Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A preliminary survey was carried out on forty-two (42) neurosurgical out-patients at Harare and Parirenyatwa Central Hospitals to establish some parameters of the postconcussional syndrome in victims of head injury. Both unstructured and structured forms of interview were used to obtain spontaneous (SPO) and elicited (ELC) responses. The symptoms of headache, dizziness and anxiety were spontaneously endorsed by 28.6 pc, 21.4 pc and 16.7 pc of the patients respectively. There was a close association between headache and dizziness (chi 2 = 5.9; p = 01; df = 1). In the ELC condition, all the nine postconcussional symptoms were endorsed as present by 59.5 pc-85.7 pc of the patients and the various symptoms were significantly associated with each other. Application for compensation was not found to be associated with increased symptomatology.
 ...
PMID:Head injury and compensation: a preliminary investigation of the postconcussional syndrome in Harare. 215 Nov 82

Head injury frequently results in headache and at times facial pain. Controversy concerns the relationship of injury in the head and neck area to chronic headache, particularly when no apparent structural traumatic lesion is demonstrable. Neuropathological studies suggest with concussion there is neuronal injury without gross pathology. Closed head injury of seemingly minor degrees may lead to chronic symptoms, often stereotypic, similar to those following concussion, and they have been described by the term post head trauma syndrome or postconcussional syndrome. Headache after head injury in an individual warrants careful medical, neurological, and neuroimaging assessment. The use of neuroimaging has greatly enhanced diagnosis in head-injured patients but has not satisfactorily clarified post head trauma symptoms in the less severely traumatized. Differential diagnosis is critical to avoid missing disabling, progressive, and life-threatening entities. In patients with head trauma neck injury should be sought. The headache may be nonspecific or mimic common nontraumatic headache disorders such as tension, migraine, and cluster. Recovery may include headache, psychological symptoms, and cognitive impairment. Neuropsychological assessment can be helpful in demonstrating deficiencies in mildly impaired individuals and explain the poor response to headache therapy in some patients suggesting more widespread injury. Therapy of head and facial pain follows the careful diagnosis and, if needed, assessment of the psychological status. Surgery, drug therapy, physical modalities, and at times a comprehensive neuropsychological rehabilitation program are necessary. Simple analgesics such as nonsteroidal antiinflammatory agents for short-term treatment and tricyclic antidepressants for chronic pain are most often effective in patients without structural damage. More complex medication regimens may include beta adrenergic blockers and monamine oxidase inhibitors. Since many injuries result from motor vehicle accidents, work-related factors, and other instances in which litigation may result, legal elements may be involved. Most often the prognosis is favorable for resolution of symptoms but a small percentage of patients will have persistent symptoms after three years. The notion that litigation prolongs the duration of the illness is not valid. In the past two decades great advances have been made in neurodiagnosis, and parallel therapeutic advances are expected in the near future.
 ...
PMID:Headache and facial pain associated with head injury. 268 67

Two patients with postconcussional syndrome whose most severe symptoms were blackouts, headaches, and amnesia episodes appeared to respond to naltrexone. Because life-saving emergency trauma services are widely available, it is likely that the incidence of postconcussional syndrome will increase.
 ...
PMID:Naltrexone treatment for postconcussional syndrome. 359 7

Neuropsychological impairment and pathologically delayed Acoustic Brain stem Responses (ABR) have been found in patients examined after minor head injury. The relation of these alterations with the emergence of post-concussional symptoms is unknown. In this study 27 patients were examined with ABR within 48 hours of a clearly defined head injury and with a complete neuropsychological test battery one month after the trauma. They were checked for postconcussional symptoms such as headache, depression or dizziness one year later. ABR recordings were pathological in four patients. Neuropsychological testing showed no difference between patients and age-matched controls. No correlation was found between postconcussional symptoms and ABR and neuropsychological examination results, posttraumatic amnesia, and neurotic symptoms present before the trauma. Subclinical brain stem involvement as shown by ABR does not seem to correlate with symptoms of the postconcussional syndrome. This greatly limits the use of ABR in forensic medicine.
 ...
PMID:[Value of neuropsychologic tests and acoustic evoked brain stem potentials in the prognosis of subjective complaints in patients with brain concussion]. 361 86

Problems in expert opinion on headache patients are encountered in particular with cases of so-called posttraumatic headache. Symptoms in the vegetative field due to a head injury are characterized by a close time relationship with the accident or trauma. So is genuine post-traumatic headache. Like the so-called postconcussional syndrome, post-traumatic headache is very vaguely defined. To verify the causal connection between headache and head injury an in-depth neurological analysis is necessary. Lesions of intra- and extra-cranial structures sensitive to pain are apt to bring about subjective complaints in the form of headache. Severe craniocerebral injuries with persisting headache may be suggestive of chronic disturbances in cerebrospinal fluid circulation. On the other hand, extensive compound skull fractures and large cranial trephination defects rarely give rise to headache. Cephalgia occurring after cerebral concussions and minor cerebral contusions subside within a short period of time. The evolution of migraine following a head injury is extremely unusual. However, severe subjective complaints may be caused by traumatic subarachnoidal hemorrhage. An exceptional situation is that of neuralgic pain after an accident with injury to the head, especially in the wake of trigeminal nerve lesions. It seems important to mention the possibility of the combination of organic and psychological factors for cephalgia following craniocerebral trauma. Symptomatic headache generally does not cause special difficulties for expert opinion. However, more problems are encountered in the evaluation and appraisal of persistent headache and other subjective complaints in conversion neurosis and psychogenic disorders. Pensions for headache should only be considered in the most severe cases.
 ...
PMID:[Legal problems in headache]. 805 16

