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

Hypothalamic involvement has been invoked to explain the periodicity of the cluster periods and rhythmicity of the pain attacks in cluster headache. To explore this hypothesis the ovine corticotrophin-releasing headaches sufferers during both cluster period and remission. A group of low back pain patients and healthy subjects comprised the control populations. For the o-CRH test, 7 healthy subjects, 7 low back pain patients, 6 cluster headache patients in remission, and 12 in cluster period were studied. Five healthy subjects, 7 low back pain patients, 6 cluster headache patients in remission, and 9 cluster period were administered the insulin tolerance test. Significantly increased basal cortisol levels were found in cluster headache patients in both illness phases (p < 0.0001), but not in low back pain patients. Significantly reduced cortisol response to the o-CRH test was observed in cluster headache patients in both phases compared to healthy controls (p < 0.02). A blunted ACTH and cortisol response (p < 0.0001 and p < 0.003 respectively) to the insulin tolerance test was present in cluster headache patients in both phases of the illness compared to healthy subjects and low back pain patients. On the contrary, the ACTH surge after insulin induced hypoglycemia was significantly increased in the low back pain patient group (p = 0.02). These results suggest that the altered hypothalamic-pituitary-adrenal axis responsiveness in cluster headache patients is not a consequence of the pain, and point to a central, probably hypothalamic derangement in this pathology.
Cephalalgia 1994 Oct
PMID:The insulin tolerance test and ovine corticotrophin-releasing-hormone test in episodic cluster headache. II: Comparison with low back pain patients. 782 95

Thirty-eight patients with late whiplash syndrome were investigated with regard to symptoms which conform with the criteria for other specific diagnoses. All had pain and tender points in the neck and 37 (97.4%) suffered from headache. Seven patients (18.4%) had occipital neuralgia in accordance with the IHS criteria and 16 (42.1%) if the IASP criteria were used. Four patients (10.5%) had oromandibular dysfunction, 20 (52.6%) had periarticular shoulder disorder, and 12 (31.6%) had thoracic outlet syndrome. Five (13.2%) had chronic mechanical low back pain and two (5.3%) segmental instability of the lumbar spine. Four (10.5%) had symptoms concurring with the diagnosis of fibromyalgia. It is concluded that many of the symptoms of patients that suffer from late whiplash syndrome conform with the criteria of other specific diagnoses.
Cephalalgia 1994 Jun
PMID:Extracervical symptoms after whiplash trauma. 795 44

A number of investigators in recent years have called for the development of devices that can monitor surface EMG levels in individuals' normal environments for use with patients who suffer from disorders in which the etiology or maintenance of the pathology is presumed to be due at least in part to musculoskeletal dysfunction, such as low back pain, phantom limb pain and tension headache. This study examined the test-retest reliability of just such a device. Twenty-six healthy controls wore a lightweight (24 ounce) device which measured bilateral upper trapezius EMG, as well as peak and integral motion, for 5 consecutive days for up to 18 h each day. ANOVAs on the four measures revealed no difference between any of the four measures over the 5 days. Intra-class correlation coefficients for the two EMG variables across 5 days were both significant with alpha levels set at 0.01. The two EMG measures were highly correlated (r = 0.77); the two motion measures were also highly correlated (r = 0.60), but at a lower magnitude than EMG values; the relationship between EMG and motion was significant, but the magnitude of the between EMG motion correlations (0.26 and 0.35) were lower than the within EMG or motion ones. It was concluded that the test-retest reliability of the ambulatory monitoring device is within acceptable limits. Implications for the use of the device with musculoskeletal pain disorders--particularly headache--are discussed.
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PMID:Reliability of an ambulatory electromyographic activity device for musculoskeletal pain disorders. 799 77

