Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnoses of the 193 patients aged 65 and over who attended the service of neurology in the past 15 years with de novo headache as their initial and main symptom were specifically analysed. Headaches beginning in elderly people represented only 5.4% of headaches in all ages, whereas 12.1% of the population in this health area was 65 or over. Head pain appeared more often in women (63%), although post-traumatic, cluster, and benign cough headaches were almost restricted to men. Tension type headache (83 patients, 43% of the aged patients) and idiopathic trigeminal neuralgia (36, 19%) were the most frequent diagnoses. Fifteen per cent of the elderly patients v 1.6% of patients under 65 presented headache secondary to serious conditions, such as stroke, temporal arteritis, or intracranial neoplasm. Only one patient over 65 met migraine criteria. It is concluded that whereas the incidence of patients with headache attending a general hospital decreases with age, the risk of headaches due to serious conditions increases 10-fold after 65.
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PMID:Experience in the diagnosis of headaches that start in elderly people. 793 91

Although secondary headaches due to e.g. temporal arteritis or a brain tumor are common among the elderly, primary headache disorders also occur in this age group, albeit less frequently than in younger individuals. A different presentation in the older age groups often makes a diagnosis difficult. Some headache syndromes, such as hypnic headache, are typical for the elderly. Furthermore, age-related physiologic changes, co-morbidities and contra indications require appropriate and targeted treatment in the elderly. Although treatments for the most common primary headaches are available, many limitations hamper their use in this group. For many headaches syndromes randomized controlled treatment trials in elderly are not available. In this article we review the clinical aspects of common primary headaches and medication overuse headache in the elderly and their treatments, with emphasis on age-specific problems. Relevance for patients: Primary headache syndromes in older patients ask for specific treatment considerations due to comorbidity, polypharmacy and an increased risk of side effects. Clinically, the headaches can be different and atypical. Results from clinical trials cannot be generalized to the elderly because these groups usually are not included in studies. In migraine, non-pharmacologic treatment should be considered, with depression and cerebrovascular disease as major comorbidities. Tension type headache, being the most common headache presentation in elderly, also includes a relatively large proportion of patients with a secondary headache warranting further testing. Trigeminal autonomous cephalalgias are rare, and can present with pseudo dementia. Medication overuse and medication-induced headaches are relatively common, for which patient education, ceasing drugs and withdrawal from caffeine containing substances are pivotal. Furthermore, hypnic headache, exploding head syndrome and benign thunderclap headache are specific for this patient group and require specific treatment.
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PMID:Primary headache syndromes in the elderly: epidemiology, diagnosis and treatment. 3087 60