Spontaneous Intracranial Hypotension
Spontaneous intracranial hypotension (SIH) typically presents as an acute orthostatic headache during an upright position, secondary to spinal cerebrospinal fluid leaks. New evidence indicates that a lumbar puncture may not be essential for diagnosing every patient with SIH. Spinal neuroimaging protocols used for diagnosing and localizing spinal cerebrospinal fluid leaks include brain/spinal MRI, computed tomography myelography, digital subtraction myelography, and radionuclide cisternography. Complications of SIH include subdural hematoma, cerebral venous thrombosis, and superficial siderosis. Treatment options encompass ...
Source: Neurologic Clinics - February 28, 2024 Category: Neurology Authors: Jr-Wei Wu, Shuu-Jiun Wang Source Type: research

Preface
Although an estimated 90% of headaches are of the primary type, the other 10% are secondary headache disorders, which are diverse and fascinating, at times potentially life-threatening, and sometimes challenging to diagnose. We update our well-received second issue on this topic, which appeared in May 2014. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 24, 2024 Category: Neurology Authors: Randolph W. Evans Source Type: research

Headache due to Vascular Disorders
Headache and cerebrovascular disease (CVD) are inextricably linked. Although in some cases headache complicating CVD may be little more than a symptomatic afterthought, in other cases, early recognition of headache ’s role in the CVD process is critical to effective management. In other words, headaches secondary to CVD span a spectrum, and in this article, we will review that spectrum. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 13, 2024 Category: Neurology Authors: John F. Rothrock Source Type: research

Headaches Attributed to Disorders of Homeostasis
Headaches attributed to disorders of homeostasis include those different headache types associated with metabolic and systemic diseases. These are headache disorders occurring in temporal relation to a disorder of homeostasis including hypoxia, high altitude, airplane travel, diving, sleep apnea, dialysis, autonomic dysreflexia, hypothyroidism, fasting, cardiac cephalalgia, hypertension and other hypertensive disorders like pheochromocytoma, hypertensive crisis, and encephalopathy, as well as preeclampsia or eclampsia. The proposed mechanism behind the causation of these headache subtypes including diagnostic criteria, eva...
Source: Neurologic Clinics - February 7, 2024 Category: Neurology Authors: Ana Marissa Lagman-Bartolome, James Im, Jonathan Gladstone Source Type: research

The Postconcussion Syndrome and Posttraumatic Headaches in Civilians, Soldiers, and Athletes
Posttraumatic headaches are one of the most common and controversial secondary headache types. After a mild traumatic brain, an estimated 11% to 82% of people develop a postconcussion syndrome, which has been controversial for more than 160  years. Headache is estimated as present in 30% to 90% of patients after a mild head injury. Most headaches are tension-type-like or migraine-like. Headaches in civilians, soldiers, athletes, and postcraniotomy are reviewed. The treatments are the same as for the primary headaches. Persistent postt raumatic headaches can continue for many years. (Source: Neurologic Clinics)
Source: Neurologic Clinics - January 16, 2024 Category: Neurology Authors: Randolph W. Evans Source Type: research

Temporomandibular Disorders, Bruxism and Headaches
Temporomandibular disorders (TMDs) and headache disorders are highly prevalent in the population. TMDs can present headache symptoms as a secondary headache and, in addition, be comorbid with primary headache disorders. This overlap has significant clinical implications for which it is essential for the physician to be aware, and they should screen for the potential presence of TMDs in a headache patient. Bruxism is a parafunctional behavior also prevalent in the population which has a role in TMDs and may influence headache symptomatology, but it is still necessary to clarify this relationship. (Source: Neurologic Clinics)
Source: Neurologic Clinics - January 13, 2024 Category: Neurology Authors: Marcela Romero-Reyes, Jennifer P. Bassiur Source Type: research

Headaches and Vasculitis
Vasculitis refers to heterogeneous clinicopathologic disorders that share the histopathology of inflammation of blood vessels. Unrecognized and therefore untreated, vasculitis of the nervous system leads to pervasive injury and disability making this a disorder of paramount importance to all clinicians. Headache may be an important clue to vasculitic involvement of central nervous system (CNS) vessels. CNS vasculitis may be primary, in which only intracranial vessels are involved in the inflammatory process, or secondary to another known disorder with overlapping systemic involvement. Primary neurologic vasculitides can be...
Source: Neurologic Clinics - January 12, 2024 Category: Neurology Authors: David S. Younger Source Type: research

Headache in Brain Tumors
This article reviews the current findings related to epidemiologic details, clinical manifestations, mechanisms, diagnostic approaches, and management of headache in association with brain tumors. (Source: Neurologic Clinics)
Source: Neurologic Clinics - January 12, 2024 Category: Neurology Authors: Soomi Cho, Min Kyung Chu Source Type: research

