High-altitude headache （HAH） is a type of headache associated with disorder of homoeostasis， and it often appears after ascent to 2 500 m or higher and resolves within 24 hours after descent to below 2 500 m. HAH may occur independently or in association with the onset of acute mountain sickness and chronic mountain sickness. This article describes the clinical features of HAH and discusses the possible pathogenesis， risk factors， preventive measures， treatment， and prognosis of HAH， in order to provide a theoretical basis for further research on HAH.
Headache

BACKGROUND

Polypharmacy in patients with chronic disease such as Migraine Headache poses potential harm in patients such that psychological distress may come in. In relation to psychological distress, Migraine Headache patients with multiple drug use are at increased risk of anxiety and depression.

The main objective of the study is to determine the association between anxiety and depression to polypharmacy in migraine headache patients by using the data in the PNA One Headache Database.

We utilized the data obtained from the Philippine Neurological Association One (PNA-1) Headache Database from 2021 to 2024 and determine the association between Anxiety and Depression to Polypharmacy in patients with Migraine.

The number of medications taken by patients does not significantly differ across depression and anxiety levels, indicating that polypharmacy has no impact on patient’s depression and anxiety. However, the study found that patients with anxiety have more tendency to report more severe headache.

The study highlights that participants, primarily middle-aged women, experience chronic headaches with high pain severity, often lasting for hours. Educational attainment may influence headache management compliance with a large proportion having only elementary education. Headache onset typically begins in early adulthood, and medication effectiveness often diminishes over time suggesting potential tolerance issues. Anxiety is associated with reporting of increased headache severity while depression does not significantly impact headache characteristics or polypharmacy. The findings emphasize the need for targeted interventions and revised treatment strategies to improve headache management outcomes.

This article reports the medical records of a patient with spontaneous internal jugular vein thrombosis manifesting as cough-induced headache who were diagnosed by digital subtraction angiography （DSA） in The Affiliated Hospital of Guizhou Medical University. The patient was a male individual aged 33 years and had the main clinical manifestation of bilateral frontal pain after severe coughing， with no headache during the interictal period. DSA showed occlusion of the left internal jugular vein， which suggested thrombosis； cranial MRI， cerebrospinal fluid examination， and D-dimer test showed no abnormalities； initial lumbar puncture showed an intracranial pressure of 330 mm H2O. Headache was improved after anticoagulant therapy and symptomatic treatment. This case report suggests that for patients presenting with cough-induced headache accompanied by high intracranial pressure， the possibility of jugular vein thrombosis should be considered in addition to the causes such as posterior fossa lesions， obstructive hydrocephalus， subdural hematoma， and jugular valve insufficiency， and jugular vein ultrasound should be performed to assist in diagnosis and facilitate timely anticoagulant therapy.
Headache ; Cough

Humans ; Post-Traumatic Headache/etiology* ; Risk Factors ; Cervical Vertebrae/surgery*

The articles involving Xiangju Capsules were retrieved, and qualitative research and quantitative research methods were combined to evaluate the evidence of the safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine( "6+1" dimensions) of this drug. Multi-criteria decision analysis(MCDA) model and CSC v2.0 software were used to comprehensively evaluate the clinical value of Xiangju Capsules in the treatment of rhinosinusitis and clarify the precise clinical positioning. The dimensions are graded A, B, C, or D. Multi-source safety evidence showed that the main adverse reactions were gastrointestinal reactions, rash, itching, dizziness, and headache. Based on the available studies, the risk is controllable and the safety is grade A. Meta-analysis showed that Xiangju Capsules + conventional western medicine could recover the Lund-Kennedy score, Lund-Mackay score, and CT score, relieve headache, nasal congestion, olfactory disturbance, and facial pain, with the effectiveness is grade B. The incremental cost-effectiveness ratio of Xiangju Capsules + conventional western medicine compared with conventional western medicine alone in the treatment of chronic rhinosinusitis was 263.71 yuan, about 0.82% of the per capita disposable income. The results of sensitivity analysis showed that the research results were relatively robust. Based on the assumption that the per capita disposable income in 2020 will be the threshold of patients' willingness to pay, it is more economical to use Xiangju Capsules + conventional western medicine. The drug belongs to grade A of the national medical insurance, with an average daily cost of 3.06 yuan, and the economy is grade B. This formula is modified from classic formulas and characteristic empirical formulas, be capable of improving immunity and preventing repeated attacks. It can be used for acute and chronic rhinitis-rhinosinusitis. It had a wide range of applicability, especially for the patients with head and face tenderness. Service innovation was reflected in the measures to guarantee supply, capacity, scalability, and coverage of grass-roots sales channels. The industrial innovation was improved through the management of medicinal resources, pharmaceutical industry, production technology, quality control, scientific research and development, and this formula won three national invention patents. Comprehensively, the innovation of Xiangju Capsules is grade B. According to the survey of 188 medical practitioners and 196 patients in 20 provinces, municipalities, and autonomous regions of China, the drug was characterized by easy preparation and administration, individualized medication, simple technology and management, convenient use, storage, and transport, and controllable adverse reactions, with the suitability is grade B. Xiangju Capsules showed the cost of 45.9 and 275.4 yuan for treatment of acute and chronic rhinitis-rhinosinusitis, respectively, being well affordable. It was sold in 35 000 medical institutions in China. The dosage form was suitable for transportation, storage, and grass-root application. With rich, sustainable, and available medicinal resources, the accessibility of Xiangju Capsules is grade A. This drug can be used for both acute and chronic rhinitis-rhinosinusitis, clearing heat and expelling pus, and strengthening the exterior to prevent relapse. After this drug was available on the market, over 4 000 cases were studied, with rich experience in human use accumulated, and characteristics of traditional Chinese medicine is grade B. Overall, the clinical value of Xiangju Capsules is class B. It is suggested that Xiangju Capsules should be used in accordance with the relevant policies of basic clinical drug administration to play its role.
Humans ; Rhinitis/drug therapy* ; Sinusitis/drug therapy* ; Medicine, Chinese Traditional ; Headache ; China ; Capsules

Headache is a common clinical complication of ischemic stroke. As a precursor of stroke, headache occurs repeatedly in the convalescent period of ischemic stroke, leading to secondary stroke and seriously hindering patients' rehabilitation. Currently, it is believed that the pathogenesis of ischemic stroke-related headache is associated with the abnormal release of vasoactive substances, high platelet aggregation, and stimulation of intracranial pain-sensitive structures. The active ingredients in traditional Chinese medicines(TCM) with the effects of activating blood to resolve stasis and clearing heat to release exterior can protect brain tissue and relieve headache by reducing the release of inflammatory cytokines, alleviating antioxidant stress, inhibiting neuronal apoptosis and so on. This paper introduces the research progress in the potential mechanism and TCM treatment of ischemic stroke-related headache, aiming to provide reference for further research and drug development of this complication.
Humans ; Ischemic Stroke/drug therapy* ; Brain Ischemia/drug therapy* ; Medicine, Chinese Traditional ; Stroke/drug therapy* ; Headache/drug therapy* ; Drugs, Chinese Herbal/therapeutic use*

Objective To analyze clinical characteristics of patients with neuropsychiatric systemic lupus erythematosus (NPSLE) and to explore the risk factors affecting the occurrence of NPSLE. Methods A total of 63 NPSLE patients and 61 non-NPSLE patients were enrolled. The clinical manifestations and laboratory examination data of the two groups were collected, and the disease characteristics of NPSLE were summarized to analyze the risk factors affecting the occurrence of NPSLE by multivariate Logistic regression. Results The most common clinical manifestations of NPSLE patients were headache (39.7%), affective disorder (33.3%) and cognitive impairment (30.2%), with cranial magnetic resonance abnormalities (63.5%) and a high cerebrospinal fluid protein positive rate (52.4%). Compared with non-NPSLE patients, there were significantly increased levels of Raynaud's phenomenon, renal involvement, anti-RNP antibody, anti-ribosomal P protein, hypocomplementemia, lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) in NPSLE patients. Multivariate Logistic regression analysis showed that renal involvement, Raynaud's phenomenon, positive anti-ribosomal P protein antibody, and elevated LMR and NLR were independent risk factors for NPSLE. Conclusion Headache is the most common symptom in patients with NPSLE, and abnormal cranial MRI and cerebrospinal fluid examination are more common. SLE patients who present with renal involvement, Raynaud's phenomenon, positive anti-ribosomal P protein antibodies, and elevated levels of LMR and NLR are more susceptible to developing NPSLE.
Humans ; Lupus Vasculitis, Central Nervous System ; Risk Factors ; Headache ; Antibodies, Antinuclear ; Cognitive Dysfunction

OBJECTIVE: To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism. METHODS: A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT₄), Neifenmi (CO₁₈), Jiaogan (AH_6a), Nie (AT₂), Zhen (AT₃), Shenmen (TF₄) and Yidan (CO₁₁). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E₂) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment. RESULTS: Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E₂ and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05). CONCLUSION Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E₂ and 5-HT to improve the level of hormone in the body.
Female ; Humans ; Acupuncture, Ear ; Bloodletting ; Serotonin ; Capsules ; Flunarizine ; Qi ; Quality of Life ; Migraine Disorders/drug therapy* ; Headache/therapy* ; Treatment Outcome ; Acupuncture Points

The basic constituent elements of ancient acupuncture prescriptions and moxibustion prescriptions for migraine and headache are extracted and summarized. The frequency and proportion of each element are counted and its characteristics are analyzed. The basic constituent elements of ancient acupuncture and moxibustion prescriptions includes five aspects: disease symptoms (main symptoms, concurrent symptoms, etiology and pathogenesis), disease type, acupuncture and moxibustion site (acupoint name, site name, meridian name), manipulation method (acupuncture method, reinforcing and reducing method, blood pricking method, moxibustion method) and curative effect. Acupuncture and moxibustion prescriptions are essential for recording the disease symptoms, while the acupuncture and moxibustion site and manipulation methods are the two core elements of ancient acupuncture and moxibustion prescriptions, which are also the premise to ensure that acupuncture and moxibustion prescriptions have good reference value.
Humans ; Moxibustion ; Acupuncture Therapy ; Meridians ; Acupuncture Points ; Headache/therapy* ; Migraine Disorders/therapy*

Migraine is the most common disabling primary headache with a significant socioeconomic burden. At present, some emerging drugs for migraine preventive treatment are under investigation internationally, which significantly promote the progress of migraine treatment. However, only few of this trial for migraine treatment are explored in China. In order to promote and standardize controlled clinical trials of migraine preventive therapy in China, and to provide methodological guidance for the design, implementation and evaluation of clinical trials, the Headache Collaborators of Chinese Society of Neurology formulated this consensus.
Humans ; Adult ; Consensus ; Migraine Disorders/therapy* ; Headache ; China ; Neurology