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[PMID]:29381924
[Au] Autor:Benz T; Nüssle A; Lehmann S; Gantenbein AR; Sándor PS; Elfering A; Aeschlimann AG; Angst F
[Ad] Endereço:Rehabilitation Clinic "RehaClinic", Bad Zurzach.
[Ti] Título:Health and quality of life in patients with medication overuse headache syndrome after standardized inpatient rehabilitation: A cross-sectional pilot study.
[So] Source:Medicine (Baltimore);96(47):e8493, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this pilot study was to determine health-related quality of life (HRQoL) in patients with history of medication overuse headache (MOH) after detoxification and a headache-specific inpatient rehabilitation program and to receive necessary information for future prospective studies.HRQoL and headache-related disability were cross-sectionally measured by Short Form 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Migraine Disability Score (MIDAS), Coping Strategies Questionnaire (CSQ), and Symptom Checklist 90 revised (SCL-90-R). SF-36, HADS, and SCL-90-R data were compared to German population norms, stratified by age, sex, and comorbidities.Fifty-one patients (72.5% females, mean age 47.3 years) were included with an average headache duration of 25.3 years. Moderate to high levels of headache were reported on the MIDAS VAS at 6.51 (range 0-10); SF-36 bodily pain was 40.3 (norm = 59.0, P < .001, 100 = best). Impaired functioning averaged at 78.4 (100 = no impairment) on the MIDAS. In contrast, SF-36 physical functioning was comparable to the norm (mean: 78.4, norm = 81.8, P = .63). All other SF-36 scales were significantly lower than expected from the norm (all P < .001). The scales depression, anxiety, obsessive-compulsive, and interpersonal sensitivity were significantly affected, whereas the levels of SCL-90-R schizophrenia nuclear and schizotypia were not lower than the norm. Coping with pain was moderate.This pilot study is the first that presents a comprehensive and simultaneously specific assessment of health and quality of life of MOH patients after detoxification and inpatient rehabilitation. Moderate to high levels of pain and self-reported disability owing to headache were observed, whereas physical function on the SF-36 was not different from the expected level of the norm. Mental health was substantially affected in several dimensions, which had been described to reduce the ability to cope with pain. MOH patients seem to have high expectations of functionality, low symptomatology, and intact well-being.
[Mh] Termos MeSH primário: Transtornos da Cefaleia Secundários/reabilitação
Nível de Saúde
Saúde Mental
Qualidade de Vida
[Mh] Termos MeSH secundário: Adaptação Psicológica
Adulto
Fatores Etários
Comorbidade
Estudos Transversais
Feminino
Alemanha
Transtornos da Cefaleia Secundários/psicologia
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Projetos Piloto
Estudos Prospectivos
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008493


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[PMID]:29226741
[Au] Autor:González-Hernández A; Marichal-Cancino BA; MaassenVanDenBrink A; Villalón CM
[Ad] Endereço:a Instituto de Neurobiología , Universidad Nacional Autónoma de México , Querétaro , México.
[Ti] Título:Side effects associated with current and prospective antimigraine pharmacotherapies.
[So] Source:Expert Opin Drug Metab Toxicol;14(1):25-41, 2018 Jan.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Migraine is a neurovascular disorder. Current acute specific antimigraine pharmacotherapies target trigeminovascular 5-HT , 5-HT and CGRP receptors but, unfortunately, they induce some cardiovascular and central side effects that lead to poor treatment adherence/compliance. Therefore, new antimigraine drugs are being explored. Areas covered: This review considers the adverse (or potential) side effects produced by current and prospective antimigraine drugs, including medication overuse headache (MOH) produced by ergots and triptans, the side effects observed in clinical trials for the new gepants and CGRP antibodies, and a section discussing the potential effects resulting from disruption of the cardiovascular CGRPergic neurotransmission. Expert opinion: The last decades have witnessed remarkable developments in antimigraine therapy, which includes acute (e.g. triptans) and prophylactic (e.g. ß-adrenoceptor blockers) antimigraine drugs. Indeed, the triptans represent a considerable advance, but their side effects (including nausea, dizziness and coronary vasoconstriction) preclude some patients from using triptans. This has led to the development of the ditans (5-HT receptor agonists), the gepants (CGRP receptor antagonists) and the monoclonal antibodies against CGRP or its receptor. The latter drugs represent a new hope in the antimigraine armamentarium, but as CGRP plays a role in cardiovascular homeostasis, the potential for adverse cardiovascular side effects remains latent.
