-This is the first headache survey in the region of Vitória, ES Brazil. A high prevalence of headache sufferers was found (52.8%). Headache was more common among women (63.9%) and less common among people older than 55 years old. The type of professional activity was not related with the headache prevalence. The most frequent causal attribution was stress. Most headache sufferers are not under regular medical treatment (9%), and most of them use analgesic drugs without proper orientation. The most used compounds are combinations with caffeine (33%) and simple analgesics (52.3%).KEY WORDS: headache, prevalence, self medication. Epidemiologia da cefaléia em Vitória, Espírito SantoRESUMO -Este estudo é o primeiro a avaliar a prevalência da cefaléia na região de Vitória, ES. Demonstrouse alta prevalência de portadores de cefaléia (52,8%), com maior freqüência no sexo feminino (63,9%) e em pessoas com menos de 55 anos. Não houve diferença de prevalência em relação ao tipo de atividade profissional. O estresse foi apontado como o fator causal mais freqüente. Verificou-se que poucos portadores de cefaléia fazem acompanhamento médico regular (9%) e que a maioria usa medicamentos analgésicos sem orientação adequada, sendo os medicamentos mais utilizados combinações contendo cafeína (33%) e os analgésicos comuns (52,3%). PALAVRAS-CHAVE: cefaléia, prevalência, auto-medicação.The importance of primary headaches is related to the high frequency of headache disorders, considerable impact of headache on work and social activities, and to the consequences of a considerable consumption of drugs by headache sufferers Here we report the results of the first large epidemiological headache survey among inhabitants of the region of Great Vitória, Espírito Santo Brazil. This study aimed to identify the prevalence of headache symptoms, the causal attributions of headache, the medical assistance sought by the headache patients, and the pattern analgesic use reported by headache sufferers in this region of the country. METHODA questionnaire was administered by a group of medical students attending a specialized headache service. This questionnaire was randomly applied to Great Vitória region inhabitants, including the cities of Vitória, Vila Velha, Cariacica, and Serra. The interviewers have randomly selected people in public areas such as bus stations, schools, churches, supermarkets, banks, shopping centers, and sidewalks. Gender, age, and main occupation data were recorded. The individuals were grouped in three age groups: <30, 30-55, and >55 years. The occupation type was classified into the following categories: home, employed, liberal professional, unemployed, rested, or student. The prevalence of headache symptom was assessed asking if the individual consider him or herself as a headache sufferer. People answering no were not considered to have headache and no further questions were done. For the ones that considered him or herself as a headache sufferer the second question has evaluated the causal attributions of headach...

This is the first study to assess the prevalence of headache and migraine among Pomeranian descendents in Brazil. A high prevalence of headache in the last 6 months was found (53.2%). Most headache sufferers were diagnosed as having migraine (55%). More women reported to have headache than men (65% and 33.8%, respectively). Migraine was the most common headache found among women (62.2%). Among men migraine was responsible for only 37.8% of the cases of headache. A high impact of headache was found, especially among migraineurs. Most of the headache sufferers declared to seek medical assistance for headache (67%) and most of them used to take common analgesics for headache relief. None of them was under prophylactic therapy.

Abnormal electromyographic activity is commonly found in patients with syringomyelia, but involuntary movements have only rarely been reported 1 .We have reported the case of a patient with large syringomyelia, who developed cervical and axial dystonia. CASE REPORTA 40-year-old woman presented with progressive sensory loss and weakness of the lower limbs, followed by urinary retention. Concomitantly, she developed repetitive

Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the “syndrome of the trephined” (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Objective To determine the usefulness of asymmetric optic nerve sheath diameter (ONSD) as an outcome factor after cranioplasty. Method We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the ONSD. Results Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty.

Objective: (1) To evaluate whether the Nine Items Questionnaire (WOQ-9) for the detection of wearing-off (WO) in Parkinson Disease (PD), by means of its screening ability, is a helpful tool to assist neurologists in diagnosing WO; (2) To determine the sensitivity and the specificity of a free Brazilian Portuguese translation of WOQ-9. Method: A sample obtained by convenience included 60 patients. The WOQ-9 was answered by the patients themselves before their routine consultations. The detection of the WO by the WOQ-9 was compared with the neurologist assessment. Statistical significance was 5%. Results: The WOQ-9 showed sensitivity of 100%, specificity of 10.3%, positive and negative predictive values of 54.4% and 100% respectively. The identification of WO by the WOQ-9 was congruent in 54.5% of cases with neurological evaluation. Conclusion: The WOQ-9 is a convenient screening tool to aid physicians to detect WO in PD patients, and it is a quick and easy self-administered questionnaire.Keywords: Parkinson's disease, levodopa, wearing-off, questionnaire. RESUMOObjetivo: (1) Verificar se o Questionário de Nove Itens (WOQ-9) para detectar wearing-off (WO) na doença de Parkinson (DP), pela sua capacidade de triagem, seria útil aos neurologistas na identificação de WO; (2) determinar a sensibilidade e especificidade da versão livre em Português Brasileiro do WOQ-9. Método: Ao todo 60 indivíduos com DP compuseram uma amostra obtida por conveniência. Os próprios pacientes responderam ao WOQ-9 antes de suas consultas rotineiras. A detecção de WO pelo WOQ-9 foi comparada com a avaliação neurológica. A significância estatística foi 5%. Resultados: O WOQ-9 apresentou sensibilidade de 100%, especificidade de 10,3%, valores preditivos positivo e negativo de 54,4% e 100% respectivamente. A identificação de WO pelo WOQ-9 foi congruente em 54,5% dos casos com a avaliação neurológica. Conclusão: O WOQ-9 é um método de rastreamento útil para identificar WO em pacientes com DP, e é um questionário de autoavaliação cuja aplicação é fácil e rápida.Palavras-chave: doença de Parkinson, levodopa, wearing-off, questionários.The treatment of Parkinson's disease (PD) remains a major challenge spite of the increasing therapeutic arsenal in recent decades and progressing knowledge of its pathophysiology. Levodopa (LD) remains the most effective and widely prescribed drug in the symptomatic treatment of PD 1 . Currently it is acknowledged that up to 50% of patients have motor fluctuations after two years of the introduction of LD or another dopaminergic agonist (DA) 2,3 . The long-term use of levodopa leads to complications directly related to the duration of the treatment. Such complications include motor symptoms (MS) and non-motor symptoms (NMS). The most frequent motor complications are the motor fluctuations and dyskinesias. Wearing-off (WO) is one subtype of motor fluctuation and occurs over time, when the effectiveness of a dose of dopaminergic agonist tends to wear off earlier than before. For confirmation of this phenomeno...

Background: Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the “syndrome of the trephined” (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Methods: We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the optic nerve sheath diameter (ONSD). Our goal was to determine the usefulness of asymmetric ONSD as an outcome factor after cranioplasty. Results: Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion: It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty.