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At least 19 recordsLinked to original sources

PubMed1992

A Canadian population survey on the clinical, epidemiologic and societal impact of migraine and tension-type headache.

Trained telephone interviewers contacted 1,573 adults across Canada about the nature and frequency of headaches suffered by them or by others in their households. Using a table of pain symptoms and other characteristics abstracted from the International Headache Society (IHS) classification, the headaches were assigned to migraine headache, tension-type headache or other diagnostic groups. Of the households sampled, 59% had at least one headache sufferer in residence. The proportion of headache sufferers with migraine was 14%; with tension-type, 36%; and with both, 14%. Migraine headache caused more disability than tension-type headache, with nearly 20% of migraine sufferers taking time off work and disability lasting for a mean of 1 day. It is concluded that the current prevalences of migraine and tension-type headache in Canada fall around the mean of previous studies, that the IHS criteria can form a basis for diagnostic classification and that the functional impact of migraine has been seriously underestimated in the past.

Adolescent↗

PubMed1992

Cervicogenic headache, migraine without aura and tension-type headache. Diagnostic blockade of greater occipital and supra-orbital nerves.

The diagnostic value of greater occipital and supra-orbital nerve blockades in patients with cervicogenic headache, migraine without aura, and tension-type headache was investigated. The pain reduction after greater occipital nerve blockade was significantly more marked in the cervicogenic headache group than in the other categories. Moreover, pain reduction in the forehead was generally only found in the cervicogenic headache patients (77%). Pain reduction (in %) was significantly more marked following the greater occipital than the supra-orbital nerve blockade. The volume effect per se was evaluated by saline injection. This procedure did not result in distinct pain reduction. The effect obtained in cervicogenic headache is, accordingly, probably due to the local anaesthesia. The present results support the postulate that different pathogenetic factors probably are responsible for cervicogenic headache, tension-type headache, and migraine without aura.

Adolescent↗

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

Transcranial Doppler ultrasonic features in episodic tension-type headache.

In a pilot study we used transcranial Doppler ultrasound (TCD) to measure cerebral blood flow velocities in 21 headache-free episodic tension-type headache sufferers and in the same number of age- and sex-matched control subjects. We found increased blood flow velocities in the anterior, middle and posterior cerebral arteries and a decreased pulsality index in the middle and posterior cerebral arteries in tension-type headache sufferers compared to controls. Vascular bruits were significantly more frequent in the basal cerebral arteries of the patients compared to controls. There were no significant asymmetries of blood flow velocities in corresponding arteries. The findings suggest a multifactorial pathogenesis in episodic tension-type headache including vascular abnormalities.

Adult↗

PubMed1992

Transcranial Doppler ultrasonic features in chronic tension-type headache.

We studied vascular features in patients suffering from chronic headache of the tension-type by means of transcranial Doppler ultrasound (TCD). Blood flow velocities of the basal cerebral arteries and the submandibular extracranial part of the internal carotid artery were compared between 20 chronic tension-type headache sufferers and the same number of age- and sex-matched control subjects. There were no significant differences of ultrasonic features between the groups. Changes in blood flow velocities do not seem to be involved in the pathogenetic mechanisms of chronic tension-type headache.

Blood Flow Velocity↗

PubMed1992

The 5-HT1-like agonist sumatriptan has a significant effect in chronic tension-type headache.

Subcutaneous treatment of chronic tension-type headache with 2 mg and 4 mg sumatriptan, a selective 5-hydroxytryptamine1-like receptor agonist, was compared with placebo in a double-blind crossover study of 36 patients. The effect was evaluated using a 6-point verbal relief rating scale and by visual analog scale ratings of headache intensity before and for 2 h after treatment. Sumatriptan induced a modest but significantly greater headache relief than placebo, whereas no significant difference was found between the two doses of sumatriptan. Headache relief following sumatriptan was significant after 60 min and still seemed to be increasing after 120 min when the examination terminated. Three possible mechanisms of action of sumatriptan in tension-type headache are discussed.

Adult↗

PubMed1992

Migraine and tension-type headache in a general population: psychosocial factors.

