Headache Medicine

Headache as the most prevalent post-vaccination adverse event after Covid-19 vaccination

Thu, 08 Feb 2024 00:00:00 +0000

Context: In 2020, the first vaccines were approved, according to the WHO. However, 
speculations have arisen regarding its efficacy and post-vaccination adverse events (AEFI). 
Objective: To evaluate the prevalence of headache as AEFI from the SARSCoV-2 vaccine in Piauí, 
Brazil.
Methods: This is a quantitative, observational, cross-sectional and prevalence study. 
The data were provided by the Post-Vaccination Adverse Events Information System (SI-AEFV),
 of cases reported in the period from January to September 2021. 
The data were analyzed and the research was approved by the Research Ethics Committee of the UFPI. 
Results: 2,008 cases were analyzed. Headache was reported in 752 cases (27.99%) as AEFI after vaccination 
against SARS-CoV-2. In most cases, the patients were from Teresina (67.62%), of mixed race/ethnicity (52.67%), 
female (79.00%) and the majority were not healthcare professionals (54. 27%). The most common age of patients, 
with the original data, was 33 years old. After correcting the data, the most common age was 28 years old. 
The majority of these cases were not serious (96.44%) and the majority of cases were associated with the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine (43.18%). Conclusion: Thus, it is concluded from the partial analysis of the results that headache is the most common adverse event after vaccination against SARS-CoV-2. The profile of patients with the most notifications was mixed-race women aged between 30 and 40 years who received the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine. Regarding the severity of the events, the vast majority were considered non-serious and no deaths were mentioned, demonstrating the safety of immunobiologicals.

Fibromigraine: A cohort study retrospective

Tue, 26 Mar 2024 00:00:00 +0000

Objectives
To diagnose fibromyalgia in patients with migraine and assess the quality of life of these patients.
Patients and Methods
A prospective, cross-sectional study was carried out, comparing groups, in a non-randomized sample, consisting of patients diagnosed with migraine. The sample was evaluated using the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) questionnaires to diagnose fibromyalgia. Quality of life and level of depression were assessed, respectively, using the Headache Impact Test-6 (HIT-6) and Patient Health Questionnaire-9 (PHQ-9).
Results
We interviewed 100 patients (5 men and 95 women) diagnosed with migraine, with a mean age of 37.1±11.0 years, ranging from 19 to 64 years. Thirty-four patients (34%) had migraine and fibromyalgia concomitantly. Migraine predominated in females, both in the presence and absence of fibromyalgia. In both groups, there was no difference in headache characteristics. In the group with fibromyalgia, there was a predominance of allodynia and a higher PHQ-9 score (p<0.001).
Conclusions
Patients with migraine are more predisposed to depression when there is an association with fibromyalgia.

Executive and attentional functions in patients with migraine

Tue, 27 Feb 2024 00:00:00 +0000

Abstract

Introduction: Migraine is a disease that affects the overall performance of the patient (especially Executive and attention functions) with a direct impact on the person's functionality, highlighting the importance of studies in order to minimize its damage. Objective: This study aimed to relate Executive and Attentional Functions with migraine, through neuropsychological tests. Methodology: Cross-sectional study (44 subjects; 29 migraineurs and 15 non-migraineurs) on attentional and executive changes in migraine. Subjects over 18 years of age were included in the study, regardless of gender, recruited for convenience at CAM FAME, FAME and Centro AMA, following the criteria of the International Classification of Headache Disorders (ICHD-3). The subjects underwent neuropsychological tests that estimated executive and attentional functioning. For attention, the Psychological Attention Assessment Battery (BPA) was used, and for Executive functions, the Five-Digit Test (FDT) was used. Student's T test, ANOVA, Mann-Whitney and/or Kruskal-Wallis U test were used, whose analyzes fixed the type I error at 0.05. Results: All BPA subtests pointed to a reduction in the attentional potential in migraine patients when compared to the control group. The FDT showed lowering in the group of subjects with migraine, when compared with the non-migraine group (inhibition = 0.3092; flexibility = 0.2323). Multivariate analysis identified a relationship between EF, Attention and migraine (p<0.05). Conclusion: Individuals with migraine present a decrease in EF and Attentional Skills and an increase in execution time when compared to non-migraine individuals.

Keywords: Headache, Migraine, Executive Functions, Attention.

Profile of hospital admissions for migraine and other headache syndromes in children and adolescents in Brazil between 2013 and 2023

Raimundo Pereira Silva-Néto, Bianca Piloni, Luan Almeida (Author) — Sun, 31 Mar 2024 00:00:00 +0000

Introduction: Migraine is a chronic neurological disease, with a prevalence of 15.2% in Brazil. It is defined as an abnormal neurovascular reaction that occurs in a genetically vulnerable individual. Clinically manifests itself in recurrent episodes of headache associated with other symptoms, dependent on triggering factors. Objective: To describe the epidemiological profile of hospital admissions of children and adolescents for migraine and other headache disorders. Methods: This was a retrospective and descriptive epidemiological study carried out with data extracted from the Brazilian Unified Health System's Hospital Information System (SIH/SUS), indexed to the Department of Informatics of the Unified Health System (DATASUS). Hospital admissions were selected based on age groups, with an emphasis on children under nine years old and adolescents between 10 and 19 years old, residing in Brazil, between July 2013 and June 2023. Results: Of 93,821 hospital admissions, there were 16,149 hospitalizations (17.2%) of children and adolescents (62.5% women and 37.5% men) due to migraine and other headache disorders. There was a predominance of the age group between 15 and 19 years old (50.2%), with a higher number of cases in the Southeast region (35.9%) and of brown ethnicity (42.6%). Over 10 years, there was a progressive increase in the number of hospital admissions, reaching a peak in 2019 (1,925/16,149; 11.9%), followed by a decline in 2020 and increasing again in subsequent years. Twenty-four deaths were found (24/16,149; 0.1%), 13 men and 11 women, with a predominance in the age group of 15 to 19 years (45.8%), coming from the Northeast region (58.3 %) and of brown ethnicity (58.4%). Deaths occurred predominantly in the years 2022 and 2023 (46.6%). Conclusions: There is an increase in the number of hospital admissions of children and adolescents due to migraine and other headache disorders with a consequent increase in the number of deaths.

