PURPOSE: Recurrent headaches are common among Korean students, causing absences from school or learning impediments. However, most school nurses are unable to provide appropriate diagnosis and treatment as they lack accurate information about the clinical aspects or treatment of headaches. The aim of this study was to investigate school nurses's clinical knowledge, assessment, and management of headache and educational needs in headache management. METHODS: This was a cross-sectional study targeting 250 school nurses who participated in the training lecture hosted by and were working at elementary, middle, and high schools. Surveys with insufficient data were excluded. RESULTS: Participants were 237 school nurses; 122 elementary school nurses, 62 middle school nurses, and 53 high school nurses, with an average age of 42.4±8.8 years. In all, 58.2% of the school nurses responded that they had received headache education, 68.8% responded that they knew the classifications of a headache, and 38.4% responded that they knew a headache assessment method. Only, 29% had a protocol for headache treatment. The educational needs (0-7 points) of school nurses to manage students with headaches were 5.8 for headache knowledge education, 5.5 for acute pharmacotherapy, 5.0 for preventive pharmacotherapy, 6.0 for lifestyle modification, and 6.0 for complementary remedy. CONCLUSION: School nurses had high educational needs for headache management but, they had insufficient knowledge of headaches and had not a protocol for the headache management in most cases. It suggests that headache knowledge education should be performed and the standardized headache management guideline should be developed to improve the performance of school nurses.
Classification ; Cross-Sectional Studies ; Diagnosis ; Disease Management ; Drug Therapy ; Education ; Headache* ; Humans ; Learning ; Life Style ; Methods ; School Nursing

PURPOSE: Recurrent headaches are common among Korean students, causing absences from school or learning impediments. However, most school nurses are unable to provide appropriate diagnosis and treatment as they lack accurate information about the clinical aspects or treatment of headaches. The aim of this study was to investigate school nurses's clinical knowledge, assessment, and management of headache and educational needs in headache management. METHODS: This was a cross-sectional study targeting 250 school nurses who participated in the training lecture hosted by and were working at elementary, middle, and high schools. Surveys with insufficient data were excluded. RESULTS: Participants were 237 school nurses; 122 elementary school nurses, 62 middle school nurses, and 53 high school nurses, with an average age of 42.4±8.8 years. In all, 58.2% of the school nurses responded that they had received headache education, 68.8% responded that they knew the classifications of a headache, and 38.4% responded that they knew a headache assessment method. Only, 29% had a protocol for headache treatment. The educational needs (0-7 points) of school nurses to manage students with headaches were 5.8 for headache knowledge education, 5.5 for acute pharmacotherapy, 5.0 for preventive pharmacotherapy, 6.0 for lifestyle modification, and 6.0 for complementary remedy. CONCLUSION: School nurses had high educational needs for headache management but, they had insufficient knowledge of headaches and had not a protocol for the headache management in most cases. It suggests that headache knowledge education should be performed and the standardized headache management guideline should be developed to improve the performance of school nurses.
Classification ; Cross-Sectional Studies ; Diagnosis ; Disease Management ; Drug Therapy ; Education ; Headache* ; Humans ; Learning ; Life Style ; Methods ; School Nursing

Craniofrontonasal dysplasia(CFND), a rare congenital syndrome, is characterized by varying degrees of frontonasal dysplasia, craniosynostosis, and variable extracranial abnormalities. It was first reported by Cohen in 1979. The inheritance pattern is not straightforward. Although all modes of Mendelian inheritance have been suggested, the most plausible explanation is that this is an X-linked condition with the unusual situation of complete expression in females, and minimal to no expression in males. In our case, CFND was diagnosed in a female neonate who had unilateral coronal craniosynostosis, frontal bossing, orbital hypertelorism, broad nasal root, clefting nasal tip, corpus callosum agenesis and mild extremity abnormalities.
Agenesis of Corpus Callosum ; Craniosynostoses ; Extremities ; Female ; Humans ; Hypertelorism ; Infant, Newborn ; Inheritance Patterns ; Male ; Orbit ; Parturition* ; Wills

The primary headaches include migraine, tension-type headache(TTH), cluster headache, and other primary headaches. An understanding of the basic pathophysiology facilitates the assessment and management of patients with headache. There have been remarkable advances in the last decade in unraveling the mystery of primary headaches. The vascular theory has been superseded by the neurovascular phenomenon, which seems to be the permissive triggering factor in migraine and cluster headache. Calcitonin gene-related peptide(CGRP) is one of the main neuropetides involved in the neurogenic inflammation, which is important in the generation of migraine. The serotonin also appears to have a pivotal role in some aspects of migraine pathogenesis. Cortical spreading depression(CSD) seems to be an important phenomenon explaining migraine with aura. The brain stem nuclei(raphe and locus coeruleus) and cortical hyperexcitability may well have a important role in generating CSD. These have been achieved through new imaging modalities such as positron emission tomography(PET) and functional magnetic resonance imaging(fMRI). In migraine, the throbbing pain is mediated by the sensitization of the meningeal nociceptor of trigeminovascular neurons. The sustained sensitization of peripheral trigeminal neurons eventually leads to subsequent sensitization of central trigeminovascular neurons, which can be manifested as cutaneous allodynia. TTH and migraine belong to the same physiological spectrum. However, they are genetically most likely multifactorial.
Brain Stem ; Calcitonin ; Cluster Headache ; Electrons ; Headache* ; Humans ; Hyperalgesia ; Migraine Disorders ; Migraine with Aura ; Neurogenic Inflammation ; Neurons ; Nociceptors ; Serotonin

