Headache
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To examine headache and depression over time in individuals who sustained mild traumatic brain injury (mTBI). Prevalence of headache and depression early after mTBI and at 1 year postinjury as well as the relationship between the two are evaluated. ⋯ While prevalence of headache is consistently high over the first year after injury, rate of depression increased over the first year for those who were followed. Given the high rate of comorbidity, those with headache may develop depression over time. Evaluation for possible depression in those with headache after mTBI should be conducted to address both conditions over the year following injury.
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A new form of headache, Headache attributed to aeroplane travel (AH), has been recognized within the International Classification of Headache Disorders 3 beta (ICHD-3beta). In 8 out of 85 AH cases we identified the coexistence of a headache with identical features of AH, but appearing during the rapid descent by car from a high mountain. Pain began shortly after the rapid descent from a medium altitude of 1920 m above sea level, the maximum peak of intensity developing within a few minutes. All of the patients reported the disappearance of pain within 20 minutes of the rapid descent. ⋯ Headache attacks sharing the same features and occurring in three distinct conditions of pressure variations (aeroplane travel, rapid altitude mountain descent, snorkelling, or scuba diving) have already been reported, although the last two only anecdotally. If confirmed by further case series, they could be gathered together in a unique heading: Headache attributed to imbalance between intrasinusal and external air pressure within the 10th chapter: Headache attributed to disorders of the homoeostasis.
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Case Reports
A Motion Simulator Ride Associated With Headache and Subdural Hematoma: First Case Report.
We report the first case report of symptomatic bilateral subdural hematomas (SDH) associated with riding a centrifugal motion simulator ride. A previously healthy 55-year-old male developed new onset daily headaches 1 week after going on the ride that were due to symptomatic bilateral SDH requiring operative intervention with a full recovery. There was no history of other trauma or other systemic or intracranial abnormality to account for the development of the SDH. ⋯ The pathophysiology is reviewed, which we believe is the same mechanism that may be responsible in this case. Although it is possible that this neurovascular injury is truly rare, it is also possible that this injury is underreported as patients and physicians may not make the association or physicians have not reported additional cases. The risk of this injury likely increases with age, as the size of the subdural space increases, and may support the maxim that "roller coasters and simulators are for kids."
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Randomized Controlled Trial
Memantine for Prophylactic Treatment of Migraine Without Aura: A Randomized Double-Blind Placebo-Controlled Study.
Uncontrolled studies in human have suggested that memantine might be a suitable option for migraine prophylaxis. ⋯ Memantine might be a tolerable and efficacious option for prophylaxis in patients with migraine without aura. Tolerability, short duration required for titration, and safety profile in pregnancy might give memantine an advantage over other antimigraine medications. The study was registered in the Iranian Registry of Clinical Trials (Registration number: IRCT2013120115616N1).