The journal of headache and pain
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A new form of headache, whose attacks seem to be stereotyped, has been recently reported; because of the peculiarity of its onset, strictly related to airplane travel, the name of "Airplane headache" was proposed. A total of 7 cases have been published. Here we present the first Italian one. Furthermore the revision of the clinical characteristics of each patient leads us to propose provisional diagnostic criteria.
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The goal of this study was to explore the relationship between indicators of sympathoneural, sympathomedullar and hypothalamic-pituitary-adrenocortical (HPA) activity and stress-induced head and shoulder-neck pain in patients with migraine or tension-type headache (TTH). We measured noradrenaline, adrenaline and cortisol levels before and after low-grade cognitive stress in 21 migraineurs, 16 TTH patients and 34 controls. The stressor lasted for 60 min and was followed by 30 min of relaxation. ⋯ A relationship between HPA activity and stress in TTH patients has to our knowledge not been reported before. In migraine, on the other hand, both sympathoneural activation and HPA activation seem to be linked to stress-induced muscle pain and recovery from pain respectively. The present study suggests that migraineurs and TTH patients cope differently with low-grade cognitive stress.
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Letter Case Reports
Can spontaneous intracranial hypotension cause venous sinus thrombosis?
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We report the methodology of an epidemiological survey of the prevalences of migraine, tension-type headache and chronic daily headache in Georgia. Medical residents visited adjacent households in Tbilisi to interview a pre-defined target of 100 biologically unrelated subjects. All respondents reporting headache in the previous year, as well as random 20 non-headache controls, were examined by a neurologist. ⋯ Eight subjects fulfilled all IHS criteria for migraine (1-year prevalence 8.6% [95% CI: 2.9-14.3%]), and 13 had probable migraine, meeting all but the criterion for duration. Nineteen had tension-type headache (20.4% [95% CI: 12.2-28.6%]) and five had chronic daily headache (5.4% [95% CI: 1-10.0%]). In comparisons of diagnoses by questionnaire and neurologist (considered the gold standard), sensitivities for the questionnaire of 89% for migraine and 67% for tension-type headache were calculated (overall kappa=0.74).