Forty patients who sustained minor head trauma were investigated by brainstem trigeminal and auditory evoked potentials (BTEP, BAEP) and middle-latency auditory evoked potentials (MLAEP). The patients were evaluated within the first 48 h following their admission and at 3 months after the injury. Outcome was scored at the follow-up examination according to six complaints: failure to resume previous professional activity, headache, memory disorders, dizziness and vertigo, behavioural and emotional disturbances, and other symptoms of a neurological nature. Post-concussion syndrome (PCS) was defined by the presence of four or more of the listed features. All three evoked potential modalities showed significantly increased latencies at the initial assessment, disclosing disseminated axonal damage. Unlike the BTEPs and the BAEPs, the MLAEPs proved to correlate to outcome at 3 months, especially in its psychocognitive aspects. These findings suggest that organic diencephalic-paraventricular primary damage may account for the occurrence of PCS.
 ...
PMID:Trigeminal and auditory evoked responses in minor head injuries and post-concussion syndrome. 860 13

A small proportion of patients with mild head injury (MHI) develop post-concussion symptoms (PCSs). We searched simple measures for the early detection of patients who are probable to develop PCSs. We recorded signs and symptoms, history of previous diseases, medications, and lifestyle factors and measured serum protein S-100B on admission in a series of 172 consecutive MHI patients admitted into the emergency room of a general hospital. A modified Rivermead Post-Concussion Symptoms Questionnaire was used to identify the patients with and without PCSs 1 month after the injury. We identified 37 patients with MHI who developed PCSs (22%). Odds ratios (OR) and 95% confidence intervals (CI) after adjustment for possible confounding variables were calculated by logistic regression. Independent early risk factors for PCSs in the MHI patients were skull fracture (OR 8.0, 95% CI 2.6-24.6), serum protein S-100B >/= 0.50 microg/l (OR 5.5, 95% CI 1.6-18.6), dizziness (OR 3.1, 95% CI 1.2-8.0), and headache (OR 2.6, 95% CI 1.0-6.5). Serum protein S-100B proved to be a specific, but not sensitive predictor of PCSs. The presence of skull fracture, elevated serum protein S-100B, dizziness, and headache may help the emergency room physician to identify patients at risk of PCSs and to refer them for further examination and follow-up.
 ...
PMID:Early predictors of post-concussion symptoms in patients with mild head injury. 1260 94

Mild traumatic brain injury (TBI) is associated with damage to frontal, temporal and parietal lobes. Post-concussion syndrome has been used to describe a range of residual symptoms that persist 12 months or more after the injury, often despite a lack of evidence of brain abnormalities on MRI and CT scans. The core deficits of post-concussion syndrome are similar to those of ADHD and mood disorders, and sufferers often report memory, socialization problems and frequent headaches. While cognitive rehabilitation and psychological support are widely used, neither has been shown to be effective in redressing the core deficits of post-concussion syndrome. On the other hand, quantitative EEG has been shown to be highly sensitive (96%) in identifying post-concussion syndrome, and neurotherapy has been shown in a number of studies to be effective in significantly improving or redressing the symptoms of post-concussion syndrome, as well as improving similar symptoms in non-TBI patients.
 ...
PMID:The usefulness of quantitative EEG (QEEG) and neurotherapy in the assessment and treatment of post-concussion syndrome. 1549 35

Sports medicine practitioners often consider athletes' self-reports of recovery for the management of concussion, and it is not clear which factors (i.e., neurocognitive performance and symptoms) athletes consider when forming perceptions of recovery from concussion. The current study assessed the relationship of perceptions of recovery to neurocognitive performance on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery and to symptoms using the Post-Concussion Symptom Scale (PCSS). A total of 101 concussed athletes (62 males, 39 females) aged 12 to 18 years old were included in the study (M(age) = 14.75, SD = 1.76). Athletes were asked to rate their "percent back to normal" (i.e., perception of recovery) at the time of evaluation. A multiple regression for neurocognitive performance and symptoms revealed a significant model that accounted for 58% of the variance in perceptions of recovery. Adolescent athletes base their perceptions primarily on somatic symptoms (e.g., headache, nausea, vomiting, etc.), and these perceptions may be incongruent with objective neurocognitive measures. Athletes' tendency to overlook several factors when forming their perceptions of recovery should caution the sports medicine practitioner from relying on self-reported symptoms as their primary criterion for return-to-play decisions. These data further support the need for valid and reliable measures for concussion management.
 ...
PMID:The relationship of symptoms and neurocognitive performance to perceived recovery from sports-related concussion among adolescent athletes. 2342 78

Postconcussion syndrome is a symptom complex with a wide range of somatic, cognitive, sleep, and affective features, and is the most common consequence of traumatic brain injury. Between 14% and 29% of children with mild traumatic brain injury will continue to have postconcussion symptoms at 3 months, but the pathophysiological mechanisms driving this is poorly understood. The relative contribution of injury factors to postconcussion syndrome decreases over time and, instead, premorbid factors become important predictors of symptom persistence by 3 to 6 months postinjury. The differential diagnoses include headache disorder, cervical injury, anxiety, depression, somatization, vestibular dysfunction, and visual dysfunction. The long-term outcome for most children is good, although there is significant morbidity in the short term. Management strategies target problematic symptoms such as headaches, sleep and mood disturbances, and cognitive complaints.
...
PMID:Postconcussion Syndrome: A Review. 2533 Jul 97


1 2 Next >>