for the treatment of tension type headache.
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PMID:[Clinical evaluation of the efficacy of the paracetamol and caffeine combination in the treatment of tension headache]. 1077 Aug 72

Tension-type headaches are a common occurrence for many people. Psychological issues such as stress, depression, and anxiety have been shown to coexist with tension-type headaches. The relationship between psychological factors and headaches is supported by literature, and treatments that combine a pharmacologic and psychological approach address the needs of the whole person. In this article, the role of psychometric testing and the application of psychological interventions for use on patients with tension-type headaches are reviewed. Recommendations are made about approaches that are designed to improve physical and psychological health.
Curr Pain Headache Rep 2001 Oct
PMID:The role of psychometric testing and psychological treatment in tension-type headache. 1156 Aug 13

Migraine and tension-type headaches have always plagued mankind. In spite of all the research dollars spent trying to determine the etiologies of these headaches, the neurology community still has not established a known cause of migraine and tension type headaches. This paper describes a study that was conducted for the U.S. Food and Drug Administration in which the efficacy of the Nociceptive Trigeminal Inhibition Tension Suppression System was evaluated and proved safe and efficacious in the reduction of medically diagnosed migraine and tension-type headache.
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PMID:Migraine and tension-type headache reduction through pericranial muscular suppression: a preliminary report. 1172 51

It has been estimated that 30% to 80% of the population has at least one tension-type headache each year. Tension-type headaches can be located in any region of the head, which can confuse a differential diagnosis with temporomandibular joint disorders and cervical dysfunction. The roles of temporomandibular joint disorders and cervical dysfunction in tension-type headache are evaluated. Definitions, pathophysiology, and treatment considerations for each are discussed.
Curr Pain Headache Rep 2002 Oct
PMID:The role of temporomandibular disorders and cervical dysfunction in tension-type headache. 1220 52

In a female population of Turkey (1146 adult females), some epidemiological and clinical characteristics of migraine and tension type headache and their subtypes were investigated. The relation of the headache severity to clinical characteristics were inquired. Migraine prevalence was found to be statistically higher in the 35-44 years age group (P < 0.01) and those who were university graduates (P < 0.001), married (P < 0.01) and living in urban areas (P < 0.01). Tension type headache was found to be higher in the 45-64 years age group (P < 0.05). Chronic tension type headache patients were found to be older than episodic type (P < 0.01) and frequently were in the lowest education level (P < 0.05). Presence of impact on daily activities because of the severity of headache was found to be related to aggravation by physical activities (P = 0.001) in tension type headache, with no clinical characteristics in migraine headache and on consideration of all headache patients with throbbing nature (P < 0.05), aggravation on physical activities (P = 0.001), nausea (P < 0.01), vomiting (P < 0.05) and phonophobia (P < 0.05).
Cephalalgia 2003 Jun
PMID:Epidemiological and clinical characteristics of migraine and tension type headache in 1146 females in Kayseri, Turkey. 1278 Jul 69