[Mh] Termos MeSH primário: Desenho de Drogas
Transtornos de Enxaqueca/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Anticorpos Monoclonais/administração & dosagem
Anticorpos Monoclonais/efeitos adversos
Anticorpos Monoclonais/farmacologia
Transtornos da Cefaleia Secundários/etiologia
Seres Humanos
Transtornos de Enxaqueca/fisiopatologia
Receptores de Peptídeo Relacionado com o Gene de Calcitonina/antagonistas & inibidores
Receptores de Peptídeo Relacionado com o Gene de Calcitonina/metabolismo
Receptores de Serotonina/efeitos dos fármacos
Receptores de Serotonina/metabolismo
Agonistas de Receptores de Serotonina/administração & dosagem
Agonistas de Receptores de Serotonina/efeitos adversos
Agonistas de Receptores de Serotonina/farmacologia
Triptaminas/administração & dosagem
Triptaminas/efeitos adversos
Triptaminas/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Receptors, Calcitonin Gene-Related Peptide); 0 (Receptors, Serotonin); 0 (Serotonin Receptor Agonists); 0 (Tryptamines); 0 (serotonin 1F receptor)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2018.1416097


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[PMID]:28821684
[Au] Autor:Scher AI; Rizzoli PB; Loder EW
[Ad] Endereço:From the Department of Preventive Medicine and Biostatistics (A.I.S.), Uniformed Services University, Bethesda, MD; and Department of Neurology (P.B.R., E.W.L.), Brigham and Women's Hospital, Boston, MA. ann.scher@usuhs.edu.
[Ti] Título:Medication overuse headache: An entrenched idea in need of scrutiny.
[So] Source:Neurology;89(12):1296-1304, 2017 Sep 19.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:It is a widely accepted idea that medications taken to relieve acute headache pain can paradoxically worsen headache if used too often. This type of secondary headache is referred to as medication overuse headache (MOH); previously used terms include rebound headache and drug-induced headache. In the absence of consensus about the duration of use, amount, and type of medication needed to cause MOH, the default position is conservative. A common recommendation is to limit treatment to no more than 10 or 15 days per month (depending on medication type) to prevent headache frequency progression. Medication withdrawal is often recommended as a first step in treatment of patients with very frequent headaches. Existing evidence, however, does not provide a strong basis for such causal claims about the relationship between medication use and frequent headache. Observational studies linking treatment patterns with headache frequency are by their nature confounded by indication. Medication withdrawal studies have mostly been uncontrolled and often have high dropout rates. Evaluation of this evidence suggests that only a minority of patients required to limit the use of symptomatic medication may benefit from treatment limitation. Similarly, only a minority of patients deemed to be overusing medications may benefit from withdrawal. These findings raise serious questions about the value of withholding or withdrawing symptom-relieving medications from people with frequent headaches solely to prevent or treat MOH. The benefits of doing so are smaller, and the harms larger, than currently recognized. The concept of MOH should be viewed with more skepticism. Until the evidence is better, we should avoid dogmatism about the use of symptomatic medication. Frequent use of symptom-relieving headache medications should be viewed more neutrally, as an indicator of poorly controlled headaches, and not invariably a cause.
[Mh] Termos MeSH primário: Transtornos da Cefaleia Secundários
[Mh] Termos MeSH secundário: Transtornos da Cefaleia Secundários/induzido quimicamente
Transtornos da Cefaleia Secundários/etiologia
Transtornos da Cefaleia Secundários/terapia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170820
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004371


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[PMID]:28665241
[Au] Autor:Kraemer MR; Sandoval-Garcia C; Bragg T; Iskandar BJ
[Ad] Endereço:Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin.
[Ti] Título:Shunt-dependent hydrocephalus: management style among members of the American Society of Pediatric Neurosurgeons.
