Current pain and headache reports
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Although the influence of age on the prevalence of migraine is well known, the clinical characterization of migraine across the lifespan remains poorly studied. Limited evidence suggests that migraine attacks get shorter and less typical with advancing age. Similar results were found for transformed migraine at different ages. ⋯ We then discuss the epidemiology and profile of transformed migraine across the lifespan. Clarifying the influence of age on migraine is of importance for clinical diagnosis and treatment. It also may contain clues to evolving disease biology.
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Neuroimaging of migraine recently has provided us with further information regarding the pathophysiology of the disorder and posed important questions as to whether migraine is a progressive disorder. This article provides the background of imaging in migraine and discusses recent advances in the field.
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Curr Pain Headache Rep · Jun 2006
ReviewCurrent views of the risk of stroke for migraine with and migraine without aura.
The association between migraine and stroke is complex and is a continued focus of attention. Several observational studies have identified migraine as an independent risk factor for ischemic stroke. However, a distinction should be made between migraine with and migraine without aura. ⋯ Most studies have not found an association between migraine without aura and ischemic stroke. Although there are several hypotheses about the biologic link between migraine with aura and ischemic stroke, the precise mechanisms remain unclear. However, because the absolute risk of stroke is low in patients with migraine with aura, and migraine without aura is likely not associated with ischemic stroke, most migraine patients will not experience a stroke event.
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Although cluster headache (CH) has been the focus of a great deal of research, it also has been the focus of a great deal of speculations that have been repeated commonly as fact. The authors conducted a thorough review of the literature and an informal poll of several noted headache experts to investigate the truth behind common myths and hypotheses regarding CH. They then present an overview of some of these more common hypotheses, observations, and myths, and offer a brief review of the existing evidence supporting or negating the theories. These include gender, genetics, suicidality, homicidality, physical appearance, personality, and psychologic features of the patient with CH.
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The experience of chronic pain can be associated with significant distress and disability; however, this is not always the case. Although attempts to control or reduce pain can be helpful for many pain sufferers, on some occasions this is not an effective option and a different response is required. ⋯ At least 15 laboratory and clinical studies make the growing case for the role of acceptance in the functioning of people with chronic pain, and evidence from treatment outcome studies is promising. It appears that acceptance-related processes will at least expand our range of psychologic treatment methods for chronic pain sufferers and, at best, significantly improve them.