Headache
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Reversible cerebral vasoconstriction syndrome (RCVS) usually presents with recurrent thunderclap headaches and is characterized by multifocal and reversible vasoconstriction of cerebral arteries that can sometimes evolve to severe cerebral ischemia and stroke. We describe the case of a patient who presented with a clinically typical RCVS and developed focal neurological symptoms and signs despite oral treatment with calcium channel blockers. Within hours of neurological deterioration, she was treated with intra-arterial milrinone, a phosphodiesterase inhibitor, which resulted in a rapid and sustained neurological improvement.
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To determine prevalence and burden of headache and migraine in the general population in Germany including patterns of healthcare and medication use. ⋯ Migraine accounts for a great part of the healthcare impact of headaches in Germany. However, the majority of migraineurs do not seek medical care and may not be optimally treated.
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Allodynia, a painful response to a usually nonpainful stimulus, is common in chronic migraine. The evaluation of allodynia can be important clinically. Dynamic mechanical allodynia (brush) testing has been shown to be both a simple and reliable way to evaluate allodynia. In this study, we show that self-administered brush allodynia testing at home is a feasible means of evaluating and recording allodynia in relationship to chronic migraine.
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Cluster headache remains substantially underdiagnosed and undertreated. Early neurologic referral is indicated in patients with a suspected diagnosis of cluster headache (CH) so that management can be optimized and unnecessary procedures avoided. ⋯ This 2-item questionnaire could be a useful tool for screening CH cases in tertiary centers.