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Biomedical subjects

L C Newman

Publications and source records attributed to L C Newman.

14 recordsLinked to original sources
PubMed1992

Evaluation of chronic daily headache--comparison to criteria for chronic tension-type headache.

The purpose of this study was to evaluate the adequacy of the International Headache Society (IHS) criteria for chronic tension-type headache and, if appropriate, suggest modifications of the IHS classification. We evaluated 100 consecutive patients with chronic daily headache. Approximately two-thirds of our patients fulfilled the criteria for chronic tension-type headache. Most of the patients who failed to meet the criteria did so because they had more than one migrainous feature. Approximately 50% of patients took excessive amounts of analgesic medication. We conclude that the IHS criteria should be modified to include chronic daily headache evolving from migraine; subtypes with and without medication overuse should be distinguished.

Adolescent↗
PubMed1992

Chronic paroxysmal headache: two cases with cerebrovascular disease.

Paroxysmal headaches often occur in benign headache disorders such as episodic cluster headache, chronic paroxysmal hemicrania (CPH) and episodic paroxysmal hemicrania. We report 2 patients with paroxysmal headaches occurring in association with cerebrovascular disease. The first patient had paroxysmal headaches from an arteriovenous malformation which resolved following embolization. In the second patient, headache followed a cerebral infarction and responded to treatment with indomethacin. We suggest that vascular disease may cause paroxysmal headaches resembling CPH. Patients with an atypical presentation of CPH warrant a neuroimaging procedure.

Adult↗
PubMed1992

Hemicrania continua: attacks may alternate sides.

Hemicrania continua (HC) is characterized by a continuous unilateral headache of moderate severity, occurring in 2 patterns; a continuous form in which headaches persist continuously without remission for years, and a remitting form, consisting of headache phases separated by periods of pain-free remission. The remitting form of HC must be distinguished from other cyclical headache disorders such as episodic paroxysmal hemicrania and episodic cluster headache. Characteristically, the headache of HC is unilateral and without sideshift. We now report a case of HC in which headaches alternate sides.

Aged↗
PubMed1992

Clinical features of chronic daily headache.

Patients with chronic daily headaches are commonly encountered in headache specialty centers but their clinical characteristics have rarely been documented. We studied 100 consecutive patients with chronic daily headache to determine their presenting characteristics and other associated features. Half of the patients described their headache as a steady ache but throbbing pain was reported in about one third. About half estimated the degree of pain as moderate but one third claimed the typical pain was severe. A consistently unilateral site was noted in only 2 percent. Associated features characteristic of migraine were often noted: Including photophobia (37 percent), photophobia (42 percent), and nausea (24 percent). Many also reported aggravating and ameliorating factors commonly associated with migraine. We conclude that the manifestations of chronic daily headache are extremely diverse, probably reflecting the heterogeneous mechanisms which underlie this condition.

Adolescent↗
PubMed1992

Episodic paroxysmal hemicrania: two new cases and a literature review.

Episodic paroxysmal hemicrania (EPH) is a rare disorder characterized by discrete bouts of hemicranial headache separated by headache-free remissions. Although EPH resembles episodic cluster headache in the location and quality of pain as well as the pattern of associated autonomic features, it is distinguished by the greater frequency and shorter duration of individual headaches. Differentiation of these disorders is important because EPH almost invariably responds to treatment with indomethacin but not to standard cluster headache therapy.

Adult↗
PubMed1991

Myocardial ischemia related to ergot alkaloids: a case report and literature review.

Ergotamine tartrate and methysergide are widely used headache treatments with important vasoconstrictive properties. We report a 31-year-old man with cluster headaches who developed severe, prolonged myocardial ischemia following combination therapy with ergotamine tartrate and methysergide. We reviewed the cardiovascular complications of each agent alone and in combination. Given the pharmacologic similarity of these agents, we propose that they may have additive or synergistic cardiac toxicity, at least in vulnerable individuals. We recommend caution when these agents are used together.

Adolescent↗
PubMed1991

Headache in HIV-1-related disorders.

To define the causes, clinical significance and characteristics of headaches in HIV-1-related disorders, we studied 49 consecutive HIV-1 infected patients who presented with headache. Work-up included CT scans, cerebrospinal fluid examinations (in the absence of a contraindication) and serologic studies. Overall, 40 of 49 patients (82 percent) had an identifiable serious cause of headache. Cryptococcal meningitis (39 percent) and CNS toxoplasmosis (16 percent) were the leading headache etiologies. Serious causes were more likely in patients diagnosed with AIDS prior to presentation but also occurred in most patients in early stages of infection. Based on this study, we suggest that patients with HIV-1 infection must be managed with a high index of suspicion when they present with new onset headaches.

Adult↗
PubMed1990

Nuchal features of cluster headache.

Nuchal symptoms were found in the majority of 100 consecutive patients with cluster headache. In 10%, pain was experienced in the neck with the initial typical orbitotemporal pain; in 37%, pain radiated from the orbit or temple to the ipsilateral side of the neck. Sometimes, neck pain heralded the onset of the attack by a few minutes. During an attack, neck stiffness was reported in 40% and tenderness in 29%. Movement of the neck, especially flexion, precipitated cluster headache in 9% of patients. This was particularly true of patients with chronic cluster headache. Neck movement aggravated the headache in 16 of 100 patients and an equal number reported amelioration of pain by neck movement, especially extension. The nuchal features did not necessarily accompany every attack and were usually overshadowed by the severity of the typical headache. Nevertheless, symptoms referable to the neck occur more commonly than is generally appreciated.

Adult↗
PubMed1989

Aspartame as a dietary trigger of headache.

Many dietary factors have been implicated as possible precipitants of headache. There have been recent differences of opinion with regard to the effect of the artificial sweetener aspartame as a precipitant of headache. To assess the importance of aspartame as a dietary factor in headache, 190 consecutive patients of the Montefiore Medical Center Headache Unit were questioned about the effect of alcohol, carbohydrates and aspartame in triggering their headaches. Of the 171 patients who fully completed the survey, 49.7 percent reported alcohol as a precipitating factor, compared to 8.2 percent reporting aspartame and 2.3 percent reporting carbohydrates. Patients with migraine were significantly more likely to report alcohol as a triggering factor and also reported aspartame as a precipitant three times more often than those having other types of headache. The conflicting results of two recent placebo-control studies of aspartame and headache are discussed. We conclude that aspartame may be an important dietary trigger of headache in some people.

Adolescent↗