جستجوی مقالات مرتبط با کلیدواژه "headache" در نشریات گروه "پزشکی"

Aortic dissection is an uncommon medical emergency with an incidence rate of approximately three per 100,000 people; the diagnosis of aortic dissection is often missed in the absence of chest pain in approximately 6% of cases.

There was a 53-year-old man with a history of migraines and high blood pressure who woke up in the morning with a severe headache and was diagnosed with carotid dissection and thoracic aortic dissection involving the ascending aorta and descending aorta.

Aortic dissections rarely present with severe headaches as their initial symptom, but aortic dissections with carotid artery dissections are typically accompanied by headache; it is important to keep in mind that the sudden onset of a frontal headache may necessitate sonography of the carotid arteries and echocardiography.

Temporomandibular joint disorders (TMJD) can cause joint pain, trismus, and headaches, which negatively impact people's quality of life and may lead to a decrease in educational level among students. Thus, this study aimed to investigate the symptoms of TMJD among students at Isfahan Azad Dental Faculty.

This descriptive-analytic study involved 62 students from Isfahan Azad Faculty of Dentistry. Pain intensity (cephalic, joint, muscle) was evaluated using the VAS scale. After completing the evaluation of the students and registering the information in the relative checklist, data were analyzed using Exact Fisher and chi-square statistical tests(α=0.05).

The study found that students with headaches did not have a higher incidence of restriction in opening their mouth and joint pain. However, students with headache had lower rates of joint noise (p = 0.04). The age of students was not related to TMD (p>0.05), and gender was not related to joint noise (p= 1.00) and joint pain (p= 0.70). The malocclu-sion status of students was not related to TMD. Parafunctional habits were related to head-aches among students (p< 0.001).

Severe headaches were common among studied students which could be related to temporo-mandibular joint disfunction as it was related to parafunctional habits. TMD symptoms were not related to age, gender (except for mouth opening restriction) and occlusion class type
.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has posed significant global health challenges, particularly for vulnerable populations.

This retrospective report from the Iranian Network for Research in Viral Diseases (INRVD) investigates the common clinical symptoms of COVID-19 in individuals with Parkinson's disease (PD). Research suggests neurological complications can occur during SARS-CoV-2 infection, but there are limited studies on neurological symptoms in PD patients with COVID-19. Given the probable heightened vulnerability of PD patients, evaluating clinical symptoms, especially neurological manifestations, is crucial.

Data from 54 patients were collected from the INRVD from March 2020 to May 2021. Nasal, oropharyngeal, and nasopharyngeal swabs were collected from patients presenting with respiratory symptoms, following Iranian CDC guidelines. Following sample collection, RT-PCR assays were performed for COVID-19 confirmation. Statistical analysis was conducted using the Chi-square test and Fisher's exact test.

Among the 54 PD patients included in the study, 27 tested positive for COVID-19. Of the 54 subjects analyzed, 38.9% were female and 61.1% were male. Comparison of COVID-19 symptoms revealed a higher rate of sore throat (74%) and shortness of breath (81%) in the COVID-19 positive group as common clinical symptoms of the disease. Interestingly, higher rates of dizziness (67%) and headache (74%) were observed in PD patients with COVID-19.

This study enhances our understanding of the diverse clinical manifestations of COVID-19 and its impact on individuals with underlying health conditions such as PD. The increased prevalence of neurological symptoms among PD patients underscores the need for further investigation to clarify whether these symptoms directly result from COVID-19 infection or if they may also be influenced by PD itself or its treatment. It is important to consider that while neurological symptoms in Parkinson's patients can be attributed to the underlying disorder or linked to medication and medical interventions, respiratory symptoms are typically associated with COVID-19.

Headache is a common complaint among traumatic patients referring to the emergency department.  To improve headache in these patients, an effective, fast-acting, accessible and inexpensive drug without a significant effect on the level of consciousness and vital signs is highly needed.

