Impact of Tension-Type Headaches in the Workplace in Brazzaville

Introduction: Tension-type headaches are the most widespread of the primary headache disorders. Due to their high prevalence, tension-type headaches represent a major public health problem with an enormous socio-economic burden. Determining their impact remains a challenge. Objective: To assess the impact of occupational tension-type headache in Brazzaville and identify associated factors. Population and Methods: This was an analytical case-control study conducted in public and private companies in the city of Brazzaville over a period of four (04) months. The case population consisted of cephalalgic employees;the control population was drawn from the same companies and was free of tension-type headaches. Study variables were divided into socio-professional, clinical and individual impact variables. Individual impact variables were represented by: the HIT-6 score, which incorporates a very broad conception of disability, covering several domains, namely: severity of pain during attacks and the restrictive and limiting nature of attacks. Results: Individual impact was severe in 18 (62.1%) men and 11 (37.9%) women. Mean age was 36.3 6.14 years for cases with severe impact. The mean duration of headache was 40.3 32.7 months for cases with severe impact. Tension headache evolved in attacks in 22 (75.9%) cases with severe impact, and continuously in seven (24.1%) cases. The average number of attacks per month was 2.52 1.04 for cases with severe impact. Cases with severe impact included 14 (48.3%) with chronic headache and 15 (51.7%) with episodic headache. Pain of severe intensity present in 48.3% of cases was associated with a severe impact of tension-type headache: OR = 151.66 [2.36 - 44245.95] and p-value = 0.037. At least one days absence from work per year was observed in 47.4% of our cases. The number of days off work per year due to tension-type headache had an interquartile range between 0 and 3 days and extremes from 0 to 14 days. It was the consequence of a severe impact on daily and/or professional activities. Conclusion: The high frequency of tension-type headaches in the workplace and its impact on the condition of workers in Brazzaville represent a real public health problem. It was found that the number of days absent from work per year due to tension headaches was the consequence of a severe impact on daily and/or professional activities. An awareness-raising program in this environment seems necessary, as well as an assessment of working conditions.

Headaches and Erectile Dysfunction Medications at UTH-Kara (Togo)

Introduction: Headaches are a common symptom affecting individuals worldwide, including in the tropical zone, and have been extensively studied in Togo. Phosphodiesterase-5 inhibitors, commonly prescribed for erectile dysfunction, are known to induce headaches, yet there is a lack of research on this topic in sub-Saharan Africa and Togo. Methods: A cross-sectional study conducted from February 1st to June 30th, 2023, including adult patients seeking erectile dysfunction treatment and prescribed PDE-5 inhibitors. Results: A total of 28 patients were included in the study, with an average age of 34.46 ± 7.5 years. The age group of 30 - 39 years was the most represented (53.57%). Among the participants, 67.86% had a history of chronic headaches. During the intake of PDE-5 inhibitors, 71.43% reported the onset of headaches. Among the 19 patients with chronic headaches, 68.42% developed headaches following PDE-5 inhibitor use (RR = 0.88, 95% CI: 0.55 - 1.40, p = 0.484). The characteristics of the induced headaches were similar to the patients’ pre-existing headaches in 78.95% of cases. Additional symptoms included nasal congestion (36.84%) and an urge to have a bowel movement (26.32%). Sildenafil (75.00%) and Tadalafil (25.00%) were the primarily prescribed PDE-5 inhibitors. The incidence of headaches did not significantly differ between the two groups (RR = 1.33, 95% CI: 0.67 - 2.64, p = 0.306). Treatment for the induced headaches involved self-medication with paracetamol (65.00%) and nonsteroidal anti-inflammatory drugs (NSAIDs) (35.00%). Conclusion: Headaches induced by PDE-5 inhibitors are a well-established reality, emphasizing the need for caution and warning in patients with pre-existing headache conditions, while individualized approaches are necessary to address the potential interplay between migraine medications and erectile dysfunction treatments.

