Cephalalgia : an international journal of headache
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The clinical manifestations of sickle cell disease (SCD) vary, but may be attributed to vaso-occlusion, chronic hemolytic anemia, and infections as a result of functional asplenia. We report a case of a man who presented with severe headache caused by an uncommon complication of SCD. ⋯ A skull bone infarction is an uncommon complication of SCD, as typically these are located in the long bones. Even more uncommon is a epidural hematoma which was probably the result of the altered bone and vessel-wall structure following the skull bone infarction. To our knowledge this is the first case reporting a skull-bone infarction with adjacent spontaneous epidural hematoma in an adult with sickle cell disease of the HbSC type. Our case emphasizes the need to recognize skull infarction and a concomitant spontaneous epidural hematoma as a possible complication of SCD.
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We investigated whether chronic headache related to medication overuse (MOH) is associated with changes in brain mechanisms regulating inhibitory cortical responses compared with healthy volunteers and episodic migraineurs recorded between attacks, and whether these changes differ according to the drug overused. ⋯ Compared with episodic migraineurs, MOH patients overusing triptans have no significant change in cortical inhibition, whereas those overusing NSAIDs have an increase in cortical inhibitory mechanisms. We attribute these changes to medication-induced neural adaptation promoted by changes in central serotonin neurotransmission.
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In recent years, there has been an increase in the reports indicating a form of headache that occurs during commercial aircraft travel. This headache, called airplane headache by some authors, is believed to be a new type of headache. The headache has very specific characteristics and all of the cases exhibited very stereotypical symptoms. ⋯ We described the clinical features of 22 cases who suffered from a headache that occurred during airplane travel. We examined other cases with similar features reported in the literature and proposed preliminary diagnostic criteria for this new form of headache. We also discussed the possible patholophysiological mechanisms that may cause this headache.