The occurrence of headache as a sequela of low back pain was examined in a sample of chronic pain patients. All patients had low back pain without history of head, neck, or upper back injury or headache onset simultaneous with the low back pain. Consistent with prior research, headache was found to be a common concomitant of back pain. In many patients, headache was found to have begun or exacerbated markedly after onset of low back pain. Prevalence of migraine in female patients was significantly higher than the population prevalence for females in the United States; this was not true for male patients. Potential mechanisms for explaining the high prevalence of migraine following low back pain are discussed, including increased muscle tension, psychosocial factors, and analgesic overuse.
Headache 1994 May
PMID:Migraine as a sequela to chronic low back pain. 802 46

Although simulated patients are increasingly used in medical education, little research has been carried out on their validity. Validity in this case defines the relationship between performance with a simulated patient and performance with a real patient. One of the objectives of this study was to determine the validity of the use of simulated patients in assessing the consultation skills of trainees in vocational training at the Department of General Practice, University of Utrecht, The Netherlands. A check-list with a rating scale was used to assess the consultation skills of trainees at the department with simulated patients as well as in their training practices with real patients. The simulated and the selected practice cases were patients with complex multi-conditional problems like low back pain, headache and chest pain. The consultation skills were subdivided into four groups: the patient-centered approach, the non-somatic approach, communication skills and interpersonal skills. The measurement of skills, in particular of consultation skills, is very difficult. A description is given of the way the research group solved this problem. The analysis was performed by determining the sensitivity and predictive value of the assessment of a simulated encounter with a routine practice encounter. A difference existed in the assessed level of consultation skills in the simulated encounter compared to the level in the training practice. In simulation the level of consultation skills was higher than in day-to-day practice. This difference can reflect the difference between competence and performance. Competence is defined as what a doctor is capable of doing and performance as what a doctor actually does in day-to-day practice.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Simulated patients in assessing consultation skills of trainees in general practice vocational training: a validity study. 803 15

In this study, the psychological functioning of patients with chronic post-traumatic headache (PTH), chronic combination headache and chronic low back pain without headache, whose time of onset was similar, and a matched group of controls was investigated. The Symptom Checklist 90-Revised (SCL-90-R), State-Trait Anger Expression Inventory (STAXI), State-Trait Anxiety Inventory, Form Y (STAI-Y), and Beck Depression Inventory (BDI) were used to assess the degree of psychopathology. A MANOVA test indicated highly significant differences between groups. In general, the pain groups fell along a continuum with PTH subjects demonstrating the highest elevations, back pain subjects demonstrating the next highest elevations, and combination subjects demonstrating fewer elevations. A cluster analysis indicated that findings were best classified into four clusters, but no one pain diagnosis predominated in any cluster. Eighty-nine percent of controls were assigned to clusters 1 or 2, which revealed essentially normal scores on all tests. It is suggested that while chronic pain patients demonstrate more psychopathology than non-pain controls, a variety of coping styles exists within each pain group independent of diagnostic categorization.
Cephalalgia 1994 Apr
PMID:Psychopathology in individuals with post-traumatic headaches and other pain types. 806 49

Headache and low back pain are common minor complications after epidural anaesthesia. Headache is due to cerebrospinal leakage through the site of accidental dural puncture. Epidural blood patch is considered as the better curative treatment. Acute or long term backache is often reported after epidural anaesthesia. Different mechanisms are suggested: needle trauma, myotoxicity of local anaesthetic and postural problem. Large prospective randomized studies are yet necessary to clarify the role of epidural anaesthesia, the duration of symptoms and the therapeutic.
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PMID:[Headache and low back pain after epidural anesthesia]. 808 42