Recurrent headaches may be caused by cerebral toxoplasmosis

AIM: To establish seroprevalence and provide characteristics of Toxoplasma gondii(TG) infection in children with recurrent headaches. METHODS: The study was performed in 178 children aged 7-17 years admitted consecutively to the Department of Pediatric Neurology from November 2009 to July 2011. The children were surveyed with a questionnaire with the help and assistance of their parents and blood samples taken on admission were studied for the presence of specific anti-TG Ig M, Ig G antibodies and Ig G avidity using enzyme immunoassay Platelia Toxo Ig M, Ig G. RESULTS: The study showed that 19 children(8 boys, 11 girls; 8-17 years old, mean age 14.36 years) hadhigh serum anti-TG Ig G antibody levels(range: 32.2 > 240 UI/m L, mean 120.18 UI/m L; positive value for Ig G was ≥ 9 UI/m L). The avidity index(AI) ranged from 0.202 to 0.925(scale: ≥ 0.5 high AI). The results for Ig M antibodies were all negative and the obtained results ranged from 0.113 to 0.25 U/m L(mean = 0.191 IU/m L) and all values below 0.8 IU/m L were considered negative. The most frequent complaints found in the seropositive patients were headaches that affected the frontal(13 children), occipital(4) and parietal areas(5). Headaches usually had a pulsating(in 7 patients) and squeezing(6) character and rarely were piercing, dull or expanding. Interestingly, 8 children did not feel discomfort during the headaches, probably because they did not have sufficiently increased intracranial pressure yet. The headaches usually appeared 1-2 times/mo, lasted for 2-6 h, and had a mean intensity of 5.5 points in a 10 point subjective scale. The comorbidities included epilepsy(5 patients), various infections in 3 children(chronic eustachitis, chronic rhinitis, chronic purulent tonsillitis, streptococcal pharyngitis, meningitis, allergic diseases), disturbances of behavior, deficits of attention, and ocular and motor concentration disorders in 1 child. The electroencephalographic and neuroimaging studies performed in our patients had a very limited value in establishing cerebral toxoplasmosis.CONCLUSION: Ten point six seven percent of the studied children had markedly increased serum anti-TG Ig G antibodies and high AI indicated chronic infestation. It is suggested that tests for TG infection should be introduced to routine diagnostics in patients with recurrent headaches.

Comparison of cosyntropin versus caffeine for post-dural puncture headaches:A randomized double-blind trial

Cosyntropin has been reported to be effective in the treatment of post-dural puncture headaches, but there is a lack of data on its effectiveness. We compared the efficacy of cosyntropin with that of caffeine in the treatment of post-dural puncture headaches. We performed an interim analysis of a prospective, double blinded, trial of adult patients presenting to the emergency department with a post-dural puncture headache. Patients were randomized to receive either intravenous caffeine or intravenous cosyntropin. Values on a 100-mm visual analog scale （VAS） were recorded at 0, 60, and 120 minutes to assess pain. Rescue therapy was documented on the study data forms. Its effectiveness was determined by the need for this therapy. Thirty-seven patients were included and four patients were excluded from the analysis because of protocol violations or incomplete data. Analysis was based on intention-to-treat. Caffeine was 80% （95% CI 60-100%） effective and cosyntropin was 56% （95% CI 33-79%） effective in treating post-dural puncture headaches. The group＇s VAS scores at 0, 60, and 120 minutes were 80 mm, 41 mm, 31 mm for caffeine and 80 mm, 40 mm, 33 mm for cosyntropin, respectively （P=0.66）. Caffeine was not more effective than cosyntropin in treating patients with postdural puncture headaches, and there was no difference in the degree of pain relief on VAS assessment.

