Introduction: Headache is an entity characterized by a painful process in the cephalic segment and may originate from cranial or facial structures, being considered a common medical complaint. The chronification process of the pain can present a decrease in quality, the functional capacity and the patient’s and labor environment, and also as well as affect their interpersonal relationships, since the chronic cephalalgic process can lead the patient to moments of social isolation, mood swings, depression. Methods: The research was conducted through a retrospective cross-sectional study, performing the analysis of medical records of patients seen at the Unifacisa’s outpatient neurology School Clinic complaining of chronic headache, from February 1st to August 31, 2019. Results: With the analysis of the medical records, 684 attendances were obtained, where 30 of the patients treated had the diagnosis of chronic headache, 29 women and 01 man. These patients received the following diagnoses: 18 (60%) patients with chronic migraine without aura, 4 (13.3%) patients with chronic migraine with aura, 12 (40%) patients with chronic daily medication overuse headache, 9 (30%) patients with chronic tensiontype headache (CTTH), 1 (3.3%) patient with basilar migraine, 2 (6.6%) patients with secondary headache. Conclusion: Although a small number of chronic headache patients were obtained, yet we realize that it is the migraine that leads to a greater demand for specialized medical care. In addition, as expected due to the latest research, a significant number of patients with headache due to excessive use of common painkillers.
Introduction Headaches are extremely common complications in emergency departments, accounting for up to 16% of visits, according to some studies and are observed in almost all patients with Idiopathic Intracranial Hypertension (IIH), which is characterized by signs and symptoms that include, in addition to headache, nausea, vomiting, diplopia, decreased visual acuity, pulsatile tinnitus, back and neck pain, among other possible manifestations. However, the clinical presentation is highly variable, which can delay diagnosis. Case report A.T.F, female, 33 years old, BMI 40.17 kg / m², with grade 3 obesity, caucasian, single, with Down Syndrome. Presents a history of post-surgical hypothyroidism, whose thyroidectomy was performed 10 years ago, due to nodular goiter. This patient presented subacute nausea, visual turbidity, diarrhea and pulsatile holocranial headache, which worsened in the horizontal position and presented slight relief in the orthostatic position. Conclusion The conduct of Fahrs Syndrome, in this case, was focused on the treatment of hypoparathyroidism and which consists of correcting metabolism disorders of phosphorus and calcium, which naturally resulted in clinical and radiological improvement, however, without definitive resolution of the condition.
Case reportG.F.M, 71 years old, male, farmer, presented a history of holocranial headache of a pulsatile type, more intense on waking, and associated with photophobia. The complaint lasted six months. He also reported episodes of tinnitus and unilateral hearing loss on the left. After conducting screening tests in the emergency department, communicating hydrocephalus and cystic lesions were found in the subarachnoid and intraparenchymal space. In the neurological examination, the positive data were bilateral papilledema and hearing loss in the left boné conduction. Given these findings, the racemous variant of neurocysticercosis and secondary hydrocephalus was suspected, causing intracranial hypertension. Thus, it was decided to start specific treatment with albendazole 15 mg/kg/day (two daily doses), associated with praziquantel 50 mg/kg/day (three daily doses), for 14 days. To reduce the inflammatory process of the lesions, it was proposed to keep the patient on dexamethasone 8 mg/day for 90 days. In addition to this scheme, topiramate 100 mg/day associated with acetazolamide 1 g/day was started, along with serial lumbar puncture to relieve intracranial pressure. ConclusionThe combination of modern diagnostic tests, use of antiparasitic drugs, optimization of anti-inflammatory treatments and minimally invasive neurosurgical procedures have improved results in patients with NCC. Even so, this is the helminth infection that most affects the CNS and represents a major public health problem in most parts of the world, since it remains a neglected pathology, like so many other parasites, given that it is susceptible to containment through simple preventive actions as well as eradication.
Objective: To characterize rest-activity rhythm in chronic migraine (CM) and to investigate the relationship between this rhythm and depressive and anxiety symptoms in patients with CM. Methods: This was a study of adults aged 20 to 40 years. The rest-activity rhythm of patients with CM (n=23) and non-headache controls (NH, n=23) was assessed by actigraphy for 15 days, and they completed the following assessments: Visual Analogue Scale for pain intensity; Headache Diary; Headache Impact Test-6; Morningness-Eveningness Questionnaire; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Beck Depression Inventory; and State-Trait Anxiety Inventory. Results: Patients with CM showed less activity over 24 hours and more fragmented sleep. Reduced interdaily stability of the rest-activity rhythm was observed, with less robustness of this rhythm in the CM group. Multiple linear regressions revealed a significant association between the rest-activity rhythm and trait anxiety variables in patients with CM, specifically regarding the relative amplitude of the cycle, activity throughout 24 hours and during sleep, and robustness of the rest-activity rhythm. Conclusions: Our findings provide evidence that the robustness of the rest-activity rhythm, activity throughout 24 hours, and sleep fragmentation are associated with trait anxiety in patients with CM. Clinical trial registration: Brazilian Clinical Trials Registry (registration number: RBR-4M5J4S).
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