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The Clinical Journal of Pain Sep 1990It is well established that multiple influences regulate cerebral blood flow; the overwhelming evidence continues to suggest that migraine is a disorder, albeit... (Review)
Review
It is well established that multiple influences regulate cerebral blood flow; the overwhelming evidence continues to suggest that migraine is a disorder, albeit temporary, of cerebral hemodynamics. Thus, the classical theory of migraine is no longer tenable as viewed strictly and rigidly. Perhaps it would be easier to say that the migraine's aura is characterized by reduction in blood flow, often hemispheric, and that sometime during the headache phase cerebral hyperperfusion occurs. The process is under the control of multiple factors: neurogenic, chemical, metabolic, and myogenic. The blood flow changes do not necessarily correlate with the patient's symptoms. Thus, even now, migraine and other vascular headaches remain as descriptive diagnoses. The final pathology of migraine remains to be determined.
Topics: Brain; Humans; Migraine Disorders
PubMed: 2135018
DOI: 10.1097/00002508-199009000-00011 -
Current Pain and Headache Reports Oct 2013Migraine pathophysiology is not completely understood and is still a matter of ongoing research. However, functional magnetic resonance imaging studies have provided,... (Review)
Review
Migraine pathophysiology is not completely understood and is still a matter of ongoing research. However, functional magnetic resonance imaging studies have provided, over the last few decades, notable insights into neuronal mechanisms underlying migraine. Recently, by using an innovative approach based on repetitive trigeminal painful stimulation, researchers have explored pain processing network functional changes associated with migraine and their correlations with specific migraineous clinical features. These functional changes have been demonstrated during different phases of migraine cycle. However, owing to the complexity of its neurobiology, migraine pathophysiology still has many secrets to be discovered.
Topics: Humans; Magnetic Resonance Imaging; Migraine Disorders; Trigeminal Nerve
PubMed: 23996723
DOI: 10.1007/s11916-013-0367-2 -
Brain & Development Jan 2016"Migraine-related conditions" are probably the second most common condition after seizure encountered in pediatric neurology requiring frequent Emergency Department... (Review)
Review
"Migraine-related conditions" are probably the second most common condition after seizure encountered in pediatric neurology requiring frequent Emergency Department visits. Among migraines, migraine-related condition presents with an acute onset sign or symptom other than headache or visual aura of unknown etiology. A delay in diagnosis is a common occurrence. Previously, the authors proposed a common clinical profile and suggested that the future review should seek the applicability of the common profile in aid to clinical diagnosis of migraine-related individual syndromes. Authors describe the clinical characteristics and differential diagnosis of the spectrum of migraine variants and beyond in children.
Topics: Child; Humans; Migraine Disorders
PubMed: 26081103
DOI: 10.1016/j.braindev.2015.05.009 -
Current Pain and Headache Reports Aug 2006It has been suggested that contact point can trigger headache in individuals with migraine. In this article, we review the anatomy of the sinonasal cavity. We then... (Review)
Review
It has been suggested that contact point can trigger headache in individuals with migraine. In this article, we review the anatomy of the sinonasal cavity. We then define contact points and discuss the pathophysiology of contact point headaches. We propose a theory to explain the relationship between migraines and contact points. We close by presenting our personal casuistic in the surgical treatment of patients with contact point and refractory headaches. In migraineurs with contact point, surgery may improve the headaches.
Topics: Humans; Migraine Disorders; Nasal Cavity
PubMed: 16834948
DOI: 10.1007/s11916-006-0038-7 -
Pediatric Emergency Care Oct 2015Migraines are common, incapacitating, and often stress inducing for pediatric patients and parents alike. According to the Agency for Healthcare Research and Quality,... (Review)
Review
Migraines are common, incapacitating, and often stress inducing for pediatric patients and parents alike. According to the Agency for Healthcare Research and Quality, more than 1 million Americans seek emergency care every year due to migraines, with increasing frequency among adolescents. The disease can vary in severity and character, often mimicking life-threatening conditions, requiring prompt nuanced recognition by emergency personnel and implementation of an effective treatment strategy. Development of emergency department guidelines for the management of pediatric migraines should be based on up-to-date evidence supporting safe, appropriate therapies for children.
Topics: Adolescent; Analgesics; Child; Emergency Medical Services; Humans; Migraine Disorders; Randomized Controlled Trials as Topic; Treatment Outcome; United States
PubMed: 26427947
DOI: 10.1097/PEC.0000000000000590 -
Clinical Cornerstone 1999Migraine is one of the most common and misunderstood disease encountered in general medical practice. An estimated 23 million Americans suffer disabling migraines, yet... (Review)
Review
Migraine is one of the most common and misunderstood disease encountered in general medical practice. An estimated 23 million Americans suffer disabling migraines, yet only a minority are diagnosed (1,2). An even smaller percentage receive optimal care. Migraine extracts a significant personal, psychologic, social, and economic toll from migraineurs and their families. An estimated 150 million workdays are lost annually due to headache at an estimated cost of $6 to $17 billion (3,4). Recent advances in understanding of the pathophysiology and acute therapy provide the potential to markedly reduce the impact of migraine. Available abortive medications have efficacy rates as high as 80%, but only a minority of afflicted patients currently receive these therapies. While reducing headache pain, they also restore function, enabling an individual to return to work, family, and personal commitments (5). Future progress in migraine management resides in early identification and optimization of migraine treatment. This article focuses on diagnosis and treatment.