A pilot study eliminating immunologically-reactive foods from the diet and its effect on symptomatology and quality of life in persons with chronic migraines and headaches

Purpose: Chronic migraines and headaches are significant public health problems, and their symptomatologies have been positively linked to diet. We explored if individuals suffering from chronic migraines/ headaches who required medication treatment had improvement in symptomatology and subjective ratings of QoL when following an immune-reactive food exclusion diet based on the results of the ImmunoBloodprint test, an IgG-mediated food sensitivity assay. Methods: Thirty-seven subjects, aged 18 and over, took part in the study. Subjects had to eliminate all reactive foods from their diet for 90 days. Migraine intensity and frequency were measured using the MTAQ, and QoL was assessed with the SF-36 survey at base- line and 30-, 60-, and 90-day follow-up. Results: Sub- jects who eliminated IgG-mediated reactive foods from their diet had reductions in migraine symptomatology and had improvements in nearly all indicators of QoL, according to the SF-36, from baseline to 90-day follow-up. Conclusions: Subjects were able to improve their migraine symptoms and QoL in response to eliminating IgG reactive foods from the diet. This test may represent a strategy to help mediate chronic migraine symptomatology without the use of medication.

Repeat RF Ablation of C2 and Third Occipital Nerves for Recurrent Occipital Neuralgia and Cervicogenic Headaches

Objective: To address the degree and duration of pain relief from recurrent cervicogenic headaches and/or occipital neuralgia following retreatment with radiofrequency ablation of the C2 dorsal root ganglion and/or third occipital nerves;to review outcomes including duration and degree of pain relief;to evaluate procedure’s complication rate and patient’s willingness to repeat the procedure;to compare effectiveness of the most recent RF ablation to patient’s first RF ablation. Methods: This is a single-center retrospective observational study of 23 patients with recurrent cervicogenic headaches and/or occipital neuralgia treated with repeated RF ablation of the C2 dorsal root ganglion and/or third occipital nerves. All patients receiving treatment from January 2010 to July 2014 are included in this single site retrospective study. This is an IRB approved medical chart review study. Results: 22 of 23 patients underwent follow-up. An average of 86.5% of participants reported pain relief on average of 25.4 weeks at time of follow-up. 41% reported side effects including suboccipital hyperesthesia and/or ear discomfort, 95% reported willingness to repeat the procedure again if severe symptoms recurred, 59% of patients reported the most recent RF ablation had the same results as the first, 32% reported the most recent RF was the most effective, and 9% reported that the first RF was the most effective. Conclusion: Repeated RF ablation is a feasible option for recurrent cervicogenic headaches and/or occipital neuralgia. Effectiveness of repeat intervention is the same or better than the first ablation. Though there was a higher likelihood of side effects including suboccipital neuralgia and/or ear discomfort on repeat treatment, the side effects were generally well tolerated.

TREATMENT OF HEADACHES BY ACUPUNCTURE AND CHINESE HERBAL THERAPY Conclusive Data Concerning 1000 Patients

IntroductionThis clinical experience concerns 1000patients suffering from headache and treat-ed by acupuncture,moxibustion andChinese herbal therapy during the decade1980-1990.It is a polycentric work.Thetherapy was given in some out-patient de-partments belonging to different local cen-tres of Italian National Health Service:themost rapresentative were the

