Features Of Tension-type Headache Research Articles

Frequency and Clinical Features of Space Headache Experienced by Astronauts During Long-Haul Space Flights.

Few anecdotal cases and 1 small retrospective study during short-duration space missions suggest that headache may occur early in flight, as part of the space motion syndrome. Whether headaches may also occur at later stages of space flights is unknown. We aimed to prospectively characterize the incidence, timing, clinical features, and management of space headaches during long-duration flights. We prospectively evaluated the occurrence, characteristics, and evolution of space headaches and the effects of treatment and countermeasures during long-haul flights with onboard questionnaires and correlated them with prevailing temperature, pressure, and ambient O2 and CO2 levels, measured within the International Space Station. In addition, we analyzed retrospective headache data from a different astronaut cohort. Headache data were reported using descriptive statistics and correlation data with intraindividual logistic regression models. Astronauts were included through (inter)national aerospace organizations. In the prospective study, 22/24 (91.7%) astronauts (mean ± SD age: 46.6 ± 6.5 years, 95.8% male) experienced ≥1 episode of headache during a total of 3,596 space days. A total of 378 episodes were reported (median 9; range 1-128) with detailed information on 189. Phenotypically, 170/189 (89.9%) episodes were tension-type headache (TTH) and 19/189 (10.1%) were migraine. Episodes in the first week differed from those in later periods in terms of phenotype (migraine 12/51 [23.5%] vs 7/138 [5.1%]; TTH 39/51 [86.5%] vs 131/138 [94.9%]; overall p = 0.0002) and accompanying symptoms: nausea: 17.6% vs 6.9%, p = 0.05; vomiting: 9.8% vs 0.7%, p = 0.005; nasal congestion: 52.9% vs 29.7%, p = 0.004; facial edema: 41.2% vs 1.4%, p < 0.001; and duration (p = 0.001). Severity and treatments were similar: acute antiheadache medication: 55.6%; other medication: 22.4%; and alternative treatments: 41.1%. Headache occurrence was not associated with temperature or ambient pressure/levels of O2 and CO2 (all p > 0.05). In the retrospective study, 23/42 (54.8%) astronauts (43.5 ± 7.2 years, 90.5% male) reported experiencing ≥1 headache episode during mission. Nasal congestion was the most common (8/33; 24.2%) accompanying symptom. Seventeen of 42 astronauts have been previously described. Astronauts during space flights frequently experience headaches. These most often have characteristics of TTHs but sometimes have migrainous features, particularly during the first week of flight in astronauts without a history of recurrent headaches before or after the space flight.

Characteristics of Tension-Type Headache among Nurse in Udayana University Hospital

Background: Headache is the most common complaint experienced by people in the world with the highest prevalence spesifically tension-type headache. Nurses are one of the professions with the risk of experiencing tension-type headache that can affect performance, costs, and work results. The purpose of this study was to determine the prevalence and characteristics of tension-type headache among nurses who work in the hospital. Method: This research is a cross-sectional descriptive study with consequtive sampling technique involving 89 nurses at Udayana University Hospital using primary data obtained from questionnaires (google form) and then analyzed by using SPSS 26. Results: The results showed that the prevalence of tension-type headache in nurses was 46.1%. Based on the most common characteristic in nurses, spesifically within the age of 26-35 years about 80.5%, female gender about 65.9%, obesity category about 39%, no stress category about 95.1%, sleep duration &gt; 6 hours about 58.5%, shift nurses about 92.7%, nurses in inpatient room about 70,7%, and below 3 years duration of work about 80.5%. Conclusion: The prevalence of tension-type headache in nurses is 46.1% with the most characteristics at the age of 26-35 years (early adulthood), female gender, dominated by obesity category, no stress category, sleep duration &gt; 6 hours, dominant in shift nurses, mostly in inpatient room nurses and below 3 years duration of work.&#x0D; Keywords: Tension-type headache, characteristics, nurse

Эпидемиологические и клинические характеристики головной боли напряжения у подростков в городе Харькове

Цель настоящего исследования — установить частоту распространенности, факторы риска и особенности клинического течения головной боли напряжения в популяции подростков г. Харькова. Проведено скрининговое исследование 2342 подростков — учеников харьковских школ в возрасте 13–17 лет с использованием опросника, диагностических критериев Международного общества головной боли, определение продолжительности, интенсивности головной боли, а также оценка влияния головной боли на повседневную активность. Установлено, что распространенность головной боли напряжения у подростков харьковских школ составила 61,1 %, при этом чаще наблюдалась ее редкая эпизодическая форма — у 59,7 %, частая эпизодическая форма — у 33,8 %. Хроническая форма головной боли напряжения отмечалась только у 6,5 % подростков. Наиболее частыми факторами риска были неблагоприятная обстановка в семье, низкая физическая активность, курение. Наличие головной боли напряжения оказывало негативное влияние на повседневную активность подростков.

Sleep disorders in children and adolescents with tension-type headaches

Introduction. Tension-type headache (TTH) represents a widespread and recurrent disease in adults, children, and adolescents, adversely affecting the quality of life, learning achievements, and social functioning. In recent publications, a high incidence of comorbid disorders in patients with TTH is discussed, in particular sleep disorders. The aim of the study was to assess the nature and prevalence of sleep disorders in children and adolescents with frequent episodic TTH and chronic TTH. Materials and methods. One hundred fifty patients aged from 8 years to 16 years 11 months with TTH were examined. Of them, 91 (49 boys, 42 girls) had frequent episodic TTH, 59 (26 boys, 33 girls) had chronic TTH. There was used Sleep Disturbance Scale for Children including 26 questions for parents. Results. The present study confirms the high incidence of sleep disorders among TTH children and adolescents. TTH was diagnosed in 129 (86.0%) out of 150 patients. The most frequently diagnosed varying degrees of severity (clinically relevant and borderline, when assessing sleep disorders in children) were insomnia (disorders of initiating and maintaining sleep) - in 65.3% of patients (including 60.4% with frequent episodic TTH and 72.9% with chronic TTH), excessive somnolence - in 74.7% (67.1% and 86.4%), sleep breathing disorders - in 26.7% (23.1% and 32.2%), disorders of arousal/nightmares - in 46.0% (42.9% and 50.8%), sleep-wake transition disorders - in 65.3% (67.1% and 62.7%), sleep hyperhidrosis - in 31.3% (26.4% and 39.0%). Thus, all sleep disorders (except for sleep-wake transition disorders) were significantly more common among the patients with chronic TTH. At the same time, in the subgroup of patients with TTH and any sleep disorders, significantly more prominent indicators of the frequency, the intensity of TTH and its negative impact on the daily activity were revealed, compared to patients with TTH lacking sleep disorders. Conclusion. The results of the assessment of children and adolescents with TTH show that when planning preventive therapy for TTH and evaluating its results, not only main clinical characteristics of TTH should be taken into account, but also the manifestations and severity of comorbid disorders, including sleep disorders observed in most patients with TTH. The revealed prevalence of various sleep disorders in the subgroup of patients with chronic TTH confirms that sleep disorders and anxiety disorders refer to significant risk factors for the transition of TTH to a chronic form, and such patients need more active multimodal treatment.

Головная боль напряжения и мигрень у женщин с угрожающим прерыванием беременности: клинико-диагностические аспекты

Актуальность. Угроза прерывания беременности (УПБ) — самое распространенное осложнение беременности, возникающее в 15–20 % случаев продолжающейся беременности. Головная боль (ГБ) — одна из частых жалоб во время беременности, распространенность ГБ у беременных женщин достигает 35 %. Цель исследования: изучить распространенность и клинические особенности головной боли напряжения (ГБН) и мигрени у беременных с УПБ в I и II триместрах, проживающих в Луганской области, для усовершенствования лечебно-профилактических мероприятий и профилактики акушерских и перинатальных осложнений у таких женщин. Материалы и методы. Обследованы 84 беременных в I и II триместрах беременности, которые находились на стационарном лечении по поводу УПБ в больницах, расположенных в Луганской области (группа I). Контрольную группу составили 47 беременных женщин с неотягощенным анамнезом и физиологическим течением беременности аналогичного гестационного срока и места проживания (группа II). Всем беременным было проведено клинико-акушерское обследование, для оценки субъективной выраженности ГБ использовался метод визуально-аналоговой шкалы (ВАШ), для качественной характеристики ГБ — болевой опросник Мак-Гилла. Результаты. Установлено, что интенсивность ГБН по ВАШ составила Ме (Q1–Q3) = 3,40 (2,90–3,78) в группе I и 2,05 (1,43–3,05) — в группе II (р = 0,015). Интенсивность мигрени по ВАШ составила Ме (Q1–Q3) = 6,45 (4,30–7,18) и 5,15 (5,10–5,20) соответственно (р = 0,533). Пациенты группы I более эмоционально описывают свою ГБ и используют больше дескрипторов для сенсорной и аффективной характеристики ГБ. У беременных группы I выявлена положительная корреляционная связь между возрастом и аффективными характеристиками ГБН: индекс числа выбранных дескрипторов для аффективной шкалы (r = 0,590, р = 0,002), ранговый индекс боли для аффективной шкалы (r = 0,478, р = 0,018). Выводы. Распространенность ГБН среди беременных с УПБ встречается в 1,92, мигрени — в 1,12 раза чаще по сравнению со здоровыми беременными и составляет 28,57 и 4,76 % соответственно. У беременных с УПБ показатели интенсивности по ВАШ ГБН в 1,66, мигрени — в 1,25 раза превышали данные контрольной группы, медианное значение интенсивности ГБН было достоверно выше.

Headache at the Chronic Stage of Ischemic Stroke.

Headache in ischemic stroke survivors after the acute stage is incompletely described. We aimed to prospectively describe the characteristics of headache and the predictors of headache at the chronic stage after ischemic stroke. We conducted a prospective observational cohort study including 102 acute ischemic stroke patients admitted to a Stroke Unit. Patients were interviewed at the acute and the chronic stage (12months after stroke). Characteristics of those headaches were collected using a previously validated headache questionnaire enabling headache classification following the International Headache Society criteria. Pre-stroke headache history was registered using the same instrument. Forty-five patients out of 89 with completed follow-up (51%) reported headache at the chronic stage. In most of the patients, headache was sporadic, mild, pressure-like, with a duration of minutes to hours, with characteristics of tension-type headache in 51% (n=23/45). Headache was a reactivation of pre-stroke headache in 33% (n=15/45), different from pre-stroke headache in 44% (n=20/45), and of new-onset in 22% (n=10/45). Only 1 patient had a new-onset headache at the acute stage that persisted with the same characteristics at the chronic stage. Pre-stroke headache (OR=5.3; 95% CI [2.01-13.98] P=.001) and female sex (OR=3.5; 95% CI [1.3-9.4] P=.013) predicted headache at the chronic stage after stroke, controlling for age, severity, and location of stroke. Headache in ischemic stroke survivors at the chronic stage is more frequent in women and in patients with pre-stroke headache. It is most frequently a headache with different characteristics of the pre-stroke headache and only rarely a new-onset headache starting at the acute stage and persisting at the chronic stage.

The number of active trigger points is associated with sensory and emotional aspects of health-related quality of life in tension type headache

Abstract Aims Some evidence supports that referred pain elicited by active trigger points (TrPs) reproduces some features of tension type headache (TTH). Our aim was to investigate the association between the number of active TrPs and health-related quality of life TTH. Methods Patients with TTH diagnosed by experienced neurologists according to the last International Headache Classification (ICHD-III) were included. Exclusion criteria included other primary headaches, medication overuse headache, whiplash injury or fibromyalgia. TrPs were bilaterally explored within the masseter, temporalis, trapezius, sternocleidomastoid, splenius capitis, and suboccipital. Health-related quality of life was assessed with the SF-36 questionnaire including 8 domains: physical functioning, physical role, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Higher scores represent better quality of life. Spearman correlation coefficients were used to determine correlations between the active TrPs and SF-36. Results Two hundred and two patients (mean age: 45±12 years) with a headache frequency of 17±7 days/month participated. Each patient with TTH exhibited 4.7±2.9 active TrPs. The number of active TrPs showed moderate weak negative associations with bodily pain (r s: −0.216; P =0.002), emotional role (r s: -0.185; P = 0.008) and vitality (r s: –0.161; P = 0.02), but not with the remaining domains: the higher the number of active TrPs, the worse the emotional role and vitality and the higher the pain interference with daily life. These results were similar in both frequent episodic and chronic TTH. Conclusions The number of active TrPs was associated with sensory and emotional aspects of quality of life in a cohort of subjects with TTH.

Restless legs syndrome and tension-type headache: a population-based study

BackgroundRecent studies have shown a significant association between restless legs syndrome (RLS) and primary headache disorders. Nevertheless, information regarding the association between tension-type headache (TTH) and RLS is limited. This study aimed to investigate the association between RLS and TTH in a population-based sample.MethodsWe selected a stratified random population sample of Koreans aged 19–69 years and assessed them using a semi-structured interview designed to identify RLS, headache type, and clinical characteristics of TTH. We determined the prevalence and clinical impact of RLS in participants with TTH.ResultsOf the 2695 participants, 570 (21.2%) and 142 (5.3%) were classified as having TTH and RLS, respectively. Among the 570 individuals with TTH, 113 (19.8%) also met the criteria for probable migraine (PM). The prevalence of RLS was significantly higher among individuals with TTH than among those with non-headache (6.0% vs 3.6%, p = 0.018). The prevalence of RLS was significantly higher in subjects with TTH who fulfilled PM criteria than in those with non-headache participants (8.0% vs. 3.6%, p = 0.018). However, RLS prevalence in individuals with TTH who did not fulfil PM criteria did not differ from that of participants with non-headache (5.5% vs. 3.6%, p = 0.063). TTH participants with RLS had higher visual analogue scale scores for headache intensity (5.1 ± 2.0 vs. 4.3 ± 1.8, p = 0.038), and higher prevalence of anxiety (20.6% vs. 8.8%, p = 0.022) and depression (14.7% vs. 3.5%, p = 0.002) than TTH participants without RLS. Multivariable analyses revealed that headache aggravation by movement (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.1–5.2) and depression (OR = 3.5, 95% CI = 1.1–11.4) were significant indicators of RLS among individuals with TTH.ConclusionsThe prevalence of RLS was higher among individuals with TTH than among those with non-headache. Some clinical presentations varied in accordance with the presence of RLS among participants with TTH.

Treatment outcomes of midfacial segment pain: experience from the Liverpool multi-disciplinary team facial pain clinic.

Midfacial segment pain (MSP) has the characteristics of tension-type headache which is confined to the midface cor- responding to the second division of the trigeminal nerve. This review presents treatment outcomes of MSP patients managed at the Multi-disciplinary Team (MDT) Facial Pain Clinic in Liverpool. Prospective clinical outcome performed in a tertiary referral centre for complex facial pain syndromes. Sino-Nasal Outcome Test (SNOT). Clinical "success" was defined as an improvement in total SNOT score of >9 points and a reduction of the ear-facial symptoms sub-domain score by ≥50% from baseline. The average age of the cohort was 49 years, with an average follow-up of 12 months. The overall pre-treatment total SNOT-22 score was 59.5 which improved significantly to 42 at latest follow-up. Although the average scores of all sub-domains improved, only the ear-facial symptoms and psychological issues sub-domains achieved statistical significance. When the criterion for success was applied, nine patients fulfilled this definition at an average of 12 months follow-up. The baseline total SNOT score in this cohort improved from 60.6 to 19.7. Half of these patients achieved success within 18 months of commencing treatment and the probability of attaining success at long-term follow-up was high. Treatment of midfacial segment facial pain is complex and requires follow-up to achieve any meaningful clinical outcome.

Treatment outcomes of midfacial segment pain: experience from the Liverpool multi-disciplinary team facial pain clinic

Midfacial segment pain (MSP) has the characteristics of tension-type headache which is confined to the midface cor- responding to the second division of the trigeminal nerve. This review presents treatment outcomes of MSP patients managed at the Multi-disciplinary Team (MDT) Facial Pain Clinic in Liverpool. Prospective clinical outcome performed in a tertiary referral centre for complex facial pain syndromes. Sino-Nasal Outcome Test (SNOT). Clinical "success" was defined as an improvement in total SNOT score of >9 points and a reduction of the ear-facial symptoms sub-domain score by ≥50% from baseline. The average age of the cohort was 49 years, with an average follow-up of 12 months. The overall pre-treatment total SNOT-22 score was 59.5 which improved significantly to 42 at latest follow-up. Although the average scores of all sub-domains improved, only the ear-facial symptoms and psychological issues sub-domains achieved statistical significance. When the criterion for success was applied, nine patients fulfilled this definition at an average of 12 months follow-up. The baseline total SNOT score in this cohort improved from 60.6 to 19.7. Half of these patients achieved success within 18 months of commencing treatment and the probability of attaining success at long-term follow-up was high. Treatment of midfacial segment facial pain is complex and requires follow-up to achieve any meaningful clinical outcome.

Postictal headache in epileptic patients

Postictal headache (PIH) is defined by the International Classification of Headache Disorders, third edition beta (ICHD-3 beta), as “headache caused by and occurring within 3 hours after an epileptic seizure, and remitting spontaneously within 72 hours after seizure termination”. People at highest risk of suffering PIH are who have generalized tonic-seizures (GTCSs) and a history of interictal headaches. An occipital epileptogenic focus may be an additional risk factor. Also PIH frequently have characteristics of migraine, the diagnostic criteria of “headache with features of tension-type headache or, in a patient with migraine, of migraine headache” in ICHD-2 has been ruled out from the ICDH-3. The high percentage of PIH in patients with epilepsy which really burden patient’s daily life. For purposes of comparison, trials should adhere to a unified definition of PIH, and ICHD-3 beta revised the ICHD-2 definition which widens the inclusion criteria to any headache attributed to a seizure and following it. In order to improve the diagnosis and management of this symptom, clinicians should pay more attention to epileptic patients with PIH.