PURPOSE: Short attacks of headache are present in the pediatric age group. Short-lasting headaches (SLH) have been infrequently reported in children and adolescents. This study aims to assess the prevalence, clinical characteristics, treatment, and prognosis of short-lasting headaches in children and adolescents. METHODS: One hundred twenty-three consecutive patients attended the Chosun University Hospital Headache Center between March 2006 and July 2007. Among 123 headache patients, 44 patients with one key criterion, namely, recurrent headaches episodes of a few seconds to less than 30 minutes, were selected. RESULTS: Of the 123 headache patients, 44 (35.8%, males 18, females 26) had SLH. The mean age was 9.24 years (range 2.3-14.2). The mean headache frequency was 11.50+/-10.30 per month, mean severity was 4.86+/-1.36 out of 10, and the mean PedMIDAS score was 7.97+/-17.51. SLH was significantly more common in children <6 years old (10/22, 45.5%) than in > or =6 years old (34/101, 33.7%) (P=0.015). The nature of pain was pressure in 30.2%, stabbing in 27.9%, throbbing in 18.6%, and dull in 11.7%. In 52.4% patients, the pain occurred in the front, one side of the temple in 28.5%, both sides of the temple in 7.1%, and back in 4.8% patients. The duration of attacks was <6 minutes in 38% and > or =6 minutes in 61.4%. The intensity of the pain was 4-6 out of 10 in 75.0%, in 13.6% 1-3, and in 11.4% 7-10. Treatment was significantly effective in reducing the frequency, duration, and severity of headaches and the PedMIDAS score after 3 months (P<0.05). CONCLUSION: Short attacks of headache are common (35.8%) in children and adolescents. These are difficult to classify according to International Headache Society criteria. The outcome, after a period of 3 months to 2 years, was favorable in most patients. Further studies are needed to gather more data and to obtain a better description of these forms of headache in the pediatric group.
Adolescent ; Child ; Female ; Headache ; Humans ; Male ; Prevalence ; Prognosis

Primary exercise headache (PEH) is usually precipitated by prolonged physically strenuous exercise. The headache is usually bilateral, severe, and pulsating in character in the patients with exercise headache. The pathophysiological mechanisms of PEH are still unknown. Most investigators believe it is vascular in origin, hypothesizing that venous or arterial distension secondary to physical exercise is the pain-inducing mechanism. The jump-rope could also evoke PEH due to intracranial venous congestion from retrograde jugular venous flow. Indomethacin is known to be effective for the majority of the cases. This is the first case with primary exercise headache from the jump-rope in Korean children.
Child* ; Exercise ; Headache* ; Humans ; Hyperemia ; Indomethacin ; Research Personnel

PURPOSE: Both headache and obesity are prevalent and chronic conditions among children. A well-known pathophysiology of migraine is that calcitonin gene-related peptide (CGRP) is an important postsynaptic mediator of trigemino-vascular inflammation. Plasma CGRP levels have been shown to increase in obese individuals during the headache phase of migraines. The purpose of this study was to assess the relationship between headache and plasma CGRP levels in obese children. METHODS: We prospectively studied plasma CGRP levels in 33 patients (20 overweight and obese subjects without headache, 13 overweight and obese subjects with headache) who visited Chosun University Hospital from March 2009 to September 2009. Blood samples were collected from cubital veins and plasma levels of CGRP were measured by radioimmunoassay. RESULTS: The mean age was 12.3+/-2.3 (range 6-15 years) and mean CGRP level was 19.1+/-2.5 pg/ml in the overweight and obese with headache group and 17.4+/-5.1 pg/mL in the overweight and obese without headache group. In the group CGRP levels lower than 19 pg/mL, mean headache frequency per month, mean severity, and mean disability were 17.0+/-18.4, 4.0+/-2.8 and 2.0+/-0.0, respectively. In the group with CGRP levels of 19 or greater pg/ml, levels were 11.0+/-9.8, 5.6+/-1.0, and 23.1+/-8.2, respectively. CONCLUSION: The mean CGRP level in overweight and obese children with headache was not significantly higher than in those without headache (P =0.202). Further, there was no significant correlation between CGRP level and frequency, severity of headache, and disability due to headache (P > 0.05). Further studies are needed to access the relationship of CGRP and pediatric headache in obese subjects.
Calcitonin ; Calcitonin Gene-Related Peptide ; Child ; Headache ; Humans ; Inflammation ; Migraine Disorders ; Obesity ; Overweight ; Plasma ; Prospective Studies ; Veins

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Tissue Expansion Devices*