 In this double-blind randomized clinical trial (RCT) on patients with head trauma, Group A was given 5% intranasal lidocaine spray while group B was prescribed 10% intranasal lidocaine spray to improve headache. Headache severity was checked based on numeric pain scale (NPS) before drug administration and then at 5, 15, 30 minutes and plus 1 hour post-drug administration, along with patient satisfaction and possible side effects. Finally, the obtained data were analyzed using SPSS 23 software.

According to the data, the maximum reduction in headache occurred 5 minutes after the drug administration. There was a significant difference between the two groups in terms of satisfaction (P value = 0.022), where group A had 100% high satisfaction while group B had 87.5% high satisfaction and 12.5% ​​had moderate satisfaction. Of the 80 patients in the study, 3 patients had tearing complications after medication administration, which resolved after 5 minutes, and one case had nasal mucosal anesthesia, which improved after 15 minutes.

According to the results of this study, the use of 5% intranasal lidocaine spray is as effective as 10% intranasal lidocaine spray in relieving headache in traumatic patients and was associated with greater satisfaction and fewer complications.

Idiopathic intracranial hypertension (IIH) is characterized by elevated cerebrospinal fluid pressure without space-occupying lesions, infections, or alterations in brain parenchyma. Diagnosing IIH in children poses a significant challenge for pediatricians, given the often nonspecific nature of clinical signs and symptoms.

Our study aims to evaluate the clinical presentations and potential risk factors among pediatric individuals diagnosed with IIH, considering the limited research in this particular domain.

Clinical data from pediatric patients diagnosed with IIH who sought care at Tehran's primary referral children's hospitals were collected from 2013 to 2021, spanning eight years. These patients were subsequently contacted to follow up on the presence of persistent headaches and visual problems. Detailed records of their initial signs and symptoms were documented. To identify prognostic factors associated with persistent headaches and visual problems in pediatric IIH patients, binary logistic regression analysis was conducted.

A total of 81 pediatric patients were included in the study, with a mean age of 13.56 ± 4.404 years at the time of their IIH diagnosis. The most frequently reported clinical symptom among these patients was headache, observed in 85.2% of cases, followed by diplopia (50.6%), visual impairment (46.9%), and nausea with/without vomiting (44.4%). Furthermore, a substantial proportion of the patients were underweight (weight percentiles < 3). Our analysis showed that male patients and those without strabismus experienced significantly more recurrent episodes of IIH (P = 0.013 and P = 0.013, respectively). Notably, recurrent episodes and higher weight percentiles emerged as predictive factors for future persistent visual problems within our study population (P = 0.032 and P = 0.045, respectively).

Recurrence of IIH was significantly less in female patients and those with strabismus. Additionally, we found that both lower and higher weight percentiles, as well as the occurrence of recurrent episodes, served as predictive factors for the development of persistent visual problems. However, our model could not predict persistent headaches.

Temporomandibular joint disorders (TMJD) can cause joint pain, trismus, and headaches, which negatively impact people's quality of life and may lead to a decrease in educational level among students. Thus, this study aimed to investigate the symptoms of TMJD among students at Isfahan Azad Dental Faculty.

This descriptive-analytic study involved 62 students from Isfahan Azad Faculty of Dentistry. Pain intensity (cephalic, joint, muscle) was evaluated using the VAS scale. After completing the evaluation of the students and registering the information in the relative checklist, data were analyzed using Exact Fisher and chi-square statistical tests(α=0.05).

The study found that students with headaches did not have a higher incidence of restriction in opening their mouth and joint pain. However, students with headache had lower rates of joint noise (p = 0.04). The age of students was not related to TMD (p>0.05), and gender was not related to joint noise (p= 1.00) and joint pain (p= 0.70). The malocclu-sion status of students was not related to TMD. Parafunctional habits were related to head-aches among students (p< 0.001).

Severe headaches were common among studied students which could be related to temporo-mandibular joint disfunction as it was related to parafunctional habits. TMD symptoms were not related to age, gender (except for mouth opening restriction) and occlusion class type
.

Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with variable symptoms and complications which is often misdiagnosed at initial manifestations. SIH results from spontaneous CSF leakage leading to brain sag. The typical findings on cranial MR imaging consist of subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, and sagging of the brain. Subdural hematoma may occur as a result of tearing of bridging veins and usually develop into chronic subdural hematoma. The majority of patients with SDH due to SIH have chronic DSH and, therefore, rarely present with neurological deficits. Evacuation of SDH may be performed for large SDH with ME (mass effects), or when dilated or asymmetric pupil is present. However in most cases, evacuation of the hematoma is not necessary and may result in worsened outcomes. The epidural blood patch (EBP) is a treatment of choice. Fortunately, most of these subdural hematomas can be handled with treatment directed at the underlying spinal CSF leak without the need for surgery. We report the case of 42-year-old man with the chief complaint of orthostatic headache. He was admitted to neurology ward and after imaging studies, it was found that he has bilateral subdural hematoma. Due to the lack of history of trauma, underlying disease, and coagulation disorder, and considering the imaging findings, the patient was referred to the pain department to perform an epidural blood patch. After performing the epidural blood patch, the patient's pain was relieved immediately, and during a three-month follow-up period, the epidural hematoma was completely absorbed. Spontaneous intracranial hypotension (SIH) is a highly misdiagnosed and underdiagnosed disorder and requires a high index of suspicion for diagnosis. During the last decades, a much larger number of spontaneous cases are identified. Literature is a bit confusing, with some authors recommending evacuation of subdural fluid in cases of deteriorating consciousness and few others recommending EBP first even in patients with comatose state but epidural patch is often an important part of treatment.

Migraine is recognized as the second most disabling disease in the world, accompanied by Bell's palsy, hearing loss, and cerebral nerve paralysis. Therefore, this study aimed to evaluate the effect of dietary triggers on the exacerbation of migraine headaches for the first time in Hormozgan province, Iran.  Individuals were randomly selected from the population of migraine patients referred to the hospital of Shahid Mohammadi in Bandar Abbas (located in southern Iran). A two-stage questionnaire was used, including demographic information and dietary habits of individuals with migraines, containing six types of drinks, 11 types of food, and a fasting diet. This study examined 200 individuals, including 66.5% women and 33.5% men. The age range of participants was from 13 to 66 years old, and the mean age of the study population was 31.42 years. Fasting showed the highest headache exacerbation, followed by coffee, alcoholic beverages, and high-fat foods. The least stimulating type can be attributed to non-alcoholic carbonated and soft drinks. Nuts and walnuts (good sources of omega-3) seemed to be the least irritating among the population, although citrus fruits were not significantly different.  Based on the results, all migraine patients should avoid fasting strictly, keep their sugar levels balanced, and prevent excessive consumption of alcohol and caffeine. The results of subsequent studies will clarify the effect of these two substances on headaches.

There is no definite recommendation for melatonin supplementation in episodic migraine. This study aimed to evaluate the effect of melatonin on reducing the frequency and severity of migraine attacks. This randomized, double-blind clinical trial was conducted at Golestan Hospital of Ahvaz, Iran, in 2021. A total of 60 patients with episodic migraine were randomly assigned into 2 groups of receiving 3 mg melatonin (intervention group; n=30) or the same dose of placebo (control group; n=30) along with baseline therapy (propranolol 20 mg, BID) for two months. The attack frequency, attack duration, attack severity (based on VAS), the number of analgesic intakes, drug complications, Migraine Disability Assessment score (MIDAS), and Pittsburgh sleep quality index (PSQI) were evaluated at baseline and in the first, second, third, and fourth months of follow-up. The independent t test, chi-square, and analysis of variance (ANOVA) with repeated measures were used to compare variables between the two groups.  In both groups, the frequency, duration, and severity of attacks, taking analgesics, MIDAS, and PSQI scores during follow-up decreased significantly (P<0.001). After treatment, the mean frequency (P=0.032) and duration of attacks (P=0.001), taking analgesic (P<0.001), and MIDAS (P<0.001) and PSQI scores (P<0.001) in the melatonin group were lower than placebo. Only the attack severity was not significantly different between the two groups (P=0.126). Side effects were observed in two patients (6.7%) in the melatonin group and one patient (3.3%) in the placebo group (P>0.999). Our study shows that melatonin was more efficacious than the placebo in the reduction of frequency and duration of migraine attacks. It was equally safe as the placebo and might be effective in the preventive treatment of episodic migraine in adults.Trial registration number: IRCT20190107042264N5.

