Headache

This book provides a detailed overview of the current state of knowledge regarding the pathophysiology of both primary headaches – migraine, tension-type headache (TTH), and cluster headache – and the very important and frequent type of secondary headache, medication overuse headache (MOH). After an introductory chapter describing relevant neuroanatomy and vascular anatomy, the evidence gained from animal models regarding the pathophysiology of migraine and the other primary headaches is reviewed. Knowledge of the genetic component in the different types of headache is then examined with reference to recent evidence, for example regarding the implication of the trigeminovascular system and cortical spreading depression in migraine. Detailed information is provided on insights into primary headaches from imaging studies, including functional magnetic resonance imaging and positron emission tomography and on their neurophysiology and biochemistry. A further series of important chapters describe present knowledge of the pathophysiology of each specific type of headache and consider future directions. Written by acknowledged experts in their fields from Europe and the United States, clinicians and students will find Pathophysiology of Headaches to be an excellent source of up-to-date information on why patients experience headaches. In addition, it will be of value for pain researchers investigating the underlying mechanisms of headache.

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.

Based on the breakthrough understanding that virtually all headaches are forms of migraine--because migraine is not a specific type of headache, but the built-in mechanism that causes headaches of all kinds, along with neck stiffness, sinus congestion, dizziness, and other problems--Dr. Buchholz's Heal Your Headache puts headache sufferers back in control of their lives with a simple, transforming program: Step 1: Avoid the "Quick Fix." Too often painkillers only make matters worse because of the crippling complication known as rebound. Step 2: Reduce Your Triggers. The crux of the program: a migraine diet that eliminates the foods that push headache sufferers over the top. Step 3: Raise Your Threshold. When diet and other lifestyle changes aren't enough, preventive medication can help stay the course. That's it: in three steps turn your headache problems around.

M. WILKINSON Patients with frequent or daily headaches pose a very difficult problem for the physician who has to treat them, particularly as many patients think that there should be a medicine or medicines which give them instant relief. In the search for the compound which would meet this very natural desire, many drugs have been manufactured and the temptation for the physician is either to increase the dose of a drug which seems to be, at any rate, partially effective, or to add one or more drugs to those which the patient is already taking. Although there have been some references to the dangers of overdosage of drugs for migraine in the past, it was not until relatively recently that it was recognized that drugs given for the relief of headache, if taken injudiciously, may themselves cause headache. The first drugs to be implicated in this way were ergotamine and phenazone. In the case of ergotamine tartrate, the dangers of ergotism were well known as this was a disorder which had been known and written about for many years. In the treatment of headache, fully blown ergotism is rare and in recent years has usually been due to self-medication in doses much greater than those prescribed although there are a few recorded cases where toxic amounts have been given.

This comprehensive, practical title invites all clinicians to take a fresh look at the evaluation and management of chronic daily headache (CDH). Developed by a distinguished international panel of experts, the book examines key social and economic issues around CDH and clarifies the diagnosis of CDH disorders, providing an understanding of the underlying biological substrates, offering guidance on the use of diagnostic testing and additional consultations, and outlining treatment strategies with the greatest potential to alleviate the burden of these patients and to provide the highest quality of care. The book fully examines the constellation of symptoms that constitute chronic daily headache, while also discussing the role of behavioral medicine and the important elements involved in taking a good history. The major forms and biology of chronic daily headache are covered, as is the role of diagnostic testing and treatment. The risk factors that lead patients to transform episodic primary headache disorders into the chronic form are examined. Invasive and neuromodulatory techniques are also discussed. A section on the classification of these disorders rounds out this important contribution to the literature. Chronic Headache – A Comprehensive Guide to Evaluation and Management will be of great interest to neurologists, primary care physicians, nurse practitioners, physician assistants, medical students, and other clinicians with an interest in chronic daily headache.

This volume describes the impact of headache disorders on public health, and their adverse consequences for society. It opens with an overview of relevant headache disorders before describing, qualitatively, how the burdens attributable to these disorders fall upon adults, adolescents and children. In the second section, beginning with a methodological introduction discussing the principles and potential pitfalls of epidemiological studies assessing prevalence, headache-attributed burden and functional impact, the burdens of headache including financial cost are examined quantitatively and in detail. The third section critically reviews society’s response, its inadequacies and the scope for improvement. Topics here include the political failure to recognize the public ill-health and cost that are the consequences of inadequate headache care; the role of the WHO in addressing the problem; headache service organization, delivery and quality; and the effectiveness and cost-effectiveness of interventions. The book closes by considering the way forward. This volume contains important messages for primary care and is likely to be of even greater interest to headache specialists and those concerned with public health and health policy.

Unmask the clinical complexity behind one of the most common neurological symptoms Headache is a common clinical complaint often overlooked by both sufferers and physicians that can be intimidating to approach and manage. Hundreds of different etiologies, both benign and life-threatening, may primarily feature the symptom, and diagnosis can therefore be challenging. Headache is a practical guide to headache medicine designed for both neurologists and general practitioners. Its expert author team introduces the principles of classification and diagnosis, and focuses in detail on the main classes of headache – migraine, tension-type and trigeminal autonomic cephalgias, including cluster headache. They also cover unusual headache disorders such as hemicrania continua and new daily persistent headache, and address the management of headache in women, children and the elderly. With a clinically focused practical approach, Headache draws on the experience of international specialists to help you diagnose and manage your patients more effectively.

Intended to promote a more appropriate and modern therapeutic approach to migraine management, this book is the first to deal with monoclonal antibodies in this context. Authored by the most respected migraine experts from around the globe and drawing on the lessons learned in both clinical trials and clinical practice, it reviews the current state of knowledge on this important therapeutic innovation, which has produced impressive data in randomized controlled trials, and the efficacy and safety of which have been confirmed in day-to-day real-world use. Given its scope, the book will appeal to a broad range of specialists, including pharmacologists, clinical pharmacologists, neurologists and internists, but also to residents and medical students.