In a cross-sectional study of headache disorders in a representative general population, the prevalence of migraine and tension-type headache was assessed in relation to various psychosocial factors. The random sample comprised 1000 25-64 year old men and women of whom 740 attended the investigation. The headache disorders were classified on the basis of a clinical interview, a physical and a neurological examination using the operational diagnostic criteria of the International Headache Society. None of the sociodemographic variables: marital status, cohabitation, educational level, occupational category or employment status were significantly associated with migraine or tension-type headache. In the univariate analyses tension-type headache was significantly associated with a high Neuroticism score on the Eysenck Personality Questionnaire whereas migraine was not. Variables on work conditions and psychosocial factors significantly associated with the headache disorders in univariate analyses were subjected to multivariate analysis. Migraine was significantly associated with exposure to chemicals and fumes at work in women and poor self-appraisal of health in men. In the univariate analyses tension-type headache was significantly related to a series of psychosocial variables. In the multivariate analyses it remained associated with a current feeling of fatigue in both sexes, time-pressure at work in women and exposure to fumes in men.

Adult↗

PubMed1992

Beta-endorphin concentrations in the peripheral blood mononuclear cells of migraine and tension-type headache patients.

Levels of beta-endorphin in peripheral blood mononuclear cells have been studied as a new approach to investigating opioid tone in migraine and tension-type headache. Sixty-one patients with migraine without aura, 39 with migraine with aura and 23 with episodic tension-type headache were compared with 37 healthy controls. Peripheral blood samples were taken from patients not enduring headache attacks and not undergoing prophylactic treatment. A significant reduction in peripheral blood mononuclear cell beta-endorphin concentrations was observed in migraine patients with and without aura, but not in tension-type headache patients. Altered transmitter modulation to peripheral blood mononuclear cells may be the cause of this alteration, which could be part of a more diffuse opioid system derangement in migraine subjects.

Adult↗

PubMed2026

Comparative effects of pharmacological interventions in the prophylactic treatment of tension-type headache: systematic review and network meta-analysis.

BACKGROUND: Tension-type headache (TTH) is the most common neurological disorder. The comparative effect of pharmacological interventions for TTH prophylaxis remains unclear. We aimed to assess the comparative effects of pharmacological interventions in the prophylactic treatment of TTH. METHODS: Ovid Medline, Embase, and Cochrane were searched from inception to 12 December, 2025. Randomized controlled trials (RCTs) of medications compared to placebo or another medication for preventing TTH were included. The primary outcome was headache days per month. A Bayesian random-effect model was employed as the primary analysis of chronic TTH. RESULTS: Thirty-five RCTs were included, 33 (88.6%) RCTs involved chronic TTH patients, and 24 RCTs provided available data for meta-analysis. Amitriptyline 100 mg presented more reduction of monthly headache days than placebo at 4 and 8 weeks (4 weeks: MD -6.59, 95% CrI -11.22 to -0.64; 8 weeks: MD -6.14, 95% CrI -10.27 to -0.87). BTX-A 100 U can reduce monthly headache days (MD -3.79, 95% CrI -7.16 to -0.33). Amitriptyline 100 mg was the highest-ranked treatment for monthly headache days at 4 (SUCRA 0.85), 8 (SUCRA 0.85), and 24 (SUCRA 0.87) weeks; 12 weeks was lidocaine 25 ml (SUCRA 0.75). Amitriptyline 100 mg and BTX-A 500 U showed a higher adverse event rate than placebo. CONCLUSION: Amitriptyline 100 mg and BTX-A 100 U may be options to reduce monthly headache days in patients with chronic TTH. Given the low to very low certainty of evidence, high risk of bias, and high heterogeneity, more studies are needed. TRIAL REGISTRATION: PROSPERO (CRD42025639586).

Humans↗

PubMed1992

Evidence for an altered dopamine beta-hydroxylase activity in migraine and tension-type headache.

Sympathetic dysfunction is often present in migraine. It has been suggested that serum dopamine-beta-hydroxylase (D beta H) can be taken as an index of peripheral sympathetic activity. We studied the serum D beta H activity in migraine with and without aura and in tension-type headache patients compared with healthy control subjects. The serum D beta H activity was significantly lower in migraine and tension-type headache patients than in the control group. No significant difference was observed among the three groups of patients studied. These findings suggest that patients with migraine and tension-type headache have a sympathetic hypofunction that may play an important role in the pathogenesis.