[So] Source:J Neurosurg Pediatr;20(3):216-224, 2017 Sep.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS). RESULTS Respondents agreed that shunt malfunction occurs most often as the result of ventricular catheter obstruction. Despite contrary evidence in the literature, most respondents (66%) also believed that choroid plexus is the tissue most often found in obstructed proximal catheters. However, free-text responses revealed that the respondents' understanding of the underlying pathophysiology of shunt obstruction was highly variable and included growth, migration, or adherence of choroid plexus, CSF debris, catheter position, inflammatory processes, and CSF overdrainage. Most respondents considered chronic CSF overdrainage to be a rare complication of shunting in their practice and reported wide variation in treatment protocols. Moreover, despite a lack of evidence in the literature, most respondents attributed chronic headaches in shunt patients to medical reasons (for example, migraines, tension). Accordingly, most respondents managed headaches with reassurance and/or referral to pain clinics. Lastly, there were variable opinions on the etiology of slit ventricle syndrome (SVS), which included early shunting, chronic overdrainage, and/or loss of brain compliance. Beyond shunt revision, respondents reported divergent SVS treatment preferences. CONCLUSIONS The survey shows that there is wide variability in the understanding and management of shunt-dependent hydrocephalus and its complications. Such discrepancies appear to be derived partly from inconsistent familiarity with existing literature but especially from a paucity of high-quality publications.
[Mh] Termos MeSH primário: Derivações do Líquido Cefalorraquidiano
Hidrocefalia/etiologia
Hidrocefalia/terapia
[Mh] Termos MeSH secundário: Criança
Falha de Equipamento
Transtornos da Cefaleia Secundários/etiologia
Transtornos da Cefaleia Secundários/terapia
Seres Humanos
Neurocirurgiões
Pediatras
Síndrome do Ventrículo Colabado/etiologia
Síndrome do Ventrículo Colabado/terapia
Sociedades Médicas
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171115
[Lr] Data última revisão:
171115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.3171/2017.2.PEDS16265


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[PMID]:28615434
[Au] Autor:Müller KI; Alstadhaug KB; Bekkelund SI
[Ad] Endereço:From the Department of Clinical Medicine (K.I.M., K.B.A., S.I.B.), UiT-The Arctic University of Norway; Department of Neurology (K.I.M., S.I.B.), University Hospital of North Norway, Tromsø; and Department of Neurology (K.B.A.), Nordland Hospital Trust, Bodø, Norway. kai.ivar.muller@unn.no.
[Ti] Título:A randomized trial of telemedicine efficacy and safety for nonacute headaches.
[So] Source:Neurology;89(2):153-162, 2017 Jul 11.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate long-term treatment efficacy and safety of one-time telemedicine consultations for nonacute headaches. METHODS: We randomized, allocated, and consulted nonacute headache patients via telemedicine (n = 200) or in a traditional manner (n = 202) in a noninferiority trial. Efficacy endpoints, assessed by questionnaires at 3 and 12 months, included change from baseline in Headache Impact Test-6 (HIT-6) (primary endpoint) and pain intensity (visual analogue scale [VAS]) (secondary endpoint). The primary safety endpoint, assessed via patient records, was presence of secondary headache within 12 months after consultation. RESULTS: We found no differences between telemedicine and traditional consultations in HIT-6 ( = 0.84) or VAS ( = 0.64) over 3 periods. The absolute difference in HIT-6 from baseline was 0.3 (95% confidence interval [CI] -1.26 to 1.82, = 0.72) at 3 months and 0.2 (95% CI -1.98 to 1.58, = 0.83) at 12 months. The absolute change in VAS was 0.4 (95% CI -0.93 to 0.22, = 0.23) after 3 months and 0.3 (95% CI -0.94 to 0.29, = 0.30) at 12 months. We found one secondary headache in each group at 12 months. The estimated number of consultations needed to miss one secondary headache with the use of telemedicine was 20,200. CONCLUSION: Telemedicine consultation for nonacute headache is as efficient and safe as a traditional consultation. CLINICALTRIALSGOV IDENTIFIER: NCT02270177. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that a one-time telemedicine consultation for nonacute headache is noninferior to a one-time traditional consultation regarding long-term treatment outcome and safety.