Case Studies on Acupuncture Principles in Headaches

Objective:This observational cohort pilot study aimed to evaluate the effects of the acupuncture methods,Jiu Cang Zhen(JCZ)and Huang Guan(HG),on changes in headache intensity in an inpatient,multimodal Zurzach Headache Programme(ZHP).Methods:Study participants consisted of patients diagnosed with chronic headache disorder(headache ds,30 days per month)or daily persistent headache.All patients received conventional therapies with active and passive approaches.The patient group was treated with JCZ and HG acupuncture methods,receiving a total of six to eight acupuncture sessions of 50 to 60 minutes each,during a 3–4-week multimodal ZHP at the RehaClinic Bad Zurzach.Pain intensity was quantified using a Numerical Rating Scale(NRS)before and after each acupuncture therapy session.Results:Ten patients were recruited,six women and four men,with a mean age of 41.7(standard deviation,[SD]=13.9).A reduction in headache intensity was reported by all patients in each of the sessions.The average NRS for pain was 4.21(SD=1.44)before acupuncture and 1.24(SD=0.93)after acupuncture(means first by number of sessions,then per n=10 patients).This resulted in a mean difference of 2.97(SD=1.04),corresponding to a standardized response mean of 2.85(95%confidence interval:2.11–3.60,one-tailed P<0.001),meaning there was a large effect.Conclusions:This pilot study shows that JCZ and HG are suitable acupuncture methods for reducing headache intensity in the treatment of headaches.A comparison with the conventional classical acupuncture methods from the acupuncture textbook for traditional Chinese medicine students in China,exploration with a larger patient group,and prolonged monitoring of pain behavior could be foci of follow-up investigations.

Headaches Associated with N95 Mask Usage amongst Healthcare Workers in Operating Theatres during COVID-19 Pandemic: A Cross-Sectional Study

Introduction: N95 respirator masks are a cornerstone in the fight against the ongoing COVID-19 pandemic. However, its use has side effects such as headaches. The primary aim of this study is to identify factors that may contribute to higher occurrences of headaches with wearing N95 masks. Methods: A cross-sectional study was conducted across healthcare providers in operating theatres of a tertiary hospital based in Singapore involved in the care of COVID-19 patients. The study involved a self-administered online questionnaire completed by all participants. Results: 176 participants were included into the study, of which 65 (36.9%) reported headaches associated with wearing N95 masks. Out of the 65 participants who experienced headaches, 28 (43.1%) reported experiencing “mild” headache, 30 (46.2%) reported experiencing “moderate” headache, and 7 (10.7%) reported experiencing “severe” headache. 44 participants (67.7%) reported that the headache has affected their work, and 20 participants (30.8%) required analgesia to relieve the headaches. Other symptoms associated with N95 mask usage include skin damage (12.3%), breathlessness (15.4%), giddiness (6.2%), nausea (6.2%) and ear pain (3.1%). Multivariate logistic regression analysis showed that participants younger than 32 years old (p = 0.001) and history of pre-existing headache disorders (p = 0.001) were associated with higher occurrences of headaches with wearing N95 masks. Conclusion: Our study showed that younger age and history of pre-existing headache disorders contribute to higher occurrences of headaches with N95 mask usage. These associations could be useful in identifying at-risk individuals so that precautions may be taken to reduce the occurrence of headaches when wearing N95 masks.

A Meta-Analysis of the Genome-Wide Association Studies on Two Genetically Correlated Phenotypes Suggests Four New Risk Loci for Headaches

Headache is one of the commonest complaints that doctors need to address in clinical settings.The genetic mechanisms of different types of headache are not well understood while it has been suggested that self-reported headache and self-reported migraine were genetically correlated.In this study,we performed a meta-analysis of genome-wide association studies(GWAS)on the self-reported headache phenotype from the UK Biobank and the self-reported migraine phenotype from the 23andMe using the Unified Score-based Association Test(metaUSAT)software for genetically correlated phenotypes(N=397,385).We identified 38 loci for headaches,of which 34 loci have been reported before and four loci were newly suggested.The LDL receptor related protein 1(LRP1)-Signal Transducer and Activator of Transcription 6(STAT6)-Short chain Dehydrogenase/Reductase family 9C member 7(SDR9C7)region in chromosome 12 was the most significantly associated locus with a leading p value of 1.24×10^(-62)of rs11172113.The One Cut homeobox 2(ONECUT2)gene locus in chromosome 18 was the strongest signal among the four new loci with a p value of 1.29×10^(-9)of rs673939.Our study demonstrated that the genetically correlated phenotypes of self-reported headache and self-reported migraine can be meta-analysed together in theory and in practice to boost study power to identify more variants for headaches.This study has paved way for a large GWAS meta-analysis involving cohorts of different while genetically correlated headache phenotypes.

