Current pain and headache reports
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Internal carotid artery (ICA) and vertebral artery (VA) dissections are among the common causes of stroke in middle-aged and young adults. The spectrum of clinical presentations of these dissections is broad. Many patients, especially those with ICA dissections, may never develop a stroke.
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The overuse of acute medications in patients who are headache-prone poses a great challenge to headache management. Medication overuse-induced headache represents one of the most common iatrogenic disorders. ⋯ The recent development of acute headache medications, especially the triptans, has provided increased migraine relief; however, the incidence of triptan-overuse headache has also increased. Awareness of medication overuse-induced headache and familiarity with the diagnosis and the treatment of this disorder are important to physicians who treat patients with headache.
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Treatment for patients who are dying from cancer and are suffering with physiologic and existential symptoms is an important and valuable skill for health care providers. However, the treatment for suffering at the end of life and the use of sedation for comfort often are misunderstood. The following is a discussion of the clinical skills and ethical considerations that health care providers should have when treating terminal patients with cancer.
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Thunderclap headache refers to an excruciating headache of instantaneous onset. It occurs as suddenly and unexpectedly as a "clap of thunder." Patients with thunderclap headache may have normal neurologic examination results and normal computed tomographic brain scans, even if they have serious underlying pathology. This has created confusion regarding nosology and the nature and extent of the diagnostic evaluation, which this article discusses.