[Mh] Termos MeSH primário: Transtornos da Cefaleia Secundários/terapia
Transtornos de Enxaqueca/terapia
Avaliação de Processos e Resultados (Cuidados de Saúde)
Manejo da Dor/métodos
Telemedicina/métodos
Cefaleia do Tipo Tensional/terapia
Cefalalgias Autonômicas do Trigêmeo/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Manejo da Dor/efeitos adversos
Manejo da Dor/normas
Medição da Dor
Telemedicina/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004085


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[PMID]:28615426
[Au] Autor:Androulakis XM; Krebs K; Peterlin BL; Zhang T; Maleki N; Sen S; Rorden C; Herath P
[Ad] Endereço:From the Departments of Neurology (X.M.A., K.K., S.S., P.H.), Statistics (T.Z.), and Psychology (C.R.), University of South Carolina, Columbia; Department of Neurology (B.L.P.), Johns Hopkins University, Baltimore, MD; and Department of Psychiatry (N.M.), Massachusetts General Hospital, Boston. Mich
[Ti] Título:Modulation of intrinsic resting-state fMRI networks in women with chronic migraine.
[So] Source:Neurology;89(2):163-169, 2017 Jul 11.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the intrinsic resting functional connectivity of the default mode network (DMN), salience network (SN), and central executive network (CEN) network in women with chronic migraine (CM), and whether clinical features are associated with such abnormalities. METHODS: We analyzed resting-state connectivity in 29 women with CM as compared to age- and sex-matched controls. Relationships between clinical characteristics and changes in targeted networks connectivity were evaluated using a multivariate linear regression model. RESULTS: All 3 major intrinsic brain networks were less coherent in CM (DMN: = 0.030, SN: = 0.007, CEN: = 0.002) as compared to controls. When stratified based on medication overuse headache (MOH) status, CM without MOH (DMN: = 0.029, SN: = 0.023, CEN: = 0.003) and CM with MOH (DMN: = 0.016, SN: = 0.016, CEN: = 0.015) were also less coherent as compared to controls. There was no difference in CM with MOH as compared to CM without MOH (DMN: = 0.382, SN: = 0.408, CEN: = 0.419). The frequency of moderate and severe headache days was associated with decreased connectivity in SN ( = 0.003) and CEN ( = 0.015), while cutaneous allodynia was associated with increased connectivity in SN ( = 0.011). CONCLUSIONS: Our results demonstrated decreased overall resting-state functional connectivity of the 3 major intrinsic brain networks in women with CM, and these patterns were associated with frequency of moderate to severe headache and cutaneous allodynia.
[Mh] Termos MeSH primário: Conectoma/métodos
Transtornos da Cefaleia Secundários/fisiopatologia
Transtornos de Enxaqueca/fisiopatologia
Rede Nervosa/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Doença Crônica
Função Executiva/fisiologia
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Meia-Idade
Descanso/fisiologia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004089


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[PMID]:28429236
[Au] Autor:Hong CK; Joo JY; Shim YS; Sim SY; Kwon MA; Kim YB; Chung J
[Ad] Endereço:Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
[Ti] Título:The course of headache in patients with moderate-to-severe headache due to mild traumatic brain injury: a retrospective cross-sectional study.
[So] Source:J Headache Pain;18(1):48, 2017 Dec.
[Is] ISSN:1129-2377
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Little is known about the long-term course of headache in patients with moderate-to-severe headache due to traumatic brain injury (TBI). We evaluated the course of headache in patients with moderate-to-severe headache due to mild TBI. METHODS: Since September 2009, patients with TBI prospectively rated their headache using a numeric rating scale (NRS). From the database containing 935 patients with TBI between September 2009 and December 2013, 259 patients were included according to following criteria: (1) newly onset moderate-to-severe headache (NRS ≥ 4) due to head trauma; (2) age ≥ 15 years; (3) Glasgow Coma Scale ≥ 13; (4) transient loss of consciousness ≤ 30 min; and (5) radiographic evaluation, such as computed tomography or magnetic resonance image. We evaluated initial and follow-up NRS scores to determine the significance of NRS changes and identified risk factors for moderate-to-severe headache at 36-month follow-up. RESULTS: At 36-month follow-up, 225 patients (86.9%) reported improved headache (NRS ≤ 3) while 34 (13.1%) reported no improvement. The NRS scores were significantly decreased within a month (P < 0.001). The follow-up NRS scores at 12-, 24-, and 36-months were lower than those at one month (P < 0.001). Multiple logistic regression analysis showed that post-traumatic seizure (odds ratio, 2.162; 95% CI, 1.095-6.542; P = 0.041) and traumatic intracranial hemorrhage (odds ratio, 2.854; 95% CI, 1.241-10.372; P = 0.024) were independent risk factors for moderate-to-severe headache at 36-month follow-up. CONCLUSIONS: The course of headache in patients with mild TBI continuously improved until 36-month follow-up. However, 13.1% of patients still suffered from moderate-to-severe headache at 36-month follow-up, for whom post-traumatic seizure and traumatic intracranial hemorrhage might be risk factors.
