Adult ; Carotid Artery, Internal ; pathology ; physiopathology ; Headache ; pathology ; physiopathology ; Humans ; Male ; Migraine Disorders ; pathology ; physiopathology

Two cases of special intracranial otogenic complications were analyzed in the aspects of clinical characteristics, diagnosis and therapy. We concluded that for patients with huge cholesteatoma which damaged the bone of skull base, or chronic otitis media patients with sharp deterioration in symptoms, accompanied by headache and fever, we should promptly do the enhanced magnetic resonance to avoid the missed diagnosis of intracranial complications.
Cholesteatoma ; diagnosis ; physiopathology ; Chronic Disease ; Headache ; Humans ; Otitis Media ; diagnosis ; physiopathology ; Skull Base ; pathology

OBJECTIVETo investigate the masseter inhibitory reflex (MIR) and its eventual changes in patients with episodic tension-type headache (TTH).

METHODSMIR was studied in 21 patients with episodic TTH and 30 healthy subjects, with age and sex matched to the study cohort. Median age of patients was 17.0 years (ranged 16~49 years), median duration of disease 12 months (1~5 years), and median frequency of headache 7.5 d per month.

RESULTSThe second period of suppression (S2) of MIR was reduced in intensity and duration in 10% of controls and 66.7% (confidence interval (CI)=45.3%~85%; P<0.05) of patients with episodic TTH (chi(2)=74.9; P<0.001). In 3 (14.3%) of patients with episodic TTH, S2 was completely absent. No significant correlation between the duration of disease and headache frequency was found.

CONCLUSIONOur results confirm the link between episodic TTH and reduction or absence of S2. Teenage patients with episodic TTH may exhibit marked pathological changes in S2 in contrast to older individuals.

Adolescent ; Adult ; Cluster Headache ; physiopathology ; Female ; Humans ; Male ; Masseter Muscle ; physiopathology ; Middle Aged ; Neural Inhibition ; Reflex ; Tension-Type Headache ; physiopathology ; Young Adult

We reported a rare case of a dialysis patient coincident pituitary prolactinoma with calcification. A 55-year-old woman who had undergone hemodialysis for 8 years was admitted to the nephrology unit because of headache, blurred vision, and hypotension. Physical examination was normal; endocrinological examination demonstrated elevated serum levels of prolactin (> 4240 mIU/L), but other hormonal profiles, such as growth hormon, adrenocorticotropic hormone, thyroid stimulating hormone, free triiodothyronine, free thyroxine, follicle-stimulating hormone and luteinizing hormone, were absolutely or relatively lower. A cranial computed tomography (CT) suggested saddle area a high-density screenage with an anteroposterior diameter of 1.0 cm. A cerebral magnetic resonance scan confirmed the pituitary adenoma accompanied with calcification. Contrast-enhanced T1-weighted images revealed a less enhancing tumor, 14 mm wide round lesion with a high intensity signal. It enlarges the sella turcica, but the optic chiasma is not displaced. We suggest that in the differential diagnosis of any hemodialysis patient with severe headache, hypotension, and visual disturbances, this syndrome should be considered as prompt pituitary adenoma.
Female ; Headache ; parasitology ; Humans ; Middle Aged ; Pituitary Neoplasms ; diagnosis ; physiopathology ; Prolactinoma ; diagnosis ; physiopathology ; Renal Dialysis ; Vision Disorders ; pathology

Insomnia is the most common sleep complaint encountered in primary care. It affects both the individual and society through the burden of medical, psychiatric, interpersonal and social consequences. The management of patients affected by insomnia depends on the accurate diagnosis of the condition, consideration of the possible aetiologies, the duration of the insomnia and its impact on both the individual and society. Herein, we discuss the appropriate management of insomnia in the community.
Headache ; diagnosis ; Humans ; Sleep ; Sleep Initiation and Maintenance Disorders ; diagnosis ; physiopathology ; psychology

OBJECTIVETo explore the better therapy for chronic tension-type headache (CTTH).

METHODSTwo hundred and eighty-eight cases were randomized into a sticking needling group (150 cases) and an acupuncture group (138 cases). In the sticking needling group, the manual sticking needling technique was adopted to stimulate the galea tendon-muscle node. In the acupuncture group, the conventional acupuncture therapy was applied to Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Taiyang (EX-HN 5), Touwei (ST 18), Hegu (LI 4), etc. The treatment was given once a day, and 30 days made one session. After two sessions of treatment and after three months follow-up, CTTH score (including the score of headache attack frequency and the score of headache severity) was observed and compared before and after treatment separately. The efficacy was evaluated in two groups.

RESULTSCTTH score was all reduced after treatment in the two groups (both P<0.01), the score in the sticking needling group was lower than that in the acupuncture group (2.38 +/- 1.22 vs 4.16 +/- 2.54, P < 0.01). The effective rate was 97.3% (146/150) in the sticking needling group, which was better than 88.4% (122/138) in the acupuncture group (P < 0.05).