Headache Associated with Coronavirus Disease 2019
Headache affects around half of patients in the acute phase of COVID-19 and generally occurs at the beginning of the symptomatic phase, has an insidious onset, and is bilateral, and of moderate to severe intensity. COVID-19 may also present complications that cause acute and persistent headaches, such as cerebrovascular diseases, rhinosinusitis, meningitis, and intracranial hypertension. In 10% to 20% of patients with COVID-19, headache may persist beyond the acute phase. In general, the headache improves over time. To date, there are no clinical trials that have assessed the treatment of persistent post-COVID-19 headache....
Source: Neurologic Clinics - January 12, 2024 Category: Neurology Authors: Pedro Augusto Sampaio Rocha-Filho Source Type: research

Cervicogenic Headaches
Cervicogenic headaches are a secondary headache disorder attributable to cervical spine dysfunction resulting in head pain with or without neck pain. Diagnosis of this condition has been complicated by varied clinical presentations, causations, and differing diagnostic criteria. In this article, we aim to clarify the approach to diagnosing cervicogenic headaches by providing an overview of cervicogenic headaches, clinical case examples, and a practical diagnostic algorithm based on the most current criteria. A standardized approach will aid in confirmation of the diagnosis of cervicogenic headaches and facilitate further r...
Source: Neurologic Clinics - January 12, 2024 Category: Neurology Authors: Aishwarya V. Pareek, Everton Edmondson, Doris Kung Source Type: research

Trigeminal and Glossopharyngeal Neuralgia
Trigeminal neuralgia and glossopharyngeal neuralgia are craniofacial pain syndromes characterized by recurrent brief shock-like pains in the distributions of their respective cranial nerves. In this article, the authors aim to summarize each condition ’s characteristics, pathophysiology, and current pharmacotherapeutic and surgical interventions available for managing and treating these conditions. (Source: Neurologic Clinics)
Source: Neurologic Clinics - January 12, 2024 Category: Neurology Authors: Anthony K. Allam, M. Benjamin Larkin, Himanshu Sharma, Ashwin Viswanathan Source Type: research

Painful Eyes in Neurology Clinic
Eye pain is a common complaint among patients presenting to the neurology clinic. It can be related to neurologic diseases, but it can also be a localized eye condition. Such disorders can be misleading, as their benign appearance might mask more grave underlying conditions, potentially leading to misdiagnoses or delayed treatment. Clinicians should be aware of the specific neurologic or systemic disorders (eg, demyelinating diseases or vascular abnormalities) that might first manifest as eye pain. Formal ophthalmic consultation is recommended for patients presenting with eye pain as the predominant complaint especially wh...
Source: Neurologic Clinics - January 9, 2024 Category: Neurology Authors: Saif Aldeen Alryalat, Osama Al Deyabat, Andrew G. Lee Source Type: research

Cough, Exertional, and Sex Headaches
In this article, the authors review the most common presentations of cough and exertional headaches and headaches associated with sexual activity. The authors elaborate on the most commonly described etiologies and identify those which are most critical to treat. The authors outline the recommendations for further evaluation and discuss effective treatment modalities for each headache type. (Source: Neurologic Clinics)
Source: Neurologic Clinics - January 9, 2024 Category: Neurology Authors: Monique Montenegro, Fred Michael Cutrer Source Type: research

Other Secondary Headaches
This article discusses extremely common odontogenic pain conditions, which may occasionally present to the neurology clinic mimicking headache, and other uncommon orofacial pain conditions, which may do the same. Typical presentations, investigative strategies, and management are discussed, as well as highlighting key diagnostic criteria and the importance of involving oral or dental specialists where diagnostic uncertainty exists. (Source: Neurologic Clinics)
Source: Neurologic Clinics - January 9, 2024 Category: Neurology Authors: Emma V. Beecroft, David Edwards, James R. Allison Source Type: research

Headache Attributed to a Substance or Its Withdrawal
Identification of substances that may cause or trigger headache is important to start effective treatment early to prevent unnecessary suffering, deterioration in quality of life, and the development of chronic pain. Treatment in case of medication overuse and other chronic headache should be decisive and effective. Drug withdrawal and introduction of effective prophylactic medication for the underlying headache disorder should be the primary treatment strategy. Typical headache-inducing substances are nitric oxide, phosphodiesterase, cocaine, alcohol, histamine, carbon oxide, and calcitonin gene-related peptide. The withd...
Source: Neurologic Clinics - January 8, 2024 Category: Neurology Authors: Mark Obermann, Zaza Katsarava Source Type: research