Headaches

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.

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.

There are two crucial issues in the treatment and management of headache patients: More than 50% of individuals experiencing headache have only been treated symptomatically, with no appropriate diagnosis established; and history and neurologic examination are essential to establishing a diagnosis, and thus selecting appropriate therapy. Headache and Migraine Biology and Management is a practical text that addresses these issues, featuring contributions from expert clinical authors. The book covers in detail topics including chronic and episodic migraine, post-traumatic headache, sinus headache, cluster headache, tension headache, and others. Chapters are also dedicated to treatment subjects, including psychiatric and psychological approaches, medication overuse, inpatient treatment, and pediatric issues. This book is an ideal resource for researchers and clinicians, uniting practical discussion of headache biology, current ideas on etiology, future research, and genetic significance and breakthroughs. This resource is useful to those who want to understand headache biology, treat and manage symptoms, and for those performing research in the headache field. A practical discussion of headache biology, current ideas on etiology, future research, and genetic significance and breakthroughs Features chapters from leading physicians and researchers in headache medicine Full-color text that includes both an overview of multiple disciplines and discusses the measures that can be used to treat headaches

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.

In this book, headache experts summarize all the currently available therapies for primary headaches and most importantly, describe the ‘tricks’ that can ensure the success of headache pharmacotherapy. Prevention and acute treatment of migraine and cluster headache receive particular attention and individual chapters are devoted to the treatment of primary headaches in special groups, i.e. children, pregnant women and the elderly. Further chapters focus on selected secondary headache disorders and cranial neuralgias for which pharmacotherapy is available. The book is designed to meet the daily practice needs of general physicians, general neurologists, neurologists in training and medical students. Headache remains a leading reason for people to seek medical consultation, and migraine and other primary headache disorders are classified by the WHO as among the most disabling medical conditions in the general population, often affecting individuals during their most productive years. Unfortunately, under treatment and mismanagement are the fate of many headache patients and this book provides a sound basis for optimizing treatment.

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.

Many people who suffer from headaches never consult a doctor, believing that no help is available, while others become frustrated and give up the search for relief. Fully revised and updated, this valuable book can save you time and trouble and help you stop the pain. It describes the full range of treatment options for migraines, cluster headaches, and tension headaches. It includes easy-to-understand information on the actions and side effects of hundreds of over-the-counter and prescription medications that prevent or abort headaches or dull the pain of a headache in progress. Special highlights: Details on the medications that have revolutionized migraine treatment Discussion of how hormones affect migraines Quick-reference guides to the medications that are most likely to work for your particular condition Helpful suggestions on how to describe your headache to your physician Hard-to-come-by information on headaches in children, teens, women, and people over fifty Alternative treatments, including herbs and acupuncture Self-help strategies such as relaxation techniques and biofeedback A national index of headache clinics and organizations