Adult↗

PubMed1992

Tizanidine in chronic tension-type headache: a placebo controlled double-blind cross-over study.

The efficacy of tizanidine in chronic tension-type headache was compared with placebo in a randomized, double-blind and cross-over study in 37 women aged 20 to 59 years with a history of headache for 7 months to 30 years (median 5 years). The treatment periods were 6 weeks with an intervening 2 week wash-out period. The treatment was started with 6 mg/day divided into three doses, and the daily dose could be increased to 18 mg/day depending on the treatment response. The effect of the treatment was measured by visual analogue scale, verbal rating scale, number of days free of headache, number of analgesics needed, and the dose of trial medication needed. In all these measurements, tizanidine was statistically significantly more effective than placebo. The pre-trial Beck Depression Inventory score did not predict the response to treatment, neither did the level of electromyographic activity of the trapezius muscle. Side-effects, drowsiness and dry mouth were significantly more common during tizanidine treatment but they were usually mild. The results of the present trial suggest that tizanidine is effective in the treatment of chronic tension-type headache in women.

Adult↗

PubMed1992

Plasma and cerebrospinal fluid beta-endorphin in chronic tension-type headache.

Previous studies have provided evidence of an increased sensitivity to pain, a decreased hypothalamic opioid tone, and decreased cerebrospinal fluid (CSF) beta-endorphin (beta-EP) concentration in patients with primary chronic headache. We applied separate specific radioimmunoassays for beta-EP in CSF and plasma on samples from age-matched controls and a group of 50 patients with chronic tension-type headache (CTH) fulfilling the diagnostic criteria set by the International Headache Society. Median CSF beta-EP concentrations (95% confidence limits) were 12.8 pmol/l (11.0-14.5) in CTH patients and 11.9 pmol/l (10.9-14.2) in the control group, which is not significantly different (P = 0.28). Plasma beta-EP concentrations did not differ either, being 3.1 pmol/l (2.4-3.7) and 3.3 pmol/l (1.8-4.0) in the patients with CTH and in controls, respectively (P = 0.88). Plasma and CSF beta-EP concentrations did not correlate. Reversed-phase high performance liquid chromatography (HPLC) of CSF pools from the headache patients and controls revealed similar profiles of beta-EP-immunoreactivity both when C-terminally and N-terminally directed antisera were used, suggesting a normal post-translational processing of the pro-opiomelanocortin gene in patients with CTH. beta-EP is not involved in the pathogenesis of CTH, or such a role is not reflected in CSF or plasma concentrations of the neuropeptide.

Adult↗

PubMed1992

Orbital phlebography: a comparison between cluster headache and other headaches.

Orbital phlebography has previously been found to be pathologic in 8 of 13 patients with episodic cluster headache. To compare the frequency and pattern of the pathologic findings in cluster headache with those in other headache categories, orbital phlebographies were carried out in patients with cluster headache, cervicogenic headache, migraine and tension-type headache (tension headache). The investigations were evaluated independently by two radiologists, one of whom had no knowledge of the diagnoses. The frequencies of pathologic findings were at maximal 2/12 in the cluster headache group, 2/11 in the cervicogenic headache group, 5/12 in the migraine group and 5/15 in the tension-type headache group. The investigators agreed completely in the evaluation of 39/50 phlebograms, with lesser disagreements in 7. In conclusion, the frequency of pathologic findings at orbital phlebography in cluster headache was not higher than in the other diagnostic categories investigated, and the pattern of the pathology was generally the same.

Adult↗

PubMed1992

The role of stressful life events in the persistence of primary headache: major events vs. daily hassles.

This study investigated the role of major stressful life events vs. minor life events (i.e., daily hassles) in the persistence of primary headache. It was hypothesized that chronic headache patients (n = 83) would be characterized not so much by exposure to a continued surfeit of inherently major life events as by a tendency to appraise cognitively and emotionally any ongoing microstressor or daily hassle as being more arousing or impactful than headache-free controls (n = 51). As predicted, chronic headache patients reported a significantly higher frequency (P < 0.01) and density (P < 0.01) of daily hassles, but not of major life events, than controls. Furthermore, minor life events were significantly correlated with headache frequency (P < 0.001) and density (P < 0.001) but not with gender, age and headache history. In terms of item content, health-related hassles (e.g., trouble relaxing) were perceived as being the most stressful. Significant differences between headache subgroups (chronic tension-type headache, migraine, mixed headache) were found, with tension-type and mixed headache sufferers reporting a higher incidence and density of daily hassles than migrainous patients. It was concluded that daily hassles were significantly associated with the persistence of headache and might be a better life event approach to chronic headache than major stressful events.

Adolescent↗

PubMed1992

Chronic daily headache: long-term prognosis following inpatient treatment with repetitive IV DHE.

We retrospectively studied the long-term (2-year) outcome of 50 consecutive patients admitted to our inpatient headache program because of chronic daily headache (CDH) associated with the overuse of analgesics, ergotamine, or both. They had been detoxified, given repetitive intravenous dihydroergotamine (IV DHE) and prophylactic medications as part of the program, and had become headache-free on this regimen. At the time of admission, 37 of the 50 patients had transformed migraine (TM), 12 had new daily persistent headache (NDPH), and 1 had chronic tension-type headache; 29 of the patients with TM, 7 of those with NDPH, and the single patient with chronic tension-type headache had coexistent migraine. Substances abused, alone or in combination, included: caffeine in 39 patients (av. 441 mg/d), acetaminophen in 32 (av. 2187 mg/d), aspirin in 24 (av. 1807 mg/d), ibuprofen in 9 (av. 1156 mg/d), narcotics in 7 (av. 10.1 mg morphine equivalents/d) and ergotamine in 11 (av. 2.3 mg/d). Twenty patients were using preventive medication at the time of admission. Follow-up evaluations were performed at 3, 6, 12, and 24 months after discharge. Forty-three patients were analyzed at 3 months. Of these, 44% had an excellent or good result and 28% a fair result; 3 were overusing analgesics. At 24 months, 39 patients were analyzed: 59% had a good or excellent result and 28% a fair result; 5 were overusing analgesics, 4 of whom were doing poorly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[Drug-induced headache].

Migraine or tension-type headache lasting for several years is frequently complicated by chronic daily headaches. Those patients recurrently take analgesics or ergotamines. Headache induced by chronic ergotamine use is well known. Recent studies, however, have shown that a similar form of headache is caused by analgesic abuse. Treatment of drug-induced headaches envisages withdrawal of the headache medication.

Analgesics↗

PubMed1992

Presentation of a new instrument: the diagnostic headache diary.

A new instrument, the Diagnostic Headache Diary, based on the operational diagnostic criteria of the International Headache Society (IHS), was tested in 61 migraine patients from a headache research clinic using the clinical diagnosis (IHS criteria) for comparison. All patients kept the diary for one to eight months. The clinical and diary diagnosis of migraine with and without aura was the same in, respectively, 72 and 87% of the patients. Nausea, photophobia and phonophobia tended to be more pronounced at the clinical interview. The diary identified 20 more cases of episodic tension-type headache and 15 fewer cases of chronic tension-type headache than the clinical interview. Two blinded observers always made the same IHS diagnoses when interpreting the diagnostic headache diary. A combination of a clinical interview and the diagnostic headache diary gives a qualitatively and quantitatively more precise diagnosis than a clinical interview alone.

Adult↗

PubMedDate not supplied

The "temporalis-inhibitory reflex" in post-lumbar puncture headache.

Nausea and rigidity of the neck muscles, typical symptoms of post-lumbar puncture syndrome (PPS), may also be found in patients suffering from chronic headache of the tension-type. A decreased duration of the late suppression period of temporal muscle activity indicating a central disturbance of pericranial muscle control, can be observed in these patients. We have studied the temporalis-inhibitory reflex in 47 neurological inpatients requiring lumbar puncture. There were no significant differences of latencies or durations of temporalis silent periods between patients with and without PPS before, and 48 h following, lumbar puncture.

Adolescent↗