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

Vascular headaches may occur in up to 20% of the population aged 17-40. One subgroup, exertional headaches, has many specific and nonspecific clinical presentations. Knowing the background events preceding the headache and the exact circumstances of the headache can help make a specific diagnosis. Three cases are presented to illustrate the diversity of triggers and their effect on aeromedical decision-making. The headaches are presented within the recently revised nomenclature for head and facial pain by the Headache Classification Committee of the International Headache Society.
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PMID:Exertional headaches with multiple triggers. 230 27

Headache and facial pain are frequent complaints. The underlying process is most often benign but serious conditions may be present requiring an urgent diagnostic approach. A careful history including psychologic evaluation and a meticulous neurologic examination are essential for an adequate selection of complementary laboratory testing.
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PMID:[Differential diagnosis of headache and facial pain]. 248 59

The efficacy of sinus surgery continues to be an issue of debate among otolaryngologists. In an attempt to address this controversy, a case-series study design was used to assess the perceived efficacy of sinus surgery in terms of the alleviation of sinus symptoms and overall health benefit. Self-administered questionnaires were mailed to 142 individuals who had sinus surgery performed between January 1984, and December 1985. After one follow-up attempt, 114 questionnaires were completed and returned (80% response). Overall, a high percentage of cases reported postoperative improvement in breathing difficulties (90%), nasal congestion (88%), headache/facial pain (85%), recurrent sinus infections (83%), and postnasal drip (80%). In addition, 88% of cases reported the surgery to be of some overall health benefit. These results suggest that sinus surgery, as perceived by surgically treated individuals, may be effective in the management of chronic sinus disease.
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PMID:Sinus disease and surgical treatment: a results oriented quality assurance study. 250 32

The function of the atlantooccipital joints is intimately connected with the function of the spine in total and the temporomandibular joint in special. The present investigation gives report of the frequent combination of headache, facial pain and pain in the temporomandibular joint, which could be found in patients of an orthopedic practice. The role of the atlantooccipital joints is stressed in a special manner and explained with the function of the arthromuscular control loop.
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PMID:[Significance of the upper neck joints in the etiology of pain in the head and neck area]. 253 54

Atypical facial pain is a clinical syndrome of facial pain that has been related to depression but whose pathogenesis is not known. We describe a 72-year-old woman with a chronic facial pain, and ectasia and left sided deviation of the basilar artery, that responded dramatically to baclofen. This case suggests that vascular compression of the trigeminal nerve may be one of the mechanisms producing this syndrome and in these cases it might respond to baclofen.
Headache 1989 Oct
PMID:Atypical facial pain, ectasia of the basilar artery, and baclofen: a case report. 258 97

Antidepressants are often effective in the management of chronic pain syndromes. They are most useful for certain types of pain complaints, such as headache, diabetic neuropathy, arthritis and facial pain. The choice of antidepressant depends on the side effects and the patient's ability to tolerate the medication. The dose is usually half of that used in the management of depression.
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PMID:Antidepressants in chronic pain syndromes. 265 May 7

In younger patients, the clinical symptoms of sudden unilateral headache and facial pain, often combined with Horner syndrome and the cerebrovascular symptoms of TIAs or stroke, should indicate the diagnosis of spontaneous carotid dissection. Angiographic findings can verify this diagnosis, showing various signs of eccentric, narrowing stenosis, false lumen, pseudoaneurysms, or complete occlusion. An addition to noninvasive Doppler ultrasonography, B-mode and Duplex investigations, although more or less nonspecific, give some indications of the diagnosis; modern imaging techniques, especially MRI, can image the intramural hematoma directly. As the hematoma is the source of the intracranial emboli, the therapy of choice in this rarely diagnosed disease should be anticoagulation.
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PMID:[Carotid dissections]. 267 40

Very little is known about the neural correlates of facial pain and headaches; diagnosis and treatment are for the most part clinically orientated. Of initial importance is the recognition of dangerous situations and the consequent appliance of additional methods of examination. The tension headache is taken as an example to show the principle aspects of therapy which also apply for the treatment of migraine. Pharmacological possibilities in acute and chronic circumstances are mentioned, in addition to the nonpharmacological alternatives. Particular emphasis is given to drug habituation, the significance of which has become increasingly recognized in recent years. The problems connected with the most common facial pains are discussed.
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PMID:[Therapy of headache]. 267 67

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.
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PMID:Headache and facial pain associated with head injury. 268 67

We studied one hundred patients with suspected temporomandibular joint (TMJ) arthropathy in whom 64 also complained of headache and/or facial pain, using high field surface coil magnetic resonance (MR) imaging, and found that headache and facial pain are commonly observed in association with inflammatory arthropathy of the TMJ. Each patient complained of pain and/or tenderness localized to the immediate vicinity of at least one TMJ. Pathologic joint effusion was demonstrated by MR in 88 of the painful joints studied. Significant meniscus displacement, with or without meniscus deformity and alteration of intrinsic signal intensity was present in 94 of the 100 painful joints examined. Fascial inflammation and atrophy of the ipsilateral muscles of mastication were observed occasionally with painful joints. There were no mechanical TMJ symptoms, such as joint clicking, crepitus or locking in 14 internally deranged and painful joints, 12 of which exhibited joint effusion and local inflammation. At least 80 patients described occlusal changes within 12 months of imaging. 28 of the pathologic joints in the series underwent subsequent meniscectomy, including routine histologic evaluation of surgical material. We conclude that internal derangement and inflammation of the TMJ should be considered in patients with unexplained headache and/or facial pain, even if mechanical TMJ symptoms are absent.
Headache 1989 Apr
PMID:Facial pain, headache, and temporomandibular joint inflammation. 271 73


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