Headache and Pain Research

종설 : 편두통과 도파민: Jeong Wook Park; Korean J Headache. 2006;7(2):65-70. Published online December 31, 2006

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Abstract PDF: This review summarized the contribution of dopamine in the pathophysiology in migraine from multiple investigators who had reported alteration in dopaminergic neurotransmission in migraine patients. A reduction in frequency and severity of attacks in migraine has been observed after they developed Parkinson‘s disease, and serum levels of dopamine was increased in patients with migraine without aura. The clinical trials involving treatment with dopamine receptor anta- gonists for migraine provide strong evidence for the involvement of dopamine. The accompanying symptoms during a migraine attack, such as nauea, vomiting, dizziness and orthostatic faintness may be related to dopaminergic activa- tion. Recent genetic association studies have addressed the possible genetic role of the dopaminergic system in migraine. The studies investigating dopamine-related candidate genes have revealed some interesting but as yet inconclusive.

종설 : 새로운 편두통 치료 약물: Min-Kyung Chu; Korean J Headache. 2006;7(2):71-78. Published online December 31, 2006

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Abstract PDF: Migraine is a common, disabling headache disorder and imposes a significant burden personally and socially. Recent advances in migraine treatment including new drugs for acute and preventive treatment make it possible for more effective migraine management. Newly introduced acute treatment drugs are second generation triptans, calcitonin gene- related related peptide receptor antagonist, 5-HT1D receptor inhibitor, and adenosine A1 receptor agonist. Second genera- tion triptans are almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan and zolmitriptan. New triptans offer more oral efficacy, a better adverse-event profile, a more rapid onset of action and a better response consistency. Newly introduced drugs for migraine preventive treatment are topiramate, zonisamide, levetiracetam, venlafaxine, botulinum toxin, lisinopril, candesartan, riboflavin, coenzyme Q10, magnesium, feverfew and petasites. Newly introduced migraine treatment drugs would help for more successful management of migraine.

원저 : 소아 반복성 두통의 다기관 임상 연구: 국제두통질환분류 제2판 제1차 수정판 적용: So-Hee Eun, Baik-Lin Eun, Kyu Young Chae, Ji-Eun Choi, Jung Chae Park, Hoon-Chul Kang, Su Jeong You, Hee Jung Chung; Korean J Headache. 2006;7(2):79-87. Published online December 31, 2006

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Abstract PDF: Background
Headaches are very common during childhood and become increasingly more frequent during adolescence. It should be carefully assessed and managed due to the disability associated with headache is substantial and includes a diminished quality of life, related to physical and mental health as well as impaired achievement of academic work, memory, personality, and interpersonal relation. This is the pilot study of prevalence, characteristics, and patterns of health care used for headache in korea. Objects and Methods: To investigate prospectively the headache's distribution and characteristics in a children & adolescence. Conducted for 7 months into 7 pediatric services in areas of Seoul & Kyungki province with 280 patients of recurrent headaches over 3 months. Protocol of evaluation(form of questionnaires, physical and neurologic examination, laboratory and neuroradiologic studies) was standardized. We used the 2nd edition of the international classification of headache disorders. Results: In our ongoing multicentric prospective study, we examined 280 consecutive children and adolescents of 4 to 18 years old. Primary headache was 244(87.1%) composed with mostly 198(70.7%) of migraine including 88(31.4%) of migraine without aura, 43(15.4%) of migraine with aura, 7(2.5%) of childhood periodic syndrome, 1(0.4%) of retinal migraine, 9(3.2%) of only presenting with chronic migraine features, and 50(17.9%) of probable migraine. Of these, 60(21.4%) had headaches on more than 15 days per month for 3 months. Conclusions: Primary headache especially migraine is most common in classification of recurrent headaches of children. Chronic daily headaches are also frequent in children with need of management. More detailed classification and specific managements about headaches in children are required.

원저 : 편두통 환자의 경부 방사선 소견: Kyu Hyun Park, Tae Woo Yoo; Korean J Headache. 2006;7(2):88-93. Published online December 31, 2006

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Abstract PDF: Purpose: According to criteria of International Headache Classification, there is no abnormal finding in routine laboratory test in migraineurs. Some cases of migraineurs have progression to chronic course. Such cases of migraineurs complained of occipital and neck pains and showed abnormal cervical radiological findings. In this study we studied the radiological finding in migraineurs complaining of chronic neck pain and distress. Subjects and Methods: The 200 patients with migraine without aura who complained of chronic headache for more than 3 years without other neurological or system diseases were included in this study. We used Korean Hand Therapy Method to confirm the location of tender points on the neck which was already published. Routine laboratory tests including cervical spine radiological study were performed. Results: Among 200 migraineurs, number of female is 148, that of male is 52. Mean age is 48 years old. The right side of neck pain is more than left side. The persons having complaints of neck pain also had tenderness on forehead, temporal, ocular and occipital area. The radiological findings are different among migraineurs. Conclusion: The chronic migraineurs having chronic progressive course and long periodic cycles for more than 3 years have some abnormal finding on the radiological finding which mechanism is not known yet.