Deramciclane, a camphor derivative, is a novel anxiolytic agent with a unique mechanism of action. It acts as a potent and specific antagonist at serotonin 5-HT2A/2C receptors, and exhibits anxiolytic efficacy in animal models. The aim of this double-blind, placebo-controlled, parallel-group study was to evaluate the efficacy, safety, and tolerability of a range of doses of deramciclane in patients with generalized anxiety disorder (GAD). Adult patients with a diagnosis of GAD (DSM-IV) and a Hamilton Anxiety Rating Scale (HAM-A) total score >or=18; a score >or=2 for the HAM-A items 'Anxious Mood' and 'Tension'; a score >or=4 on the Clinical Global Impression of Severity of Illness (CGI-S) Scale; and a score <or=20 on the Montgomery-Asberg Depression Rating Scale (MADRS) were enrolled in the study. Following a 1-2 week placebo run-in period, patients were randomized to receive deramciclane (10, 30, or 60 mg/day in two divided doses) or placebo for 8 weeks, followed by a 2-week placebo wash-out period. The primary efficacy measure was change in HAM-A score from baseline to week 8. Adverse events were monitored throughout the study. Withdrawal reactions were assessed at the end of the study (week 8) and during the placebo wash-out period using the Physician's Withdrawal Checklist (34 items). In the intent-to-treat population (n=208), both the deramciclane 30 mg/day and 60 mg/day doses provided clinically relevant improvements in HAM-A total score after 8 weeks of treatment, reaching statistical significance compared with placebo in the 60 mg/day dose group (p=0.024) and a clear trend in the 30 mg/day group (p=0.059). On the HAM-A psychic anxiety factor, significant improvements were seen in patients in the deramciclane 30 mg/day and 60 mg/day treatment groups compared with those in the placebo group (p<0.05). Adverse events were reported at a similar frequency across all four treatment groups; the most commonly reported adverse event was headache. No withdrawal reactions were observed on abrupt discontinuation of deramciclane. In conclusion, deramciclane 60 mg/day showed significant evidence of efficacy for the treatment of GAD in adult patients. The efficacy for the 30 mg/day dose was close to the larger dose although not significant in the primary analysis, and there was no significant evidence of efficacy for the 10 mg/day dose. Deramciclane was safe and well-tolerated up to the 60 mg/day dose over an 8-week period.
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PMID:Deramciclane in the treatment of generalized anxiety disorder: a placebo-controlled, double-blind, dose-finding study. 1594 21

Cystic adrenal masses are a relatively rare condition, and are usually nonfunctioning and asymptomatic. Differential diagnosis includes pheochromocytoma (PHEO) and adrenal carcinoma; 8-10% of patients with PHEO may be completely asymptomatic. Moreover, fewer than 10% of PHEOs secrete pure epinephrine. We report a case of a E-secreting pure cystic PHEO presenting with an incidental adrenal mass. A 49-year-old Turkish woman was hospitalized at Farabi Hospital for further examinations of a right adrenal cystic mass with a thick wall that was incidentally discovered by abdominal ultrasonography during examination for nausea, vomiting, headache, and angina-like chest pain in another hospital. On admission, her blood pressure was 100/60 mmHg. Tension Holter monitoring revealed paroximal hypertension (178/136 mmHg) and hypotension (78/54 mmHg) attacks. Of urinary catecholamines and its metabolites, only urine metanephrine was markedly increased, despite a urine epinephrine level near the upper limit of normal ranges. Abdominal computed tomography and magnetic resonance imaging studies revealed a cystic round tumor approx 5 cm in diameter, located in the right adrenal gland. Right adrenalectomy was performed; the surgical specimen revealed pure cystic PHEO. Postoperatively, the urine metanephrine level returned to normal range and urine epineprine level was decreased approx 60%. In conclusion, a diagnosis of E-secreting PHEO should be considered in patients with nonspecific symptoms, presenting with an incidental cystic adrenal mass, even in the absence of hypertension.
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PMID:Epinephrine-secreting cystic pheochromocytoma presenting with an incidental adrenal mass: a case report and a review of the literature. 1638 97

We aimed to describe and classify headaches associated with acute stroke, by interviewing patients consecutively admitted to a stroke unit using a validated headache questionnaire and the International Classification of Headache Disorders of the International Headache Society (IHS). One hundred and twenty-four patients (61% ischaemic and 39% haemorrhagic stroke) reported headache. Headaches started mostly on the day of stroke, were more often continuous, pressure-type, bilateral and located in the anterior region, were increased by movement and by cough and lasted for a mean of 3.8 days. Tension-type was the most frequent type of headache. Eleven per cent of headaches could not be classified using the criteria of the IHS. Previous primary headache was documented in 71 patients. The presence of nausea/vomiting due to acute stroke can confound headache classification using the IHS criteria. In up to half of the patients, headache seems to be a reactivation of previous primary headache.
Cephalalgia 2008 Apr
PMID:Headache in acute stroke. A prospective study in the first 8 days. 1824 Dec 22


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