[Mh] Termos MeSH primário: Lesões Encefálicas Traumáticas/complicações
Progressão da Doença
Transtornos da Cefaleia Secundários/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Seguimentos
Transtornos da Cefaleia Secundários/etiologia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1186/s10194-017-0755-9


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Teixeira, Manoel Jacobsen
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[PMID]:28271298
[Au] Autor:Brazoloto TM; de Siqueira SR; Rocha-Filho PA; Figueiredo EG; Teixeira MJ; de Siqueira JT
[Ad] Endereço:Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil. thibrazoloto@gmail.com.
[Ti] Título:Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study.
[So] Source:Acta Neurochir (Wien);159(5):799-805, 2017 May.
[Is] ISSN:0942-0940
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgical trauma at the temporalis muscle is a potential cause of post-craniotomy headache and temporomandibular disorders (TMD). The aim of this study was to evaluate the prevalence of pain, masticatory dysfunction and trigeminal somatosensory abnormalities in patients who acquired aneurysms following pterional craniotomy. METHODS: Fifteen patients were evaluated before and after the surgical procedure by a trained dentist. The evaluation consisted of the (1) research diagnostic criteria for TMD, (2) a standardized orofacial pain questionnaire and (3) a systematic protocol for quantitative sensory testing (QST) for the trigeminal nerve. RESULTS: After pterional craniotomy, 80% of the subjects, 12 patients, developed orofacial pain triggered by mandibular function. The pain intensity was measured by using the visual analog scale (VAS), and the mean pain intensity was 3.7. The prevalence of masticatory dysfunction was 86.7%, and there was a significant reduction of the maximum mouth opening. The sensory evaluation showed tactile and thermal hypoesthesia in the area of pterional access in all patients. CONCLUSIONS: There was a high frequency of temporomandibular dysfunction, postoperative orofacial pain and trigeminal sensory abnormalities. These findings can help to understand several abnormalities that can contribute to postoperative headache or orofacial pain complaints after pterional surgeries.
[Mh] Termos MeSH primário: Aneurisma Roto/cirurgia
Craniotomia/efeitos adversos
Dor Facial/etiologia
Transtornos da Cefaleia Secundários/etiologia
Transtornos da Articulação Temporomandibular/etiologia
Doenças do Nervo Trigêmeo/etiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Base do Crânio/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1007/s00701-017-3137-9


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[PMID]:28229320
[Au] Autor:Herekar AA; Ahmad A; Uqaili UL; Ahmed B; Effendi J; Alvi SZ; Shahab MA; Javed U; Herekar AD; Khanani R; Steiner TJ
[Ad] Endereço:Headache Research Foundation of Pakistan, Karachi, Pakistan.
[Ti] Título:Primary headache disorders in the adult general population of Pakistan - a cross sectional nationwide prevalence survey.
[So] Source:J Headache Pain;18(1):28, 2017 Dec.
[Is] ISSN:1129-2377
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The large geographical gaps in our knowledge of the prevalence and burden of headache disorders include almost all of Eastern Mediterranean Region (EMR). We report a nationwide population-based study in Pakistan, an EMR country with the sixth largest population in the world, conducted as a project within the Global Campaign against Headache. METHODS: We surveyed six locations from the four provinces of Pakistan: Punjab, Sindh, Khyber Pakhtunkhwa and Baluchistan. We randomly selected and visited rural and urban households in each. One adult member (18-65 years) of each household, also randomly selected, was interviewed by a trained non-medical interviewer from the same location using a previously-validated structured questionnaire translated into Urdu, the national language. We estimated 1-year prevalences of the headache disorders of public-health importance and examined their associations with demographic variables using multivariate analysis. RESULTS: There were 4223 participants (mean age 34.4 ± 11.0 years; male 1957 [46.3%], female 2266 [53.7%]; urban 1443 [34.2%], rural 2780 [65.8%]). Participation proportion was 89.5%. Headache in the previous year was reported by 3233 (76.6% [95% CI: 75.3-77.8%]). The age- and gender-adjusted 1-year prevalence of migraine was 22.5% [21.2-23.8%] (male 18.0% [16.8-19.2%], female 26.9% [25.6-28.2%]), of tension-type headache (TTH) 44.6% [43.1-46.1%] (male 51.2% [49.7-52.7%], female 37.9% [36.4-39.4%]), of probable medication-overuse headache 0.7% [0.5-1.0%] (male 0.7% [0.5-1.0%], female 0.8% [0.5-1.1%]) and of other headache on ≥15 days/month 7.4% [6.6-8.2%] (male 4.4% [3.8-5.0%], female 10.4% [9.5-11.3%]). Migraine was more prevalent in females by a factor of 3:2 although this association barely survived (P = 0.039) after correcting for other factors. TTH was more prevalent in males by about 4:3 (P = 0.026). All headache and migraine were age-related, peaking in the age group 40-49 years; TTH peaked a decade earlier. Higher education (P = 0.004) and income (P = 0.001) were negatively associated with prevalence of migraine. CONCLUSION: With three quarters of its population affected, headache disorders must be on the public-health agenda of Pakistan. Worldwide, these disorders are the third leading cause of disability; information from specific enquiry into the burden attributable to headache disorders in this country is needed to inform health policy and priority-setting, and will be reported soon.
[Mh] Termos MeSH primário: Transtornos da Cefaleia Primários/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Estudos Transversais
Feminino
Transtornos da Cefaleia Secundários/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Transtornos de Enxaqueca/epidemiologia
Paquistão/epidemiologia
Prevalência
Cefaleia do Tipo Tensional/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170428
[Lr] Data última revisão:
170428
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.1186/s10194-017-0734-1


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[PMID]:28220377
[Au] Autor:Chen Z; Chen X; Liu M; Dong Z; Ma L; Yu S
[Ad] Endereço:Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.
[Ti] Título:Altered functional connectivity architecture of the brain in medication overuse headache using resting state fMRI.
[So] Source:J Headache Pain;18(1):25, 2017 Dec.
[Is] ISSN:1129-2377
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Functional connectivity density (FCD) could identify the abnormal intrinsic and spontaneous activity over the whole brain, and a seed-based resting-state functional connectivity (RSFC) could further reveal the altered functional network with the identified brain regions. This may be an effective assessment strategy for headache research. This study is to investigate the RSFC architecture changes of the brain in the patients with medication overuse headache (MOH) using FCD and RSFC methods. METHODS: 3D structure images and resting-state functional MRI data were obtained from 37 MOH patients, 18 episodic migraine (EM) patients and 32 normal controls (NCs). FCD was calculated to detect the brain regions with abnormal functional activity over the whole brain, and the seed-based RSFC was performed to explore the functional network changes in MOH and EM. RESULTS: The decreased FCD located in right parahippocampal gyrus, and the increased FCD located in left inferior parietal gyrus and right supramarginal gyrus in MOH compared with NC, and in right caudate and left insula in MOH compared with EM. RSFC revealed that decreased functional connectivity of the brain regions with decreased FCD anchored in the right dorsal-lateral prefrontal cortex, right frontopolar cortex in MOH, and in left temporopolar cortex and bilateral visual cortices in EM compared with NC, and in frontal-temporal-parietal pattern in MOH compared with EM. CONCLUSIONS: These results provided evidence that MOH and EM suffered from altered intrinsic functional connectivity architecture, and the current study presented a new perspective for understanding the neuromechanism of MOH and EM pathogenesis.
[Mh] Termos MeSH primário: Encéfalo/fisiopatologia
Transtornos da Cefaleia Secundários/fisiopatologia
Imagem por Ressonância Magnética/métodos
Rede Nervosa/fisiopatologia
Descanso/fisiologia
[Mh] Termos MeSH secundário: Adulto
Encéfalo/diagnóstico por imagem
Mapeamento Encefálico/métodos
Córtex Cerebral/diagnóstico por imagem
Córtex Cerebral/fisiopatologia
Feminino
Transtornos da Cefaleia Secundários/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Rede Nervosa/diagnóstico por imagem
Córtex Pré-Frontal/diagnóstico por imagem
Córtex Pré-Frontal/fisiopatologia
Córtex Visual/diagnóstico por imagem
Córtex Visual/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170419
[Lr] Data última revisão:
170419
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1186/s10194-017-0735-0



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