Could scalp pain be a type of unclassified headache?

Raimundo Pereira Silva-Néto, Denise Evelyn Machado de Almeida (Author) — Sun, 31 Mar 2024 00:00:00 +0000

The scalp is the structure that covers the skull. It is commonly affected by painful processes resulting from infestations, infectious or inflammatory diseases. This pain located in the scalp does not have well-defined clinical characteristics and is not yet included in the ICHD-3 diagnostic criteria. The authors suggest including this pain in the next classification of headaches as a headache attributed to a scalp disorder.

Unlocking Insights: Harnessing AI for Headache Awareness and Understanding

Sun, 31 Mar 2024 00:00:00 +0000

Bilateral tonic pupil during a migraine attack: a case report.

Thu, 28 Mar 2024 00:00:00 +0000

Tonic pupil or Adie's pupil occurs due to parasympathetic denervation, and it is characterized by mydriasis with little or no response to light, with pupillary contraction to accommodation. It is caused by eye pathologies, such as infections, trauma, neoplasms, inflammatory diseases, and systemic diseases with autonomic dysfunction. Few cases have been reported of bilateral tonic pupils associated with migraine attacks. Our aimed to describe the case of a young female patient with a history of chronic migraine without aura, who presented acutely with bilateral pupillary mydriasis during a migraine attack, characterized as tonic pupil, and to discuss the possible causes of mydriasis during a migraine attack.

Continuous Unilateral Cephalalgia Due to Systemic Lupus Erythematosus: A Case Report

Lucas Teixeira, Matheus Cruz (Author) — Thu, 28 Mar 2024 00:00:00 +0000

Background
Hemicrania continua is a rare form of cephalalgia featuring a chronic and persistent headache in only one side of the head.
Objectives
In this report, we present a case of a patient with hemicrania continua and systemic lupus erythematosus (SLE).
Methods
We collected patient data through the electronic medical record. Afterward, we reviewed the literature regarding hemicrania continua and its pathophysiology and correlation with neurovascular alterations, inflammation, and SLE.
Results
A 42-year-old woman visited the emergency department due to worsening constant unilateral cephalalgia that had been present for the past 6 months. The patient reported a highly intense (10/10) headache in the entire left hemicrania that radiated to the left shoulder. During physical examination, she presented with nystagmus, vertigo, and aggravated cephalalgia associated to body movement and, despite having no optic nerve thickening. In addition, she had jaundice, tachycardia, and splenomegaly. Complimentary exams found deep anemia, depletion in complement system and anti-nuclear factors, suggesting a possible hemolytic anemia (AIHA) due to SLE. Treatment was initiated with hydrocortisone and prednisone, associated with amitriptyline, fluoxetine and diazepam, reaching full remission. These syndromes have aggravated each other, and possibly the explanation for the cephalalgia remission was the control of AIHA and SLE. It features a rare case in literature and thus warrants discussion.

Internal carotid artery dissection associated with acute dengue virus infection: a case report

Annelise Akemi Higa Lee, Ana Carolina Montouro Stoarri, Renan Domingues (Author) — Thu, 28 Mar 2024 00:00:00 +0000

Cervical artery dissections (CAD) can occur spontaneously or as a direct result of significant trauma. Viral infections, such as SARS-CoV2, influenza, and Epstein Barr, are risk factors for spontaneous CAD. Dengue virus infections have dramatically increased in recent decades, and Brazil is one of the endemic areas. The dengue virus can cause headache and neurological complications such as encephalitis, myelitis, Guillain-Barré syndrome, and myositis. No report has yet been found in the literature of dissection of the internal carotid artery secondary to dengue infection. Our objective is to report the case of a patient with dissection of the internal carotid artery associated with acute dengue virus infection.

Hypertension and Migraine: A Bibliometric Analysis

Heba Ramadan (Author) — Tue, 26 Mar 2024 00:00:00 +0000

Introduction

Hypertension, or high blood pressure, is a common and serious health issue. It has no specific symptoms, and for that, it is called the silent killer. Migraine attacks may be alarming for those with hypertension.

Objective

This review aims to analyze the trending publications concerning hypertension and migraine.

Methods

This bibliometric analysis analyzed the trending publications about hypertension and migraine. The Scopus database was used, and the bibliometric analysis was applied to show the most productive authors, the journals that most contributed in this field, countries, institutions, and keywords used. Hypertension and migraine showed elevated growth in the published articles throughout the years.

Results

For the last ten years, from 2013 to 2022, there has been a dramatic increase, especially in the last few years in publications related to hypertension and migraine. The highest number of publications were in the United States, the most productive authors being Dodick, D.W. and Pezzini, A., Harvard Medical School had the most published articles; and Headache journal was on the top 10 journals that had publications on this subject.

Conclusion

Migraine is recently considered a sign of hypertension, and this bibliometric analysis focused on the remarkable interest that has appeared in the research community.