Immediate cytology and the presence of a subspecialist radiologist increase the adequacy of FNAC. The adequacy rate of non-cytology-supported FNAC or nonsubspecialist FNAC is below the adequate rate expected from the literature or as recommended in national guidelines.
MethodsData were prospectively collected from 975 eligible patients (554 females; 583 Caucasians; age range = 4.5-18.1 years) with headaches. Patients were included only if they were > 4 years old and had suffered headache course for > 6 months and or 5 separate headache attacks. We have adopted previous descriptions of terms for anatomical sites for location [1]. Side locked unilateral headache (SLUH) is defined as a headache that is for all time fixed unilaterally and never changed side. Headache diagnosis was made on the basis of ICHD -II, 2004 [2]. Headache diagnosis included migraine (n=585); tension type headaches (n= 234); other headache types (n=91) and remained unclassified in 65 (7%) patients.
Results119/975 (12%) of patients experienced recurrent SLUH during a mean headache course of 2.3 years. It was more for unilateral SLUH to localise to the right than the left (60% vs 40%). Topographically, temporal headache was the most frequent, followed by frontal and then parietal. Headaches were SLUH in 11.5% of patients with migraine; 8% with TTH and 23% patients with headache that not yet specified. Brain imaging was normal or showed no significant abnormalities in all scanned patients.
DiscussionSinister aetiologies of SLUH were excluded among our patients. Primary headache was the most common headache category among patients with SLUH. Although, migraine constituted 60% of our study series, frequency of SLUH among migraineurs and those with nonmigraine headaches did not reach statistical significance (11.5% vs 13%).
ConclusionBefore one could reach a conclusion of sinister aetiologies when faced with a patient with SLUH, primary headaches such as migraine and TTH should be considered.
MethodsClinical data for 1029 patients (588 females; 627 Caucasians; mean age = 11.4 years) with headaches were prospectively examined in this hospital based study. Headache diagnosis was made on the basis of ICHD -II, 2004. 1. Headache diagnosis included migraine (n=598); tension type headaches (n=158); other headache types (n=91) and remained unclassified (n=182) patients. We have adopted previous descriptions of terms for anatomical sites for headache location. 2. Occipital locked headache (OLH) is defined as headache that is for all time fixed to the occipital region and never changed side.
Results48/1029 (4.7%) of patients experienced recurrent OLH during a mean headache course of 2.3 years. It was more for OLH to localise bilaterally (87.5%) as only four (8%) and two (4%) patients had right and left OLH respectively. Headache diagnosis was migraine (n=29); tension type headaches (n=5); and other headache types (n=5). Headache remained unclassified in 10/48 patients. Brain imaging was either normal (n=46) or showed no significant abnormalities (n=2).
DiscussionIn this study, sinister aetiologies of OLH were excluded among our patients. Primary headache was found to be the most common headache category among patients with OLH. Frequency of OLH was 5% and 4.4% patients with migraine and those with non-migraine headaches respectively.
ConclusionPrimary headaches such as migraine and TTH are common causes of OLH, although OLH was infrequently found among patients with migraine and those with other primary headache types.
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