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

The preliminary results of some new studies on cluster headache (CH) point to: (a) the existence of a form, secondary episodic CH, which should be included in the classification of headache; (b) the significant role played by air temperature variations and the number of daylight hours on the onset of CH active periods. Data from the evaluation of pupil response to corneal stimuli suggest a widespread alteration of the pain/autonomic integrative processes at the level of the central nervous system. Finally, data on new preventive (i.e., verapamil and ozone) and symptomatic (i.e., hyperbaric oxygen and sumatriptan) treatments are reported.
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PMID:Cluster headache. Recent developments in clinical characterization and pathogenesis. 166 10

Transcranial Doppler (TCD) and fiberoptic oximetry for continuous measurement of jugular venous oxygen saturation (SjO2) were used as perioperative monitoring of cerebral circulation in a patient with Takayasu disease who received bilateral aorto-carotid bypass. Following revascularization of the left carotid artery, mean velocity in the middle cerebral artery (MV) increased (lt 300%, rt 200% of control values) and SjO2 also increased. Following revascularization of right carotid artery, MV increased (lt 500%, rt 400% of control values) but SjO2 was unchanged. After bilateral revascularization, high velocity continued for about 10 days, and convulsion with headache occurred. Therefore hyperperfusion syndrome was suspected. By perioperative monitoring of MV and SjO2, it might be possible to evaluate intracranial hemodynamics, necessity of shunt operation as well as bilateral bypass, and postoperative hyperperfusion syndrome.
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PMID:[Perioperative monitoring of cerebral circulation in a patient with Takayasu disease]. 168 98

Nifedipine antagonises influx of calcium through cell membrane slow channels, and sustained release formulations of the calcium channel blocker have been shown to be effective in the treatment of mild to moderate hypertension and both stable and variant angina pectoris. Preliminary findings also indicate that these formulations are effective in the treatment of Raynaud's phenomenon and hypertension in pregnancy, and that they reduce the frequency of ischaemic episodes in some patients with silent myocardial ischaemia. The exact mechanism of action of nifedipine in all of these disorders has not been defined. However, its potent peripheral and coronary arterial dilator properties, together with improvements in oxygen supply/demand, are of particular importance. A major goal of sustained release therapy is to permit reductions in the frequency of nifedipine administration, preferably to once daily, and thus improve patient compliance. Two new once-daily formulations--the nifedipine gastrointestinal therapeutic system (GITS) and a fixed combination capsule comprising sustained release nifedipine 20 mg and atenolol 50 mg--have exhibited marked antihypertensive efficacy. The GITS preparation has also been used effectively in the treatment of stable angina pectoris, and both formulations appear to be well tolerated. Sustained release nifedipine formulations are generally better tolerated than their conventionally formulated counterparts, particularly with regard to reflex tachycardia. Adverse effects seem to be dose related, are mainly associated with the drug's potent vasodilatory action, and include headache, flushing and dizziness. Generally, these effects are mild to moderate in severity and transient, usually diminishing with continued treatment. Thus, sustained release nifedipine formulations are useful and established cardiovascular therapeutic agents which have demonstrable efficacy in various forms of angina, mild to moderate hypertension and Raynaud's phenomenon. Further, promising results shown by the nifedipine GITS formulation, with its advantage of once daily administration suggest that it is likely to become one of the preferred nifedipine formulations for the treatment of hypertension and the various forms of angina.
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PMID:Sustained release nifedipine formulations. An appraisal of their current uses and prospective roles in the treatment of hypertension, ischaemic heart disease and peripheral vascular disorders. 171 8

We tested the efficacy of nocturnal nasal ventilation (NNV) using the BIPAP ventilator in patients with restrictive thoracic diseases by withdrawing them from NNV for an average of 1 wk. One male and five female patients were enrolled in the study; four with restrictive chest wall diseases, and two with muscular dystrophies. All patients had chronic CO2 retention (PaCO2 greater than 50 mm Hg) and had been improved by using NNV for at least 2 months before the study. Four patients were switched to the BIPAP ventilator from standard portable volume ventilators at least 1 month prior to the study without changes in gas exchange or symptoms. After withdrawal of NNV, patients had no deterioration in daytime vital signs, pulmonary functions, maximal inspiratory or expiratory pressures, or arterial blood gases compared with measures made immediately before withdrawal and 1 wk after resumption. However, patients had more dyspnea at rest, increased daytime somnolence, more morning headaches, less daytime energy, and felt less rested in the morning during withdrawal of NNV. Furthermore, nocturnal monitoring demonstrated greater tachycardia, tachypnea, oxygen desaturation, and hypoventilation during withdrawal of NNV. We conclude that NNV administered by the BIPAP ventilator is effective in ameliorating nocturnal hypoventilation and daytime symptoms in patients with chronic CO2 retention caused by severe restrictive thoracic diseases. These data also suggest that the efficacy of NNV may depend more on amelioration of nocturnal hypoventilation than on resting of ventilatory muscles.
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PMID:Efficacy of nocturnal nasal ventilation in patients with restrictive thoracic disease. 173 43

The article deals with a 16-year old patient who was suffering from bronchial asthma with frequent severe respiratory obstructive crises and decreased values of functional pulmonary tests since his eleventh year. He was on salbutamol and teoline therapy, and since one year and a half on continuous inhalation corticosteroid therapy. During one of the episodes of bronchobstruction when he was on broncholdilatation and oxygen therapy the patient was given novalgetol because of headache. This provoked a grave astmatic attack with loss of consciousness. One and a half year later he was given novalgetol during a dyspneic drisis with headacke. Five minutes later asthatic attack and generalized urticaria appeared as anaphylactic reaction to novalgetol. This is a good example how drugs form the group of amonomethansulphonate (novalgetol), used in analgetic purposes, can induce, like aspirin, asthamtic crisis and anaphylactic reaction. Therefore they should be avoided in asthamtic patients.
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PMID:[An anaphylactic reaction after administration of Novalgetol in an asthmatic patient]. 178 18

The elderly as a whole suffer fewer headaches than the young. For the majority headache will represent a minor annoyance to be endured or treated with any available drug in the medicine chest. For some, migraine headaches or tension-type headaches become entwined with every daily activity. With the advent of modern pharmacology, headache can often be treated successfully. Trigeminal neuralgia is a source of particularly high morbidity among the elderly, but may be treated very satisfactorily with carbamazepine or baclofen. Paroxysmal hemicrania is exquisitely sensitive to indomethacin, while cluster headache patients receive relief from oxygen inhalation, corticosteroids or lithium. Headache may be the signature of the disease which leads to serious morbidity and mortality. The 'sentinel' headache of subarachnoid haemorrhage is evaluated by a physician in 15% of patients who will eventually rupture an intracranial aneurysm. Morning headache with nausea and vomiting may represent increased intracranial pressure caused by a tumour, haematoma or abscess. The elderly patient with a new headache needs emergency evaluation for temporal arteritis and rapid corticosteroid treatment if the diagnosis is confirmed, to prevent blindness. The broad spectrum of headache, at times a benign aggravation, while at others the harbinger of death, makes the careful evaluation of each headache imperative. This article attempts to make the difficult evaluation of head pain a little easier.
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PMID:Treatment of the elderly patient with headache or trigeminal neuralgia. 179 4

Angina pectoris results from an insufficient flow of oxygen to the myocardia cells. It is not an unusual complication in the dental office, the most frequent factors that trigger angina are: -stress, -pain, -exercise. The treatment consists in providing oxygen and vasodilators. Hypertension is characterized by an increase in the diastolic arterial blood pressure over 120 mmHg and by other clinical manifestations. Stress, pain, and exercise are the most frequent factors responsible for hypertensive disease. Hypertensive disease can lead to various complications ranging from a headache to myocardial infarct or hemiplegia. Treatment consists of different types of vasodilators.
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PMID:[Angina pectoris and hypertension]. 181 3

ASA Grade I and II patients admitted for day-case urological surgery received no premedication or an oral dose of temazepam 10 mg. Anaesthesia was induced with methohexitone and maintained with nitrous oxide, oxygen and halothane or enflurane via a Mapleson A circuit. The incidence of post-operative headache was investigated by an independent observer. Eighty patients were studied (50 male and 30 female) of whom 32 (40%) had post-operative headaches. Post-operative headache was significantly correlated with female sex and frequent 'normal' headache occurrence. The lack of previous surgical experience was a significant risk factor and a loose insignificant association existed with age, the use of halothane and the presence of pre-operative headache. Temazepam premedication had no effect and was associated with significantly more patients complaining of feeling cold.
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PMID:Post-operative headache--a multifactorial analysis. 187 4

In acute attacks of cluster headache (CH), the mainstays of treatment are inhalation of pure oxygen (due to lack of any side effects), ergotamine aerosol, and intranasal application of local anaesthetics. The following treatments have hitherto been recommended for the prevention of attacks: young patient with first manifestation-methysergide; middle aged patient with episodic or chronic CH-steroids; older patient with history of resistance to therapy-lithium. These guidelines have been superceded as a result of the demonstration of the efficacy of several other drugs which have reduced side effects. This increased variety of treatments also reduces the importance of clinical differentiation between episodic and chronic cluster headache. Today, the drugs of first choice for treatment of episodic cluster headache are steroids or calcium channel blockers like verapamil, replacing methysergide which is now drug of second choice. In chronic CH, verapamil and lithium are normally prescribed, steroids-possibly in combination with one of the other drugs-are regarded as drugs of second choice. Another possibility, used with increasing frequency, is valproate acid, and the experimental drug budipine may be a further alternative in therapy resistant patients. There is no convincing role for invasive surgical procedures, particularly in the light of the increased number of effective drugs. The treatment of choice for chronic paroxysmal hemicrania is indometacin, although individual patients may respond to salicylates, naproxene, prednisone and ergotamine.
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PMID:[Cluster headache and chronic paroxysmal hemicrania: current therapy]. 187 17

Cortical spreading depression (SD) has been implicated in the pathophysiology of classical migraine headache and cerebral ischemia. A reduction in cerebral blood flow (CBF), mimicking that seen during the aura and headache phase of migraine, is typically observed following SD in the rat. This phenomenon may also play a role in potentiating ischemic brain damage. In the present study, brief cortical exposure to 1 M KCl produced a marked suppression of EEG amplitude which persisted 20 min in the rat. Upon normalization of the EEG, cortical blood flow declined 20-30% and remained low for at least 2 h. Treatment with a 1 mg/kg i.v. dose of the 21-aminosteroid antioxidant tirilazad mesylate (U-74006F), 2 min following KCl application, completely blocked the hypoperfusion while leaving the magnitude and duration of the EEG suppression and mean arterial pressure unchanged. Tirilazad mesylate is a potent inhibitor of oxygen radical-mediated lipid peroxidation both in vitro and in vivo. Thus, based on present results, an oxygen radical hypothesis is proposed to account for the SD-induced cerebral hypoperfusion.
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PMID:The 21-aminosteroid antioxidant tirilazad mesylate, U-74006F, blocks cortical hypoperfusion following spreading depression. 193 84


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