CONCLUSIONThe manual sticking needling technique at galea tendon-muscle node achieves the superior results of reducing the pain attack frequency and severity of CTTH as compared with the acupuncture therapy of the routine acupoint selection.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Muscles ; physiopathology ; Tendons ; physiopathology ; Tension-Type Headache ; physiopathology ; therapy ; Treatment Outcome

A 54-year-old man presented with change in behaviour, nocturnal enuresis, abnormal limb movement and headache of one week's duration. The diagnosis of butterfly glioma (glioblastoma multiforme) was made based on imaging characteristics and was further confirmed by biopsy findings. As the corpus callosum is usually resistant to infiltration by tumours, a mass that involves and crosses the corpus callosum is suggestive of an aggressive neoplasm. Other neoplastic and non-neoplastic conditions that may involve the corpus callosum and mimic a butterfly glioma, as well as associated imaging features, are discussed.
Aged ; Biopsy ; Brain Neoplasms ; diagnostic imaging ; Corpus Callosum ; diagnostic imaging ; Glioblastoma ; diagnostic imaging ; Headache ; physiopathology ; Humans ; Male ; Middle Aged ; Movement Disorders ; physiopathology ; Nocturnal Enuresis ; physiopathology

OBJECTIVETo evaluate the clinical efficacy of warming-needle moxibustion on cervical headache.

METHODSSixty-one patients of cervical headache were randomly divided into a warming-needle moxibustion group (30 cases) and an acupuncture group (31 cases). Tianzhu (BL 10), Fengchi (GB 20), Wangu (GB 12), Tianyou (TE 16), Hegu (LI 4), Taichong (LR 3) and Zulinqi (GB 41) were selected in the two groups. Patients in the acupuncture group were treated with acupuncture; patients in the warming-needle moxibustion group were treated with warming-needle moxibustion at Tianzhu (BL 10), Fengchi (GB 20) and Wangu (GB 12) and acupuncture at the remaining acupoints. The treatment was given once every other day, 3 times a week, and totally 4-week treatment was given. The duration and frequency of headache, numerical rating scale (NRS) of headache and cervical range of motion (ROM) were compared before and after treatment in the two groups; also the efficacy of the two groups was evaluated.

RESULTSAfter treatment, the duration and frequency of headache, headache NRS.and cervical ROM score were improved in both groups (all P < 0.05), which were more significant in the warming-needle moxibustion group (all P < 0.05). The total effective rate was 84.3% (25/30) in the warming-needle moxibustion group, which was significantly superior to 61.3% (19/31) in the acupuncture group (P < 0.05).

CONCLUSIONThe warming-needle moxibustion presents significant efficacy on cervical headache, which can obviously improve headache symptoms and cervical ROM.

Acupuncture Points ; Adult ; Cervical Vertebrae ; physiopathology ; Female ; Headache ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Neck Pain ; complications ; physiopathology ; therapy ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

BACKGROUNDFunctional neuroimaging study has opened an avenue for exploring the pathophysiology of cluster headache (CH). The aim of our study was to assess the changes in brain activity in CH patients by the regional homogeneity method using resting-state functional magnetic resonance imaging technique.

METHODSThe functional magnetic resonance imaging scans were obtained for 12 male CH patients with spontaneous right-sided headache attacks during "in attack" and "out of attack" periods and 12 age- and sex-matched normal controls. The data were analyzed to detect the altered brain activity by the regional homogeneity method using statistical parametric mapping software.

RESULTSAltered regional homogeneity was detected in the anterior cingulate cortex, the posterior cingulate cortex, the prefrontal cortex, insular cortex, and other brain regions involved in pain processing and modulation among different groups.

CONCLUSIONIt is referred that these brain regions with altered regional homogeneity might be related to the pain processing and modulation of CH.

Adult ; Case-Control Studies ; Cluster Headache ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To study the influence of endoscopic sinus surgery (ESS) on nasal airway resistance (NAR) of intranasal contact point headaches. METHOD: The NAR and nasal airflow sensation were measured with anterior rhinomanometry in 20 patients (40 sides) before and after the ESS. RESULT: A telephone follow-up six months after operation, 16 (85%) cases were cured, 3 (15%) were improved and 1 (5%) had no response and the effective rate was 95%. NAR decreased significantly after the operation. The change rates in NAR before and after the decongestion were (-0.34+/-0.23), (-0.75+/-0.21) and (-0.68+/-0.20), (-0.74+/-0.16) kPa x s/L, respectively, and there was a significant difference (P<0.05). CONCLUSION The improvement of nasal functions by ESS is due to the alteration of the anatomic structure of the nasal cavity and the amelioration of mucosal edema. The rhinomanometry can be used as a useful clinical tool in determining nasal patency.
Adult ; Airway Resistance ; Endoscopy ; Female ; Follow-Up Studies ; Headache ; pathology ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology