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Post-stroke Headache
AbstractPurpose of ReviewStroke is a major health concern and a leading cause of long-term disability. Persistent post-stroke headache (PPSH) is a common complication of stroke yet little is known about its specific characteristics or optimal management. The purpose of this review is to discuss the epidemiology, presentation, and hypothesized pathophysiology of PPSH. Acute and preventive treatment options, as well as specific concerns regarding triptans and the newer CGRP antagonists, will be discussed in detail as well.Recent FindingsThe 2018 International Classification of Headache Disorders, 3rd edition (ICHD-3) was the...
Source: Current Pain and Headache Reports - September 7, 2023 Category: Neurology Source Type: research

Sex and Gender Considerations in Episodic Migraine
AbstractPurpose of ReviewWe seek to update readers on recent advances in our understanding of sex and gender in episodic migraine with a two part series. In part 1, we examine migraine epidemiology in the context of sex and gender, differences in symptomatology, and the influence of sex hormones on migraine pathophysiology (including CGRP). In part 2, we focus on practical clinical considerations for sex and gender in episodic migraine by addressing menstrual migraine and the controversial topic of hormone-containing therapies. We make note of data applicable to gender minority populations, when available, and summarize kn...
Source: Current Pain and Headache Reports - June 9, 2022 Category: Neurology Source Type: research

Bruxism in Acute Neurologic Illness
AbstractPurpose of ReviewWhile traditionally encountered in ambulatory settings, bruxism occurs in patients with a variety of acute neurologic illnesses including encephalitis, intracerebral hemorrhage, traumatic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke. Untreated bruxism in acute neurologic illness can lead to tooth loss, difficulty in mouth care resulting in recurrent aspiration pneumonia, endotracheal tube dislodgement, and even tongue laceration or amputation. Inpatient clinicians should be aware of the etiologies and management strategies for bruxism secondary to acute neurologic illnes...
Source: Current Pain and Headache Reports - April 10, 2021 Category: Neurology Source Type: research

Diagnosis, Treatment, and Management of Dejerine –Roussy Syndrome: a Comprehensive Review
AbstractPurpose of ReviewPost-stroke pain represents a complex condition with few standardized diagnostic criteria. As such, the array of symptoms is often difficult to categorize and diagnose. Central post-stroke pain (CPSP), also known as Dejerine –Roussy syndrome, presents as painful paresthesia in any part of the body that is usually coupled with sensory abnormalities.Recent FindingsIn patients who had experienced a cerebrovascular accident, CPSP typically affects the same areas of the body that are also impacted by the general motor and sensory deficits that result from stroke. Though it is generally debated, CPSP i...
Source: Current Pain and Headache Reports - July 14, 2020 Category: Neurology Source Type: research

Headache in the Older Population: Causes, Diagnoses, and Treatments
AbstractPurpose of ReviewPrimary headaches are less common and differ in presentation in older versus younger individuals. Secondary headaches become more common among older patients.Recent FindingsDiagnosis and management of headaches in those>  65 years are discussed. Migraine and tension-type headaches are rarely new onset in this age group and should be a diagnosis of exclusion. In older individuals, migraine is more likely to be bilateral with less sensory sensitivities. Migraine aura may present without headache; careful assessment is needed to exclude stroke. Other primary headaches discussed include cough, hy...
Source: Current Pain and Headache Reports - May 28, 2020 Category: Neurology Source Type: research

Challenges of Robotic Gynecologic Surgery in Morbidly Obese Patients and How to Optimize Success
This article reviews the benefits of a minimally invasive approach in obese patients and provides a thorough guide to perioperative management of obese patients undergoing robotic gynecologic surgery. A useful set of tips and tricks to overcome many of the technical challenges in performing robotic surgery in the obese patients is included.Recent FindingsIn the USA, obesity has risen to affect 39.8% of the population, which leads to increased incidence of mortality, hypertension, diabetes, heart disease, and stroke. Moreover, obese patients are at greater risk of perioperative complications during gynecologic surgery. With...
Source: Current Pain and Headache Reports - June 30, 2019 Category: Neurology Source Type: research

Perioperative Considerations in the Management of Anticoagulation Therapy for Patients Undergoing Surgery
AbstractPurpose of ReviewAs ambulatory surgery has become increasingly more common, the appropriate management of anticoagulation therapy in patients undergoing invasive procedures has become progressively more relevant to healthcare professionals. The purpose of this literature review is to provide an overview of current common anaticoagulants and their pharmacological properties and to evaluate recent relevant literature and bridging therapy and provide recommendations on risk-guided therapy.Recent FindingsWith the development of new drugs and the advancing study and practice of anticoagulation use, clinicians must keep ...
Source: Current Pain and Headache Reports - February 22, 2019 Category: Neurology Source Type: research

Episodic Migraine With and Without Aura: Key Differences and Implications for Pathophysiology, Management, and Assessing Risks
AbstractPurpose of ReviewTo review the pathophysiologic, epidemiologic, and clinical evidence for similarities and differences between migraine with and without aura.Recent FindingsThe ICHD-3 has recently refined the diagnostic criteria for aura to include positive symptomatology, which better differentiates aura from TIA. Although substantial evidence supports cortical spreading depression as the cause of visual aura, the role (if any) of CSD in headache pain is not well understood. Recent imaging evidence suggests a possible hypothalamic origin for a headache attack, but further research is needed. Migraine with aura is ...
Source: Current Pain and Headache Reports - October 5, 2018 Category: Neurology Source Type: research

Cerebral Hyperperfusion Syndrome After Carotid Revascularization and Acute Ischemic Stroke
AbstractPurpose of ReviewCerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion.Recent FindingsCHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke. Pr...
Source: Current Pain and Headache Reports - March 19, 2018 Category: Neurology Source Type: research

Utility of Radionuclide Bone Scintigraphy in Complex Regional Pain Syndrome
AbstractPurpose of ReviewTo describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPBS patterns typically seen in CRPS patients.Recent FindingsCRPS is a debilitating disorder frequently presenting with pain to ordinarily non-painful stimuli, redness, swelling, following fractures, stroke, myocardial infarction, surgery, or even minor trauma, and its diagnosis, based on clinical criteria and supportive imaging findings, is difficult. Of the available...
Source: Current Pain and Headache Reports - February 1, 2018 Category: Neurology Source Type: research