2011;51:1161-1166) Objective.— We aimed to report 6 new cases of bifocal nummular headache (NH), showing their clinical characteristics and comparing them with those formerly described. Background.— NH is a focal head pain felt in a small, well-circumscribed, coin-shaped area. Among all the reported cases (over 200), 6 patients localized their pain in 2 or more separate areas. Methods.— We reviewed all patients diagnosed with NH at the headache clinics of 2 tertiary hospitals, searching for cases with head pain in 2 different areas. Results.— Six patients (4 female, 2 male; age at onset 40.8 ± 19.1, range 24-69 years) presented with bifocal NH. The shape and size of both painful areas were identical in each patient. They were located at symmetrical points of CP673451 either side in 3 patients, while 2 patients had both symptomatic areas on the same side of the head. The chronological pattern was synchronous in 2 patients, and the other 4 showed an additive pattern with onset intervals between the 2 areas ranging from 2 months to 30 years. Pain intensity was slightly different in each area in 4 of the cases. Four patients were treated with a preventive (gabapentin or carbamazepine) with good
clinical response. Conclusion.— Although not frequently found, some patients may have bifocal or multifocal NH. “
“Objective.— The primary goal of this study was to use headache criteria-based classification for headache types described by service members. Background.— Headache is common in soldiers returning from the wars Galunisertib solubility dmso in Afghanistan and Iraq. To date, few papers have provided detailed descriptions of these headaches. Methods.— The first 25 patients seen by a certified headache specialist at the Traumatic Brain Injury Center at Womack Army Medical Center, Fort Bragg, NC, between August 2008 and December 2009 are reported. Results.— Service members described
a total of 55 headaches. Most, but not all, headaches began within 1 week after injury. Migraine type was most common. Aura occurred in 5 soldiers. Continuous headaches were described in 88%. Uncommon headache types including cluster type were diagnosed. Additional symptoms and service outcomes are described. Conclusions.— We conclude that headaches occurring after various types of head injury, including explosions, selleck can be assigned primary and secondary headache diagnoses using standard classifications not necessarily available to larger survey-based studies. “
“(Headache 2010;50:937-942) Background.— Many clinicians use peripheral nerve blocks (NBs) and trigger point injections (TPIs) for the treatment of headaches. Little is known, however, about the patterns of use of these procedures among practitioners in the USA. Objectives.— The aim of this study was to obtain information on patterns of office-based use of peripheral NBs and TPIs by headache practitioners in the USA.