Exploring cerebral structural and functional abnormalities in a mouse model of post-traumatic headache induced by mild traumatic brain injury

Mild traumatic brain injury(mTBI)-induced post-traumatic headache(PTH)is a pressing public health concern and leading cause of disability worldwide.Although PTH is often accompanied by neurological disorders,the exact underlying mechanism remains largely unknown.Identifying potential biomarkers may prompt the diagnosis and development of effective treatments for mTBI-induced PTH.In this study,a mouse model of mTBI-induced PTH was established to investigate its effects on cerebral structure and function during short-term recovery.Results indicated that mice with mTBI-induced PTH exhibited balance deficits during the early post-injury stage.Metabolic kinetics revealed that variations in neurotransmitters were most prominent in the cerebellum,temporal lobe/cortex,and hippocampal regions during the early stages of PTH.Additionally,variations in brain functional activities and connectivity were further detected in the early stage of PTH,particularly in the cerebellum and temporal cortex,suggesting that these regions play central roles in the mechanism underlying PTH.Moreover,our results suggested that GABA and glutamate may serve as potential diagnostic or prognostic biomarkers for PTH.Future studies should explore the specific neural circuits involved in the regulation of PTH by the cerebellum and temporal cortex,with these two regions potentially utilized as targets for non-invasive stimulation in future clinical treatment.

Radiotherapy for hyoid bone metastasis from lung adenocarcinoma:A case report

BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metastasis of lung adenocarcinoma to the hyoid bone,accompanied by a distinctive headache.Previous documentation involved surgical resection of the hyoid mass.We present a case displaying the benefits of palliative radiotherapy.CASE SUMMARY A 72-year-old non-smoking,non-alcoholic woman,initially under investigation for a year-long elevation in absolute lymphocyte count,presented with a monthlong history of intermittent throat pain.Despite negative findings in gastroenterological and otolaryngologic examinations,a contrast-enhanced chest computed tomography scan revealed a mediastinal mass and questionable soft tissue thickening in her left anterolateral neck.Subsequent imaging and biopsies confirmed the presence of lung adenocarcinoma metastasis to the hyoid bone.The patient was treated with platinum-based chemo-immunotherapy along with pembrolizumab.Ultimately,the lung cancer was unresponsive.Our patient opted for palliative radiation therapy instead of surgical resection to address her throat pain.As a result,her throat pain was alleviated,and it also incidentally resolved her chronic headaches.This is the second documented case of lung adenocarcinoma metastasizing to the hyoid bone.CONCLUSION Palliative radiotherapy may add to the quality of life in symptomatic patients with cancer metastatic to the hyoid bone.

A case of Rickettsia felis infection-induced encephalitis in a pregnant woman

Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.

Predicting Acute Mountain Sickness Using Regional Sea-Level Cerebral Blood Flow

Objective To investigate the role of sea-level cerebral blood flow(CBF)in predicting acute mountain sickness(AMS)using three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL).Methods Forty-eight healthy volunteers reached an altitude of 3,650 m by air after undergoing a head magnetic resonance imaging(MRI)including 3D-pCASL at sea level.The CBF values of the bilateral anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),and posterior inferior cerebellar artery(PICA)territories and the laterality index(LI)of CBF were compared between the AMS and non-AMS groups.Statistical analyses were performed to determine the relationship between CBF and AMS,and the predictive performance was assessed using receiver operating characteristic(ROC)curves.Results The mean cortical CBF in women(81.65±2.69 mL/100 g/min)was higher than that in men(74.35±2.12 mL/100 g/min)(P<0.05).In men,the cortical CBF values in the bilateral ACA,PCA,PICA,and right MCA were higher in patients with AMS than in those without.Cortical CBF in the right PCA best predicted AMS(AUC=0.818).In women,the LI of CBF in the ACA was different between the AMS and non-AMS groups and predicted AMS with an AUC of 0.753.Conclusion Although the mechanism and prediction of AMS are quite complicated,higher cortical CBF at sea level,especially the CBF of the posterior circulatory system,may be used for prediction in male volunteers using non-invasive 3D-pCASL.

