Headache
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Headache-specific self-efficacy refers to patients' confidence that they can take actions that prevent headache episodes or manage headache-related pain and disability. According to social cognitive theory, perceptions of self-efficacy influence an individual's adaptation to persistent headaches by influencing cognitive, affective, and physiological responses to headache episodes as well as the initiation and persistence of efforts to prevent headache episodes. ⋯ As predicted, patients who were confident they could prevent and manage their headaches also believed that the factors influencing their headaches were potentially within their control. In addition, self-efficacy scores were positively associated with the use of positive psychological coping strategies to both prevent and manage headache episodes and negatively associated with anxiety. Multiple regression analyses revealed that headache severity, locus-of-control beliefs, and self-efficacy beliefs each explained independent variance in headache-related disability.
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To assess the utility of neuroimaging in the evaluation of children presenting with two of the most common forms of headache, migraine and chronic daily headache, and to determine the utility and pathological yield of neuroimaging in specific headache syndromes in children whose neurological examinations are normal. ⋯ The yield of neuroimaging in children with uncomplicated migraine and normal neurological examination was 3.7%. The yield in children with chronic daily headache and normal neurological examination was higher at 16.6%. The abnormalities discovered included arachnoid cysts, Chiari I malformations, sinus disease, occult vascular malformations and "dilated Virchow-Robin spaces." While none of the neuroimaging findings were apparent clinically, their discovery did not influence the diagnosis, management, or outcome of the patients. None of the abnormalities necessitated surgical intervention or were associated with the headache presentation. Therefore, neuroimaging is not warranted in children and adolescents with defined clinical headache syndrome diagnoses whose neurological examinations are normal.
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The coexistence of chronic paroxysmal hemicrania and trigeminal neuralgia is called chronic paroxysmal hemicrania-tic syndrome. We describe the case of a man who has suffered both types of pain occurring synchronously but with different localization on the ipsilateral side. ⋯ To the best of our knowledge, this is the third case to be reported, the first in the male sex. We review this new disorder and discuss the pathophysiology.