Headache related to use of cholinesterase inhibitors: study of a Cognitive Function Clinic population

donepezil, rivastigmine and galantamine are standard treatment for mildto-moderate Alzheimer’s disease (AD). Generally ChEIs are well tolerated [1], with a high retention rate [2]. Common adverse events (nausea, vomiting, diarrhoea, insomnia, muscle cramps) are related to cholinergic stimulation. The British National Formulary also lists headache as a side effect. Pooled donepezil clinical trial data indicated 8%–13% of patients experienced headache as an adverse event (vs. 9% in placebo group), which was considered medication-related in about half the patients [3]. To further investigate this, an observational study to measure headache frequency in a Cognitive Function Clinic population prescribed ChEIs was undertaken. Over a 5.5-year period (January 2001–June 2006 inclusive), 143 patients were commenced on ChEIs (Table 1). In addition to planned follow-up, patients and caregivers were provided with a telephone contact number in case of adverse drug effects. Two men (aged 70 and 56 years) with mild-to-moderate AD (MiniMental State Examination [MMSE] scores 25/30 and 23/30, respectively) complained of new daily headaches with features of tension-type headache within days of commencing donepezil at a low dose (5 mg/day). Headaches were continuous, global in distribution, aching in nature and unrelated to posture. One man noted headache improvement on lying still; he withdrew from treatment, with cessation of headaches and associatJ Headache Pain (2006) 7:440–441 DOI 10.1007/s10194-006-0335-y

Pediatric post-traumatic headache

Post-traumatic headache after craniocerebral trauma is not an uncommon occurrence in children and adolescents. It can occur after mild, moderate, or severe injury. The headache may have features of tension-type headache, migraine, or probable migraine and is rarely seen in isolation. It is often part of a syndrome encompassing a variety of somatic and psychobehavioral symptoms. In time, the headache and accompanying symptoms gradually resolve over a period of 8 to 12 weeks. However, sometimes it may become chronic, requiring a multidimensional management approach including pharmacologic intervention, physical rehabilitation, and cognitive-behavioral therapy as used in the adult population.

Tension-type headache: Classification and diagnosis

Tension-type headache (TTH) is the most prevalent form of primary headache in the general population. In this article, the diagnostic challenges of TTH are discussed. The classification of these headaches according to the second edition of the International Classification of Headache Disorders (ICHD-2) and the main differences between the ICHD-2 and the first edition of the classification (ICHD-1, 1988) are discussed. The typical features of TTH also are highlighted. Finally, the differential diagnosis of episodic and chronic TTH, emphasizing the situations more likely to raise doubts, is discussed. The wide clinical spectrum of TTH frequently challenges the physician's diagnostic acumen. A structured approach to the patient and a better comprehension of this variability of presentation should translate into better quality of care and a more specific diagnosis for TTH sufferers.

The tension headache component of chronic daily headache

Chronic daily headache (CDH) is an overarching term that includes multiple types of frequent primary headaches that are not trigeminal-autonomic cephalgias. The components of typical CDH can be divided into a more severe or "big" headache and a less severe or "little" headache. The big headaches tend to have features of migraine while the little headaches have features of tension-type headache (TTH). Whether this represents a spectrum or continuum or whether it is the superimposition of two unique headache entities is open to debate. For subjects with big and little headache, the concept that the TTH component is part of a spectrum seems likely. Subjects with only TTH and no migrainous component seem to represent a different entity, pure chronic TTH. These patients have a daily moderate headache that is poorly responsive to current therapies and appears to be a different TTH than the migraine tension type of CDH. The TTH component of CDH may represent multiple subdivisions of TTH.

Midfacial segment pain: implications for rhinitis and sinusitis.

During the past decade, studies on facial pain have shown that there is a distinct group of patients who have a form of facial neuralgia that has all the characteristics of tension-type headache, except that it affects the midface; it is called midfacial segment pain. The pain is described as a feeling of pressure, although some patients might feel that their nose is blocked when they have no nasal airway obstruction. Midfacial segment pain is symmetric, and it might involve areas of the nasion (the root of the nose), under the bridge of the nose, on either side of the nose, the peri- or retro-orbital regions, or across the cheeks. There might be hyperesthesia of the skin and soft tissues over the affected area. Nasal endoscopy and CT scans are typically normal. Most patients with this condition respond to low-dose amitriptyline, but noticeable improvement might require up to 6 weeks.