The objective of this review is to conduct a thorough analysis of the utilization of acupuncture as a non-pharmacological method for managing pain, with a specific focus on its effectiveness in addressing chronic musculoskeletal pain and headaches.

Method and Materials:

 A comprehensive search was conducted on electronic databases such as PubMed and Google Scholar to identify relevant studies published until January 2024. The search employed keywords such as "acupuncture," "acupuncture mechanism," "headache," "musculoskeletal pain," and "pain management." Studies were included if they assessed the use of acupuncture in different clinical populations and reported outcomes related to pain intensity, functional status, and cost-effectiveness. Ultimately, a total of 6 articles were selected for the final analysis.

The studies included in this review encompassed a diverse range of patient populations, specifically focusing on individuals who received acupuncture treatment. The findings indicated that acupuncture was associated with improved pain control and reduced reliance on medication among patients suffering from chronic musculoskeletal pain and headaches. Additionally, one study demonstrated the long-term cost-effectiveness of utilizing acupuncture in this manner..

The results of this review provide support for the implementation of acupuncture as part of non-pharmacological approaches in clinical settings. Future research should concentrate on identifying the most effective combinations of acupuncture and standard care, as well as elucidating the mechanisms that underlie the synergistic effects of this treatment modality.

Migraine is a common, painful and, in severe and chronic cases, debilitating disease characterized by frequent, unilateral and pulsating attacks with moderate to severe intensity, sensitivity to light, nausea or vomiting. The aim of this study was to investigate the effectiveness of Transcranial Direct Current Stimulation [tDCS] on headache sign and sleep quality in migraine patients.

Method and Materials: 

The current research design was a semi-experimental type of pre- test, post-test with 2-week follow-up. The statistical population of this study was all patients suffering from migraine in Yazd city, a sample of 30 people was selected using the available sampling method and they were placed in two experimental and control groups by random sampling. The tools used in this research were Ahvaz Migraine Questionnaire and Pittsburgh Sleep Quality Questionnaire. The tDCS treatment method included 5 sessions of 20 minutes with a current of 2 mA .The data were analyzed using the analysis of covariance method.

The results showed that there is a significant difference between the experimental and control groups in the scores of headache sign and sleep quality in the post-test and follow-up [p<0/01].

The study showed that tDCS treatment has an effective role in improving headache sign and sleep quality.

Infantile colic is a prevalent issue within the first three months of life. Research indicates that children of mothers who suffer from migraines are more than twice as likely to experience colic.

The aim of this study was to explore the association between a history of maternal migraines and the occurrence of infantile colic.

A case-control study involving 154 infants who visited the Rafsanjan Pediatric Clinic in 2022 was conducted. The participants were selected through convenience sampling and categorized into two groups based on the Wessel criteria for colic: Infants with colic (n = 77) and those without (n = 77), ensuring they were matched for age and sex. Data were collected using a questionnaire designed by the researchers, which gathered information on the mother and infant’s age, the infant’s sex, number of pregnancies, gestational age, birth weight, method of feeding, paternal history of migraines, and maternal fulfillment of the International Headache Society’s migraine criteria.

The analysis revealed that a history of maternal migraines was significantly more common in infants with colic than in the control group (Odds Ratio [OR]=6.17, P < 0.001). Further, multivariable logistic regression analysis, after adjusting for potential confounders, indicated that a maternal history of migraines increased the likelihood of infantile colic fivefold (OR = 5.008, 95% confidence interval: 2.258 to 11.104, P < 0.001).

This study confirms a significant association between maternal migraines and infantile colic, suggesting that maternal migraines could be a risk factor for colic in infants.

