Our study shows the presence of several KCNK18 gene mutations in both migraine with aura and migraine without aura. However, the precise role of this gene in migraine predisposition deserves further studies.

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Introduction: Hypertension is a potent and modifiable risk factor for cardiocerebrovascular diseases, accounting for more than 50% of deaths for stroke and 25% of those for coronary heart diseases. Systolic blood pressure (SBP) increases continuously throughout adult life and the prevalence of isolated systolic hypertension (ISH) rises accordingly, reaching about 60% among those in their sixties and 75% in those aged 75 years and older. Objective: This study was planned to assess prognostic factors influencing the long-term maintenance of the blood pressure in elderly. A retrospective study was performed, studying 127 old patients (mean age 76,7 ± 7,1 years) with a diagnosis of uncontrolled essential hypertension, with an equal distribution between gender. The mean systolic blood pressure was 160 ± 14 mmHg, while the mean diastolic blood pressure was 82 ± 9 mmHg. It was thus prescribed an antihypertensive drug therapy to reach the systolic blood pressure value <140 mmHg and the diastolic blood pressure value < 85 mmHg, that was obtained in 78% of patients. The efficacy of the drug therapy was followed ever 3 months over a period up to 2 years. Results: Results indicated that the monotherapy was effective only in 22 patients (17,3%), while the most part of patients required a combined, multidrug therapy, that for the most cases included a diuretic associated with either a calcium-channel blocker or a drug acting on the renin-angiotensinaldosterone system (RAAS). The prognostic factors involved in the long-term maintenance of the blood pressure were evaluated by a discrete time survival model. The univariate analysis, using the Log-rank test, indicates that only the treatment with an ACE inhibitor drug positively correlated with a long-term efficacy of the antihypertensive therapy (p=0.019). The multivariate analysis unravelled that the presence of hypercholesterolaemia (observed in 46% of patients) was an important negative prognostic factor for the long-term efficacy of the therapy (RR:3.2 IC: 1.3-8.2, p=0.013). The multivariate analysis emphasised as well the role of the RAAS drugs in the treatment of hypertension, confirming that the use of an ACE inhibitor positively correlated with the long-term efficacy of the antihypertensive therapy (Relative Risk: 0.25, CI: 0.10-0.062, p=0.03) and indicating an important role for the sartans. Conclusions: Our data demonstrated indeed that, in hypercholesterolaemic patients, the prescription of a sartan drug allowed the long-term maintenance of the therapy (RR: 0.16 CI: 0.05-0.54, p=0.003), reducing of about 84% the relative risk of the loss of efficacy.

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Primary stabbing headache has been known for several decades. However, the pathophysiology of this disease is not still understood. It is clinically characterized by single episodes or short-lasting series of stabbing pain recurring from once to many times per day in an irregular pattern. The diagnosis is clinical and any other possible cause should be excluded. The therapeutic approach indicates Indomethacin as the first choice of treatment, although case reports describe a therapeutic response to Melatonin, Celecoxib, Nidedipine, Paracetamol and Gabapentin. We describe the case of 5 patients with diagnosis of primary stabbing headache without comorbidity of anxiety or depression that shows a partial response to Indomethacin, but do respond to Benzodiazepines. There is little on the use of Benzodiazepines in primary headaches. They are used in patients with chronic migraine when there is a comorbidity of anxiety and depression. The unexpected efficacy of these molecules in our patients is encouraging and represents a hint to think about using these molecules in other types of primary headaches.