European journal of neurology : the official journal of the European Federation of Neurological Societies
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Decompressive craniectomy (DC) is used regularly in traumatic brain injury (TBI). There are, however, no cost-effectiveness studies of the procedure. ⋯ Mortality after severe TBI leading to DC was high, but amongst the survivors, the health-related quality of life was equal to normal population. Most survivors were able to live at home and were almost as satisfied with their health as in general people are. Cost of neurosurgical treatment was low, and also including all evaluated costs, cost of a QALY gained was acceptable.
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Medication overuse headache is a common subtype of chronic headache involving the overuse of simple analgesics, opioids, ergotamine or triptans or combinations of these medications. Medication overuse may worsen the headache and has been described to have many characteristics similar to addiction. The purpose of this study was to validate and optimize the Severity of Dependence Scale (SDS) for use amongst people with chronic headache. ⋯ The SDS is valid for detecting medication overuse and dependency like behaviour amongst people with chronic headache. The adapted version may be used to identify chronic headache patients who may benefit from detoxification.
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We report validation of the Russian-language version of the Lifting The Burden headache screening and diagnostic questionnaire in a population-based sample of 501 individuals in four cities (Smolensk, Tchelyabinsk, Nishny Novgorod and Tver) and three rural areas (Tula, Tver and Gornyi) of Russia. ⋯ We concluded that the questionnaire can be utilized in a population-based countrywide survey of the burden attributable to primary headache disorders in Russia.
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Clinical Trial
Short-term effectiveness of simple advice as a withdrawal strategy in simple and complicated medication overuse headache.
The aim of this study was to compare the effectiveness of intensive advice (to withdraw the overused medication/s) as a withdrawal strategy in patients with simple and complicated medication overuse headache (MOH). ⋯ Simple advice is highly effective in simple MOH and effective in most complicated MOH patients and should be regarded as the first step in a step-care approach to MOH management.
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Migraine with aura (MA) has been found to be a risk factor for cardiovascular disease including ischaemic stroke and myocardial infarction. Studies have also reported a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting as to whether this is restricted to MA or also holds true for migraine without aura (MO). This study aims to examine the relation between headache and cardiovascular risk factors in a large cross-sectional population-based study. ⋯ Both MA, MO and non-migrainous headache are associated with an unfavourable cardiovascular risk profile, but different mechanisms seem to underlie the elevated risk in MA than in the other headache types.