Biomedical subjects
Publications and source records attributed to Hilton Mariano da Silva.
The connection between headache and the cervical spine has been a theme of debate for decades. Cervicogenic headache is a headache related to the cervical spine that often is misdiagnosed and treated inadequately because of confusing and varying terminology. In this article, we discuss our experience in diagnosing and treating cervicogenic headache.
The purpose of our study was to prospectively evaluate the impact of preventive drug treatment on the quality of life of patients with episodic migraine (EM). Quality of life evaluations can enhance traditional measures of therapeutic efficacy. Thirty-five consecutive EM without aura patients attending a tertiary care unit (Batatais Headache Clinic) entered the study. They were given a prescription for preventive medication and completed the validated Portuguese version of the generic instrument Short Form-36 (SF-36) questionnaire. Six months later, patients were given another SF-36. We compared the pre-treatment and post-treatment scores for the SF-36 and analysed the headache diaries. The mean age of the 35 patients (32 women and 3 men) was 40.2 years (range 18-60 years). All 35 patients completed the pretreatment and follow-up SF-36. The pre-treatment and post-treatment mean frequency of migraine attacks was 9.16 and 2.4 crises per month, respectively (p<0.05). After the six months of preventive treatment, six of the eight domains evaluated by the SF-36 (role physical, bodily pain, general health, vitality, social function and mental health) showed statistically significant (p<0.05) improvement. The preventive treatment of migraine leads to a significant improvement in the quality of life of patients with EM. This improvement was measurable by the general quality of life instrument SF-36.
Headache as a chief complaint is rare in the paediatric emergency room. Actually, very seldom cases secondary to life threatening conditions as non-traumatic subarachnoid haemorrhage have been reported. A child with severe headache and nuchal rigidity and no other abnormalities on the physical examination is reported. Magnetic resonance angiography and cerebral angiography disclosed a ventricular arteriovenous malformation in the choroid plexus, supplied by the anterior choroidal artery, classified according to Spetzler grading system as grade 3 (deep venous drainage: 1; eloquence area: 0 and size: 2). The differences in the clinical presentations of the central nervous system arteriovenous malformation between children and adults are discussed.