Granulomatous lobular mastitis treated by a combined internal and external treatment of traditional Chinese medicine:A case report

BACKGROUND Granulomatous lobular mastitis(GLM)is a rare benign inflammatory disease of the breast and is classified under comedo mastitis in traditional Chinese medicine(TCM).The etiology of this disease is unknown,and it mainly occurs in women of childbearing age.The diagnosis depends on histopathological biopsy.At present,there is no systematic and standardized treatment plan for GLM.In the absence of evidence supporting an infectious etiology,affected patients might continue to receive multiple courses of antibiotics and unnecessary surgery.CASE SUMMARY A 37-year-old Chinese woman with a history of coronavirus disease 2019 infection presented with swelling and pain in the left breast.She also had erythema,nodules in the lower extremities,arthritis in both knees,cough,and headache.In the early stage of GLM,the mass was not significantly reduced by conservative treatment with internal application of TCM;hence,surgical treatment was carried out.The aim of postoperative treatment was to drain the pus,eliminate the necrosed tissue,and expand the muscles;fumigation and washing using TCM was applied.CONCLUSION Combined internal and external treatment with TCM,following the principle of“Prioritize internal treatment before ulceration and emphasize external treatment after ulceration”was effective in our patient with GLM.The prognosis was good.We believe that TCM offered valuable therapeutic benefits in this disease.

鼻颅底真菌感染误诊1例

1临床资料患者,男,72岁,因反复头痛、咽喉痛3年,于2022-09-04收入重庆市人民医院。入院时患者头痛呈持续性隐痛,以后枕部为甚;咽喉痛放射至全颈,颈部活动受限,只能进流食。3年前患者无明显诱因出现头痛、咽喉痛,伴双耳痛及双耳持续流脓,多在当地医院对症处理。

Pajama Headaches

Yrou may recall the media reported at the beginning of this year a strange new global phenomenon-the pajama ban. It started in Cardiff, in Wales in the United Kingdom, in January. A Tesco supermarket in the St Mellon area of Cardiff escorted an indignant Elaine Carmody

Headaches Don't Have to Rule Your Life

和感冒一样,头痛也是最常见的一种“小恙”。尽管是小恙。但它can seriously interfere with(妨碍)your enjoyment of Iife,因此大意不得。那么如何预防头痛呢?文章提出了十诫:从心理到生理,从饮食起居到日常保健,可谓无微不至。

Retrospective Analysis of the Correlation between TMD, Headache and Bruxism

Aims: To evaluate the association between bruxism, headaches, and temporomandibular disorder (TMD). Methods: A keyword search of the clinical notes of patients’ charts in AxiUmTM was performed using the search terms “TMD”, “headache”, and “sleep bruxism” to identify these patients. The inclusion criteria were patients with partial of full dentition, aged 18 to 65 years old who attended the UNLV School of Dental Medicine clinics between January 2014 and September 2018. Patients with incomplete records and those who were completely edentulous formed the exclusion criteria. Data were analyzed using the Pearson Correlation Coefficient. Results: The final sample was made up of 529 patients. The highest percentage of study subjects were in the age range of 29 - 34 (17.9%), with a statistically significant correlation to pain on opening (P = 0.0403). Females showed a statistically significant correlation to TMJ clicking (P = 0.0033). Caucasians also had a statistically significant correlation to TMJ clicking (P = 0.0001). In addition, a statistically significant correlation between pain on opening or chewing and headaches was also observed (P = 0.0081). Conclusion: Within the limitations of the present study, Caucasians, and females presented with more TMJ clicking than the other study subjects. Young adults, in particular, experienced more pain on opening or chewing.