원저 : 만성두통에서 성상신경절차단의 효과: Doo-Ik Lee, Keon Sik Kim, Wha Ja Kang, Su Young Kim, Sabina Lim, Jae-Dong Lee, Do-Young Choi, Yun-Ho Lee; Korean J Headache. 2006;7(2):94-99. Published online December 31, 2006

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Abstract PDF: Background
Because the cause and etiology of chronic headache are not yet fully explained, the treatment is not simple and difficult. Chronic headache imposes considerable burdens on sufferer and society as well. Although stellate ganglion block(SGB) is usually used for the treatment of chronic headache, we evaluated and compared the effectiveness of SGB in treating chronic tension headache and migraine patients on pain alleviation and improving the quality of life after an 8 weeks treatment duration. Methods: Patients who experienced headache for more than 4 hours a day and more than 15 days a month were diagnosed as chronic headache and 46 subjects in total were enrolled in this study. The patients were randomly classified into two groups, migraine group(MG, n=26) and tension headache group(TG, n=20). The patients of both groups were treated with only SGB twice a week for 8 weeks and evaluated effectiveness after 4 and 8 weeks of treatment, and 4 weeks after the end of treatment. The effectiveness of these treatments in two groups were analyzed using Visual Analogue Scale(VAS) pain scores and Brief Pain Inventory(BPI). Results: The VAS and BPI after 8 weeks of treatment showed significant differences compared with those of MG and TG before treatment and there were no differences between two groups. The VAS and BPI of two groups, 4 weeks after the end of treatment, showed also statistically significant improvement compared with those before treatment in both groups. Conclusions: The above results suggested that SGB might be an useful modality for alleviating the pain and improving the quality of life in TG and MG patients.

증례 : 비행에 의해 유발되는 두통: Young-Do Kim, In-Uk Song, Jeong-Wook Park, Joong-Seok Kim, Jae-Young An, Yeong-In Kim, Kwang-Soo Lee; Korean J Headache. 2006;7(2):100-102. Published online December 31, 2006

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Abstract PDF: A 46-year old man was admitted to neurology department because of severe headache associated only with airplane travel. When the plane started descending, a severe jabbing pain suddenly developed in the occipital area. The pain remained severe for 15 to 20 minutes until the plane landed. After the plane had landed, the pain alleviated spon- taneously and recovered completely after about 45 minutes. The brain computer tomography revealed chronic bilateral maxillary and right frontal sinusitis.

증례 : 재발성 벼락두통 2례: 고혈압 위기: Hyung-Geun Oh, Hyung-Kook Park, Tae-Woong Kim, Kyung-Bok Lee, Kwang-Ik Yang, Dushin Jeong, Ki-Bum Sung, Moo-Young Ahn; Korean J Headache. 2006;7(2):103-105. Published online December 31, 2006

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Abstract PDF: Thunderclap headache(TCH) begins suddenly and is severe at onset. There are many kinds of cause including headache attributed to hypertensive crisis. Headache is generally regarded as a symptom of high blood pressure despite the conflicting opinions on the association of headache and arterial hypertension. Acute hypertensive crisis can be easily overlooked in a patient presenting with TCH. In such cases, hypertension might be misconstrued as a part of stress response, secondary to TCH. Two young adult women complained recurrent TCH. When they suffered from headache, the systolic blood pressure was above 160mmHg. There weren't response to analgesics but antiypertensive medication. These head- aches are fulfilling the ICHD-II criteria for headache attributed hypertensive crisis without hypertensive encephalopathy. We suggest hypertensive crisis might be required in the differential diagnosis of TCH.

증례 : 돌발 기침과 두통: Kyungmi Oh, Seong-Cheol Cho, Byung-Jo Kim, Kun-Woo Park, Dae-Hie Lee; Korean J Headache. 2006;7(2):106-108. Published online December 31, 2006

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Abstract PDF: A 56-year-old man presented with a 40-day history of paroxysmal cough and hemicranial headaches occurring 5 to 10 times per day. The characteristic of headache was severe dull & aching nature in the left frontotemporal area for approximately 20 minutes. The headache attack was always accompanied concurrently by paroxysmal cough. Nasopharyngeal MRI revealed neck mass which encasing left cervical internal carotid artery and lower cranial nerves. Cough and headache, and other multiple lower cranial palsies were progressed and aggravated. We believe that the symptoms presented as simultaneous paroxysmal cough and headache might be related to mass lesion which stimulated vagus nerve.

