Cephalalgia : an international journal of headache
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Review Case Reports
Nummular headache: peripheral or central? One case with reappearance of nummular headache after focal scalp was removed, and literature review.
Nummular headache, or coin-shaped cephalagia, is defined as a mild to moderate, pressure-like pain that is felt exclusively in a circumscribed area. More than 200 cases of nummular headache have been reported since it was defined in 2002, but the pathogenesis remains unclear. ⋯ Our case and evidence from the literature review support the peripheral mechanism of nummular headache. Nummular headache might be a local pain disorder stemming from terminal branches of a sensory nerve and could induce peripheral sensitization in one or several primary sensory neurons.
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Review
Migraine and vascular diseases: a review of the evidence and potential implications for management.
The higher-than-expected incidence of vascular diseases reported in migraineurs suggests that migraine may, in some cases, be a dangerous condition rather than just a distressing but harmless disorder. We provide a systematic review of data linking migraine to vascular diseases. ⋯ Forthcoming guidelines should appropriately recommend supporting migraineurs not only with measures aimed at decreasing headache frequency, thus improving quality of life, but also with general measures and preventive strategies aimed to reduce the overall vascular risk. In fact, headache specialists should take care not only of relieving pain but also of assessing and treating concurrent vascular risk factors, while gynecologists, in particular, should routinely consider the presence and type of migraine before prescribing oral contraceptives.
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Olfactory hallucinations (phantosmias) have rarely been reported in migraine patients. Unlike visual, sensory, language, brainstem, and motor symptoms, they are not recognized as a form of aura by the International Classification of Headache Disorders. ⋯ We propose that olfactory hallucinations are probably an uncommon but distinctive form of migraine aura, based on their semiology, timing and response to headache prophylaxis.
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Patients with chronic or difficult to treat headaches are generally under the care of general practictioners or neurologists in private practice. Some are referred to a headache specialist for evaluation and advice. ⋯ This is called integrated headache care. This review summarizes experiences in integrated headache care settings in Europe and the USA, describes these settings, and reports outcome data.
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The objective of this systematic review was to assess the effectiveness of spinal manipulations as a treatment for migraine headaches. ⋯ Current evidence does not support the use of spinal manipulations for the treatment for migraine headaches.