Postpartum headache is a common emergency department complaint with a wide differential diagnosis. Distinguishing primary from secondary, more sinister, causes of headache is an important skill for the emergency physician.
We present a case of a 31-year-old G1P1womanwho presented at five days postpartumwith a 48-hour headache and an otherwise uncomplicated pregnancy. She had several precipitating postpartum risk factors, including use of hypotonic fluids in labour, oxytocin to augment labour, changes in food and drink patterns, and was mildly hypertensive. Urgent investigations in the emergency department found her to be severely hyponatremic (sodium: 121 mmol/L (normal: 136-144)) without evidence of preeclampsia. She was admitted to hospital to correct her electrolyte imbalance. This case highlights the importance of remaining vigilant in differentiating concerning causes of postpartum headache, as well as identifying key precipitants which may put women at risk for postpartumhyponatremia.

Temporomandibular disorders (TMD) include a number of clinical conditions involving the masticatory muscles, temporomandibular joint (TMJ), and adjacent structures. The main feature of TMD is pain. According to past studies, TMD can have genetic causes. One of the genes that seems to be important in this regard is COMT. This study aims to compare the effect of COMT gene polymorphism rs4680 on the occurrence of simultaneous head, neck and back pain in patients with TMD.

This study was conducted as a case-control study on patients aged between 18 and 65 with TMD disorder. After meeting the conditions for entering the study, a written informed consent was obtained from the people participating in this project. Then a blood sample of 5cc was prepared from each person and poured into tubes containing EDTA anticoagulant and used for DNA extraction and identification. The COMT gene was sent to the genetics laboratory and was compared in terms of the polymorphism of the COMT gene using the PCRARMS technique.

The sample size was 100 people aged 18 to 65 years. Variables with normal distribution were analyzed with Chi-Square test and variables with non-normal distribution with Mann-Whitney test. After genetic analysis in terms of rs4680 gene polymorphism, 18 people (18%) were identified with AA, 80 people (80%) with GA and 2 people (2%) with GG. “temporal headache in the last 30 days”, “temporal headache change with chewing hard foods”, “temporal headache change with opening the mouth or moving the jaw forward or to the sides”, “ Temporal headache changes with jaw habits such as teeth touching, pressing or grinding teeth together, chewing gum “, “ Temporal headache changes with jaw activities such as talking, kissing or yawning “, “ having Back pain during the last 4 weeks”, having pain in the arm, leg, joints (neck) during the last 4 weeks”, “headache during 4 last weeks” and “time of onset of headache in the temporal region” did not have significant relationships with COMT gene polymorphism rs4680 in patients with TMD. (repectively, p value=0.873، p value=0.658، p value=0.518 p value=0.685، p value=0.884،p value=0.654، p value=0.723، p value=0.831، p value=0.692).

According to previous studies, there is a significant relationship between rs4680 polymorphism in the COMT gene and the occurrence of temporomandibular disorders (TMD), although in our study, no significant relationship was found between headache and neck and back pain with this polymorphism.

Headache has been a common problem for humans since ancient times. The aim of this study was to investigate the prevalence of ear, nose, and throat diseases in patients with headache.

In this descriptive cross-sectional study, we reviewed medical records of 100 patients presenting with headache to the ENT clinic of Imam Khomeini Hospital in Urmia, Iran, between 2019 and 2021. The type of headache (primary or secondary) was diagnosed based on medical history, clinical examinations, and paraclinical examinations (CT scan) and completion of a checklist for each patient. Chi-square and independent t-tests were used to analyze data. The p value < 0.05 was considered significant.

Of 100 patients, 58 (58%) had primary headaches with a mean age of 1.72 ± 4.77 years, and 42 (42%) had secondary headaches with a mean age of 5.57 ± 1.43 years (p < 0.01). There was a significant difference in the type of headache and location of pain in patients except for the back of the head and the top of the head (p < 0.05). Of the 58 patients with primary headaches, 26 (44.8%), and of the 42 patients with secondary headaches, 10 (23.8%) woke up from sleep due to headache (p < 0.03). Of the 58 patients with primary headaches, 38 (65.5%), and of the 42 patients with secondary headaches, 12 (28.6%) had their headache worsened by light and noise (p < 0.001).

Of all patients, 42% had secondary headaches, which most commonly had symptoms of sinus pain. These patients were treated by an otolaryngologist. Patients with non-sinus headaches were referred to a neurologist.