증례 : 대동맥류박리에 의한 두통 2례: Eujung Park, Oh-Young Kwon, Seonguk Jung, Nack-Cheon Choi, Ki-Joung Park, Hee-young Kang, Byeong Hoon Lim; Korean J Headache. 2006;7(2):109-111. Published online December 31, 2006

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Abstract PDF: A 73-year-old woman with atherosclerosis and a 56-year-old woman with hypertension complained frontal headache. Chest X-ray showed the mediastinal widening and chest CT revealed aortic dissection in both patients. Headache is rare as an initial symptom of aortic dissection. The headache was assumed be due to either vessel distension or pericarotid plexus ischemia. In the patients who have the risk factors for atherosclerosis and the mediastinal widening in chest X-ray, aortic dissection should be considered as a cause of headache.

증례 : 말초 혈액의 호산구 증가 없이 발생한 호산구성 뇌막염: Dong-Geun Lee, Joong-Seok Kim, In-Uk Song, Jeong-Wook Park, Kwang-Soo Lee; Korean J Headache. 2006;7(2):112-114. Published online December 31, 2006

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Abstract PDF: Eosinophilc meningitis is a rare clinical entity that can be useful in narrowing the differential diagnosis of central nervous system. The causes of eosinophilic meningitis are diverse: parasite infection, fungal infection, idiopathic hypereosinophilic syndrome, and Hodgkin's disease. But the most common cause of eosinophilic meningitis is invasion of the central nervous system by helminthic parasites, particularly Angiostrongylus cantonensis. And the most cases have occurred in Southeast Asia and throughout the Pacific basin, which are endemic areas. We report a patient with primary eosino- philic meningitis without eosinophilia.

증례 : 자발성 접형동 후벽 누관에 의한 세균성 뇌막염 1례: Jun-Young Lee, Dae-Hyun Kim, Jae-Moon Kim; Korean J Headache. 2006;7(2):115-117. Published online December 31, 2006

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Abstract PDF: Spontaneous cerebrospinal fluid(CSF) fistula constitutes only 3% to 4% of all CSF fistulas. The posterior wall of sphenoid sinus is rarely implicated as a site of spontaneous CSF fistula. A 41-year-old woman was admitted for headache, fever and continuous rhinorrhea. She had not experienced head injury. The CT scan revealed the pneumocephalus and a defect at the posterior part of sphenoid sinus. Bacterial meningitis was diagnosed by the CSF examination. The rhinorrhea was found to have a glucose content compatible with CSF. By isovist CT cisternography, we found? CSF fistula was likely to be on the left posterior wall of sphenoid sinus. We performed transnasal endoscopic sinus surgery with anti- biotic treatment. She recovered from her symptoms and has been free of CSF rhinorrhea. Because CSF rhinorrhea and pneumocephalus implicates the bony defect, rapid evaluation and treatment for a CSF leak site is essential.

증례 : 다발성 농양 및 안내염을 동반한 크렙시엘라 뇌막염 1례: Jong-Kwan Park, So-Young Park, Dong-Ha Lee, Yong-Jin Cho, Joong-Yang Cho, Han-Joon Kim, Keun-Sik Hong; Korean J Headache. 2006;7(2):118-120. Published online December 31, 2006

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Abstract PDF: Klebsiella pneumoniae usually causes pneumonia, pyogenic liver abscess, and bacteremia. Meningitis is a rare form of Klebsiella infection. We report a case of Klebsiella meningitis associated with liver abscess, renal abscess, and endoph- thalmitis. A 69-year-old man presented with headache, fever and altered mentality. Antibiotic therapy was administered under the impression of bacterial meningitis based on brain CT and CSF examination. Despite the improvement of CSF profiles, patient was deteriorated with aggravation of laboratory profile such as liver enzyme, bilirubin, and creatinine levels. Multiple liver and renal abscesses were found on abdominal CT and treated with abscess drainage. Klebsiella was isolated in blood, urine and liver abscess cultures. During the hospitalization, endophthalmitis occurred and resulted in visual loss despite treatment. Klebsiella infection should be considered as one of causative pathogen in case of meningitis associated with abscess and endophthalmitis.

초록: Korean J Headache. 2006;7(2):121-136. Published online December 31, 2006

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