A rare case of acute subdural hematoma due to dural metastasis from malignant pleural mesothelioma is reported. A 65-year-old man was brought to a nearby hospital complaining of lumbago. He suddenly complained of headache on the third hospital day and fell into a deep coma within a short while. Computed tomography showed a crescent shaped high density area in the right fronto-temporo-parietal region with midline shift to the left side. He was admitted as an emergency case to our clinic on April 24, 1989. Under the diagnosis of acute spontaneous subdural hematoma, emergency operation was performed. Nests of malignant sarcomatous cells were found in the clot obtained during the procedure, but the origin of the tumoral cells could not be identified. The patient failed to recover from the comatose state and died with pancytopenia on the 17th hospital day. General autopsy showed wide-spread malignant pleural mesothelioma with metastases to the lung, liver and bone marrow. Examination of the head revealed dural metastatic tumor and a subdural hematoma over the left hemisphere. Histopathology showed that many tumor cell nests were found only within the dilated veins of the dura. There, acute subdural hematoma was assumed to have developed suddenly and there was massive bleeding from the capillaries of the inner vascular layer of the dura. The relevant literature about intracranial metastasis of malignant pleural mesothelioma was reviewed, and the mechanism of subdural hematoma due to dural metastasis from malignant tumor was discussed.
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PMID:[A case of acute subdural hematoma due to dural metastasis from malignant pleural mesothelioma]. 813 66

Musculo-skeletal complaints are widespread. In a population survey in Ullensaker, a local community 40 kilometers north-east of Oslo, only 15% reported no musculo-skeletal symptoms during the last year. Just as many, 15%, predominantly women aged 50-70 years years, reported having such symptoms every day during the last year. 53% reported that they had experienced low back pain during the last year. The corresponding figures for headache, neck symptoms and shoulder symptoms were 49%, 48% and 46% respectively. Headache was most common among the younger women and neck and shoulder symptoms among middle-aged, while hip and knee symptoms were most frequent in the elderly women. Women in all age groups reported symptoms from more parts of the body than the men did.
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PMID:[Musculoskeletal complaints in a population. Occurrence and localization]. 819 30

We report the findings of a total population survey of Thugbah community in the Eastern Province of Saudi Arabia (SA) to determine its point prevalence of neurological diseases. During this two-phase door-to-door study, all Saudi nationals living in Thugbah were first screened by trained interviewers using a pretested questionnaire (sensitivity 98%, specificity 89%) administered at a face-to-face interview. Individuals with abnormal responses were then evaluated by a neurologist using specific guidelines and defined diagnostic criteria to document neurological disease. The questionnaire was readministered blind by a neurologist to all those with abnormal responses and a 1-in-20 random sample of those without abnormal responses, respectively. The family members of an individual with an abnormal response were also screened to improve accuracy. A total of 23,227 Saudis (98% of the eligible subjects) were screened and those residing in Thugbah on the reference date (22,630) were used to calculate the point prevalence rates. Forty-two percent of those screened were in the first decade of life and only 1.5% were more than 60 years old. There were marginally more females (50.2%) than males (49.8%). Consanguineous marriages especially between first cousins were present in 54.6%. The demographic characteristics of Thugbah community were similar to those in other parts of SA. The overall crude prevalence ratio (PR) for all forms of neurological disease was 131/1,000 population. All subsequent PRs are per 1,000 population. Headache syndromes were the most prevalent disorder (PR 20.7). The PR for all seizure disorders was 7.60, and the epilepsies (6.54) were more frequent than febrile convulsions (0.84). Mental retardation, cerebral palsy syndrome, and microcephaly were common pediatric problems with PRs of 6.27, 5.30 and 1.99, respectively. Stroke, Parkinson's disease, and Alzheimer's disease were uncommon with respective PRs of 1.8, 0.27 and 0.22. Central nervous system (CNS) malformations (0.49) such as hydrocephalus and meningomyelocele were more prevalent than spinal muscular atrophy (0.13), congenital brachial palsy (0.13) and narcolepsy (0.04). Multiple sclerosis was rare (0.04). Osteoarthritis and low back pain syndromes were the main non-neurological conditions seen. The major medical diseases that may be neurologically relevant were diabetes mellitus, hypertension, and connective tissue disorders.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A community survey of neurological disorders in Saudi Arabia: the Thugbah study. 827 77


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