Biomedical subjects

L C Sanin

Publications and source records attributed to L C Sanin.

4 recordsLinked to original sources

PubMed1996

Coexistence of migraine and idiopathic intracranial hypertension without papilledema.

Eighty-five patients with refractory transformed migraine type of chronic daily headache (CDH) had spinal tap as a part of diagnostic work-up. Twelve had increased intracranial pressure without papilledema, transient visual obscurations, or visual field defects. The headache profile of these 12 patients was not different from that of transformed migraine type of CDH. Acute headache exacerbations responded to specific antimigraine agents such as ergotamine, dihydroergotamine (DHE), and sumatriptan, whereas prophylactic antimigraine medications were only partially helpful. Addition of agents such as acetazolamide and furosemide, after the diagnosis of increased intracranial pressure, resulted in better control of symptoms. These observations suggest a link between migraine and idiopathic intracranial hypertension that needs further research. In refractory CDH with migrainous features, a spinal tap to exclude coexistent idiopathic intracranial hypertension without papilledema may be indicated.

Acetazolamide↗

PubMed1994

The International Headache Society (IHS) headache classification as applied to a headache clinic population.

Four hundred patients attending a headache clinic were classified using the IHS criteria. The majority required more than two, often three or four, diagnoses. Even though migraine was the most common diagnosis, only 1/4 of those with a migraine diagnosis had it as the only diagnosis. Seventy-five percent of migraine patients had coexistent chronic tension-type headache (CTTH), drug-induced headache or both. Ninety-six percent of patients diagnosed as having migraine with aura also suffered from migraine without aura. More than 1/3 of patients (37.7%) attending the clinic suffered from chronic daily headache (CDH) (chronic cluster headache excluded), which is not included as a separate entity in the IHS classification. Pure CTTH formed only a small minority of CDH, whereas 86.6% of CDH had migraine as one of the diagnoses. Drug-induced headache was a prominent second or third diagnosis. The advantages and disadvantages of multiple verses single diagnosis in CDH and the need to recognize the natural history of headache disorders in the classification are discussed.

Ambulatory Care Facilities↗

PubMed1993

Severe diffuse intracranial vasospasm as a cause of extensive migrainous cerebral infarction.

We report on a 47-year-old white female with a long history of recurrent episodes of migraine with aura, who progressed to develop a continuous intractable headache during the course of which cortical blindness and quadriparesis occurred due to extensive and bilateral hemispheric cerebral infarction. Severe diffuse intracranial major arterial vasospasm was demonstrated by arteriogram. All studies were negative for CNS vasculitis, including cerebral biopsy. The arterial spasm reversed itself, but the patient did not improve. Smoking was the only additional risk factor. Vasospasm is an important cause to be considered in migrainous infarctions. The use of vasoconstrictor agents such as DHE in patients with migraine with prolonged aura has to be carefully re-evaluated.

Blindness↗

PubMedDate not supplied

Extratrigeminal cluster headache.

Three cases with periodicity and pain profile characteristic of episodic cluster headache, whose headaches were solely confined to the regions of the head and neck outside the trigeminal territory, are reported. Two were females, who had associated nausea and vomiting with severe attacks. The male patient exhibited autonomic symptoms in the eye during the attacks. Alcohol induced headache in one. All three patients responded to anticluster headache therapy. These cases are illustrative of a wider spectrum of clinical manifestations of cluster headache than was originally recognized. They question the theory that cluster headache may be due to a lesion involving the cavernous sinus. One the other hand, it points to involvement of a more complex pain circuit consisting of upper cervical nerves, posterior fossa innervation, trigeminal system and the autonomic pathways.

Adult↗