Topics: Adrenergic beta-Antagonists; Antidepressive Agents, Tricyclic; Biofeedback, Psychology; Calcium Channel Blockers; Humans; Migraine Disorders; Patient Education as Topic; Recurrence; Risk Factors; Serotonin Receptor Agonists
PubMed: 10682185
DOI: 10.1016/s1098-3597(99)90037-6 -
Headache Mar 2008Migraine is a neurologic disorder characterized by a cycle of attacks, including headache, separated by attack-free periods. Increasingly, episodic migraine is... (Review)
Review
Migraine is a neurologic disorder characterized by a cycle of attacks, including headache, separated by attack-free periods. Increasingly, episodic migraine is recognized as a disorder that may escalate to chronic migraine, with a frequency of 15 or more attacks per month. Migraine exacts a toll on the quality of life (QoL) of affected individuals, their families, and their workplace. Migraine adversely affects a patient's QoL during an attack, but also has an impact between attacks. This interictal burden on the patient manifests itself as worry in anticipation of the next painful attack and concern over its possible adverse impact on future plans or activities. The high prevalence of migraine, 12% in industrialized countries and approximately 28 million people in the United States, is considered a low estimate. Patients with disruptive migraines frequently overuse self-prescribed medications or may postpone a visit to a physician, which delays accurate diagnosis and appropriate treatment for migraine. Consequently, migraine remains underdiagnosed and undertreated. An extensive literature search of migraine reviewed its associated disability and reduced QoL during, and especially between, attacks. Assessment tools to evaluate the interictal burden on QoL, and to help in migraine diagnosis and patient-physician communication, are readily available. Nevertheless, patients with frequent and recurring migraines, who suffer a reduced QoL, continue to be underrecognized and undertreated. This segment of the migraine population could benefit from preventive therapy.
Topics: Analgesics; Clinical Trials as Topic; Disability Evaluation; Humans; Migraine Disorders; Patient Satisfaction; Physician-Patient Relations; Quality of Life; Surveys and Questionnaires
PubMed: 18179565
DOI: 10.1111/j.1526-4610.2007.01004.x -
The Journal of Headache and Pain Sep 2005Migraine is a complex pathology and it should be regarded as a disease evolving during the lifetime along with other comorbid conditions. Migraine susceptibility may be... (Review)
Review
Migraine is a complex pathology and it should be regarded as a disease evolving during the lifetime along with other comorbid conditions. Migraine susceptibility may be unmasked by exogenous substances and the occurrence of migraine attacks may change following drugs given for therapeutical purposes. The evolution of migraine should be followed up because childhood migrainous manifestations may vary over the years and an earlier diagnosis may not apply later on.
Topics: Cardiovascular Diseases; Comorbidity; Disease Progression; Humans; Migraine Disorders
PubMed: 16362694
DOI: 10.1007/s10194-005-0215-9 -
Journal of Midwifery & Women's Health 2011In spite of the fact that migraines are one of the major problems seen by primary care providers, almost half of people with migraines do not obtain appropriate... (Review)
Review
In spite of the fact that migraines are one of the major problems seen by primary care providers, almost half of people with migraines do not obtain appropriate diagnosis and/or treatment. Migraine occurs in about 18% of women, and is often aggravated by hormonal shifts occurring around women's menses, during pregnancy, and during perimenopause. Quality of life with migraines is often greatly diminished, and many women miss work days and/or are less productive with migraines. Women's health care providers are very likely to see women with poorly managed migraines, but are often not comfortable diagnosing and treating their patients with headaches. A variety of self-care treatments, acute care prescription and non-prescription headache medications, and preventive medications are available and if used by a knowledgeable provider can provide relief for many women who might not otherwise receive appropriate care.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Antidepressive Agents, Tricyclic; Female; Humans; Migraine Disorders; Pregnancy; Quality of Life; Risk Factors; Serotonin 5-HT1 Receptor Agonists; Women's Health
PubMed: 21535375
DOI: 10.1111/j.1542-2011.2011.00024.x -
Cephalalgia : An International Journal... Feb 1995Over 3 years we evaluated two patients, an adolescent and a child, with migraine-like headache and ischemic stroke. Based on our clinical observations and on literature... (Review)
Review
Over 3 years we evaluated two patients, an adolescent and a child, with migraine-like headache and ischemic stroke. Based on our clinical observations and on literature review of migraine and stroke in the pediatric age group, we believe that the criteria of migrainous infarction outlined by the International Headache Society (IHS) could be occasionally too restrictive. Therefore, we suggest subclassifying migrainous infarction into: (i) "definite", referring to the patients whose ischemic stroke fulfills all the IHS criteria, (ii) "possible", referring to ischemic strokes which fulfill some, but not all, criteria. This subclassification of migrainous infarction may be relevant in clinical practice and in human research studies.
Topics: Adolescent; Cerebrovascular Disorders; Child; Female; Humans; Male; Migraine Disorders
PubMed: 7758094
DOI: 10.1046/j.1468-2982.1995.1501026.x