- Alcohol-Induced Headache: A Narrative Review Based on Migraine Pathophysiology
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Woo-Seok Ha
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Headache Pain Res. 2026;27(1):21-29. Published online February 23, 2026
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DOI: https://doi.org/10.62087/hpr.2025.0027
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Correction in: https://doi.org/10.62087/hpr.2025.0027.e1
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 Abstract
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- Alcohol-induced headache (AIH) is one of the most common headache experiences and is associated with a substantial socioeconomic burden; however, its pathophysiological mechanisms and clinical classification remain inadequately defined. Accumulating evidence indicates that AIH shares key biological pathways with migraine, particularly involving activation of the trigeminovascular system and calcitonin gene-related peptide (CGRP) signaling. Although currently available hangover remedies are supported by limited high-quality evidence, anti-CGRP treatments have emerged as a biologically plausible option for the situational prevention and acute treatment of AIH. A phenotype-based approach is therefore essential for achieving accurate diagnosis and effective management of alcohol-related headaches. Future well-designed clinical trials focusing on CGRP antagonists are warranted to address this common yet neglected disorder.
- Availability, Accessibility, and Utilization of Diagnostics and Therapeutics for Spontaneous Intracranial Hypotension in Asia
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Soyoun Choi, Woo-Seok Ha, Soo-Jin Cho, Aynur Özge, Betül Baykan, Esme Ekizoglu, Kiratikorn Vongvaivanich, Koichi Hirata, Linh Tuyen Nguyen, Mamoru Shibata, Min Kyung Chu, Otgonbayar Luvsannorov, Ryotaro Ishii, Shengyuan Yu, Shih-Pin Chen, Shuu-Jiun Wang, Takao Takeshima, Tsubasa Takizawa, Vinh Khang Nguyen, Wei-Ta Chen, Yen-Feng Wang, Soo-Kyoung Kim, Mi Ji Lee
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Headache Pain Res. 2025;26(2):142-153. Published online June 16, 2025
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DOI: https://doi.org/10.62087/hpr.2025.0005
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- Purpose: Recent advances in imaging techniques have significantly enhanced the diagnosis of spontaneous intracranial hypotension (SIH). However, these developments have been reported mostly in Europe and the United States. This study aimed to evaluate the availability and utilization of diagnostic and treatment modalities for SIH in Asia, through a survey of regional headache specialists.
Methods
A literature search was conducted using PubMed, and members of the Asian Regional Consortium for Headache were contacted. Participants completed a two-step survey evaluating the availability, accessibility, and frequency of SIH diagnostic and treatment methods in their countries and institutions. Descriptive statistics were used to analyze the data.
Results
Twenty physicians from eight countries completed both rounds of the survey. Lumbar puncture, brain magnetic resonance imaging (MRI), and spinal MRI are widely available across Asia, but real-time imaging techniques—such as dynamic computed tomography myelography and digital subtraction myelography—that precisely localize cerebrospinal fluid leaks are less accessible. Blind or semi-targeted epidural blood patches (EBPs) are available at most centers, but are easily accessible in only about half of cases. Surgical interventions are rarely available.
Conclusion
Most diagnostic methods for SIH are available in Asia, despite some regional disparities. The utilization of EBP and surgical interventions remains somewhat limited. This highlights the need for greater awareness and standardization of diagnostic methods in Asia.
