- Tolosa-Hunt Syndrome Complicating Idiopathic Hypertrophic Pachymeningitis: Case Report and Consideration About its Pathogenesis
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Suntae Hwang, Nayoung Kim, Byung-Kun Kim, Jasung Koo, Jong-Moo Park, Jung Ju Lee, Ohyun Kwon
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Published online December 31, 2008
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- Tolosa-Hunt Syndrome Complicating Idiopathic Hypertrophic Pachymeningitis: Case Report and Consideration About its Pathogenesis
- 편두통과 긴장형두통 환자에서의 자기공명영상 백질 이상
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Nayoung Kim, Suntae Hwang, Ja-Seong Koo, Ohyun Kwon, Jong-Moo Park
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Korean J Headache. 2007;8(2):69-72. Published online December 31, 2007
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- Background
Several reports have documented a high frequency of white matter abnormalities by MRI in migraineurs. However, there have been few studies on MRI abnormalities in tension-type headache. The purpose of our study was to determine whether the incidence and distribution of MRI abnormalities in tension-type headache differ from those in migraine Methods: We analyzed consecutive magnetic resonance imaging findings of 121 patients with migraine and tension type headache under 50 years old. Of the 121 patients, 74 were diagnosed as having migraine and 47 were diagnosed as having tension-type headache. Clinical information was obtained from headache patients database. MRI was revie- wed with respect to location, number and volume of focal white matter hyperintensities in FLAIR image. The location of white matter abnormalities were classified into periventricular and subcortical lesions. Results: White matter abnormalities were observed in 23% of migraine patients and; 28% of tension-type headache. Among the migraineurs, white matter abnormalities were seen in 22% with migraine without aura and 33% with mi- graine with aura. There was no significant difference in incidence of white matter abnormalities between the patients with migraine and tension-type headache(p=0.67) and between the patients with migraine without aura and with aura (p=0.62). The white matter abnormalities were most frequently located in subcortical area in both groups. Conclusions: The incidence and distribution of white matter abnormalities in MRI was not significantly different between the patients with migraine and tension-type headache. These findings suggest that two disorders may share a common pathomechanism.
- 일반연제-Clinical Characteristics of Migraine and Tension-type Headache: The Experience in Eulji Hospital
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Byung-Kun Kim, Hee-Jun Bae, Ja-Seong Koo, Oh-Hyun Kwon , Jong-Moo Park
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Korean J Headache. 2005;6(1):103-103. Published online June 30, 2005
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- Objectives
To analyze the epidemiological and clinical characteristics of migraine and tension-type headache(TTH) in secondary general hospital. Methods: Between January 2004 and April 2005, 625 patients(age, mean=42.7 years, ranging from 14 to 79 years; 454 women and 171men), who presented with headache as chief complaints, were recruited prospec- tively. Information on epidemiological and clinical characteristics was collected from the structured questionnaire and registry. The criteria defined by the International Headache Society were used in the diagnosis. A total of 95% of the patients had primary headache: migraine(26.9%, mean age±SD=36.0±11.4 years, 148 women and 20 men), probable migraine(5.1%), episodic TTH(21.3% mean age±SD=45.6±14.2 years, 89 women and 44 men), probable episodic TTH(6.6%), primary chronic daily headache which includes chronic migraine, chronic TTH, hemicrania continua, and new daily-persistent headache(19.4%), and other primary headache(15.7%). We analyze the clinical characteristics of migraine (except chronic migraine) and episodic TTH. Results: Sixteen patients(9.5%) of those with migraine had migraine with aura. The mean age at onset was 24.6±9.2 years in migraine and 37.9±14.5 years in TTH(p<0.05). Female sex was more prevalent in migraine (p<0.05). Migraine headaches were unilateral(57%), pulsating(52%), aggravated by physical activity(80%), and were accompanied by vomiting(58%), photophobia(70%), and phonophobia(76%). TTH were unilateral(55%), pulsating(18%), aggravated by physical activity(23%), and were occasionally accom- panied by photophobia(22%) and phonophobia(33%). The most frequently reported trigger factors for migraine were stress(82%), fatigue(72%), menstruation(36% of women), alcohol(30%), cold or hot weather(27%), missing a meal(24%), weekend(13%), overeating(12%), and food(7%). The most frequently reported trigger factors for TTH were stress(77%), fatigue (62%), missing a meal(20%), cold or hot weather(18%), alcohol(17%), menstruation(11% of women), overeating (8%), weekend(5%), and food(5%). Patients with migraine had a greater prevalence(p<0.05) of medication overuse history. Beck depression inventory score was not different between migraine(22.0±4.8) and TTH(23.4±5.8). Beck anxiety inventory score was significantly higher in TTH group(p<0.05). Sixty percent of migraineurs and 55% of patients with TTH reported receiving a physician diagnosis of headache. However, only 21% of migraineurs and 29% of patients with TTH received a diagnosis of their headache correctly. Sixty-five percent of misdiagnosed migraineurs reported a diagnosis of TTH. Thirty-one percent of misdiagnosed patients with TTH reported a diagnosis of migraine. Conclusions: Migraine and TTH are a common cause of recurrent headache in secondary general hos- pital. Stress and fatigue were most frequent triggering factors for both headache types. Prevalence of depression and unilaterality of headache is not different between two groups. Migraine most frequently misdiagnosed as TTH.
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