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Citations
Citations to this article as recorded by  - Temporal and regional trends in the diagnosis and treatment of spontaneous intracranial hypotension: a systematic review
Woo-Seok Ha, Soyoun Choi, Mi-Kyoung Kang, Hye Yun Kim, Soo-Jin Cho, Soo-Kyoung Kim, Mi Ji Lee
The Journal of Headache and Pain.2026;[Epub] CrossRef - Diagnostic Value of Flow-Void Sign for Localizing Ventral Dural Defects in Spine MRI
Soo-Im Jang, Soyoun Choi, Seung Ae Kim, Hoe Jong Jeong, Ja-Young Choi, Mi Ji Lee
Journal of Clinical Neurology.2026; 22(3): 364. CrossRef - Current Concepts in the Diagnosis and Management of Spontaneous Intracranial Hypotension
Woo-Seok Ha, Min Kyung Chu
Journal of the Korean Neurological Association.2026; 44(2): 110. CrossRef - Surgical Treatment of Spontaneous Intracranial Hypotension: Clinical Characteristics and Outcomes in a Surgically Treated Cohort of Type 1 and Type 3 Leaks
Woo-Seok Ha, Hyun Woong Mun, Soomi Cho, Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Min Kyung Chu, Yoon Ha
Journal of Clinical Medicine.2026; 15(13): 4972. CrossRef
- Primary Headache Associated with Sexual Activity Presenting with Persistent Genital Arousal Disorder: A Case Report
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Woo-Seok Ha, Hye-Kyung Baek
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Headache Pain Res. 2024;25(2):117-121. Published online September 2, 2024
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DOI: https://doi.org/10.62087/hpr.2024.0012
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13,043
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- Persistent genital arousal disorder (PGAD) is characterized by unwanted and distressing genital sensations that are not associated with concomitant sexual interest or thoughts. Several etiologies have been proposed, but the underlying mechanism of the condition remains unclear. In this report, we describe a case of PGAD presenting with primary headache associated with sexual activity (PHASA). A 57-year-old female with no history of headache experienced recurrent, unwanted episodes of genital arousal lasting 3 to 5 days for 4 years. One day, she began to experience intense genital arousal that she had never experienced before. On the fourth day of arousal, while attempting intercourse with her partner, she experienced an abrupt explosive headache, which was repeated during another session of intercourse a week later. The patient underwent laboratory tests, as well as brain magnetic resonance imaging (MRI) and magnetic resonance angiography, all of which showed normal findings. She was referred to a sexual medicine specialist and prescribed amitriptyline, escitalopram, and propranolol with a diagnosis of PGAD. Her sexual arousal gradually diminished, and when she stopped all medications 3 months later, all symptoms had disappeared. On further investigation, spinal MRI revealed a Tarlov cyst. She has been in remission for three years. This case illustrates the co-occurrence of PHASA and PGAD and suggests a possible common pathophysiology shared between these two rare disorders.
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Citations
Citations to this article as recorded by - Early nimodipine treatment in reversible cerebral vasoconstriction syndrome: A serial transcranial Doppler study
Soohyun Cho, Minjung Seong, Mi Ji Lee
Headache: The Journal of Head and Face Pain.2025; 65(9): 1617. CrossRef - Hallmarks of primary headache: part 4 – rare headache syndromes
Gabriele Sebastianelli, Woo-Seok Ha, Roberta Messina, Li-Ling Hope Pan, Alejandro Labastida-Ramirez, Eloisa Rubio-Beltran, Doga Vuralli, William Wells-Gatnik, Sophie Merve Yener, Paolo Martelletti
The Journal of Headache and Pain.2025;[Epub] CrossRef
- Association between Psoriasis and Migraine in a Nationwide Cross-Sectional Study in Korea
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Woo-Seok Ha, Soohyun Cho
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Received July 6, 2026 Accepted July 27, 2026 Published online August 20, 2026
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DOI: https://doi.org/10.62087/hpr.2026.0031
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Abstract
- Purpose: Psoriasis and migraine are common chronic disorders that may share neuroimmune mechanisms, although the biological basis of their association remains uncertain. This study investigated the association between psoriasis and migraine, focusing on psoriasis severity and migraine subtypes, using a large population-based database.
Methods
This population-based cross-sectional study used data from the Korean National Health Insurance Service database. We identified 329,363 adults who underwent national health screening in 2019, including 8,892 patients with psoriasis and 320,471 individuals without psoriasis. Psoriasis severity was classified according to the use of systemic or biologic agents, and migraine was categorized according to the presence of aura. Multiple logistic regression analyses were performed with adjustment for age, sex, comorbidities, body mass index, smoking status, alcohol consumption, income, and residential area.
Results
In the fully adjusted model, patients with psoriasis had higher odds of prevalent migraine than individuals without psoriasis (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.10–1.25). This association was observed in both mild psoriasis (OR, 1.17) and moderate-to-severe psoriasis (OR, 1.19). Psoriasis was also significantly associated with non-aura-coded migraine (OR, 1.17; 95% CI, 1.10–1.25), whereas migraine with aura was not significantly associated with psoriasis.
Conclusion
Psoriasis was cross-sectionally associated with higher odds of prevalent migraine, including non-aura-coded migraine, after adjustment for measured demographic, clinical, and lifestyle factors. Longitudinal studies are needed to determine temporality and address potential detection bias related to healthcare utilization.
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