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Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
10:39

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Published on: June 2, 2014

Update on chronic daily headache.

James R Couch1

  • 1Professor of Neurology, Department of Neurology, University of Oklahoma Medical School, 711 Stanton L. Young Boulevard, Suite 215, Oklahoma City, OK, 73104, USA, James-Couch@ouhsc.edu.

Current Treatment Options in Neurology
|November 25, 2010
PubMed
Summary
This summary is machine-generated.

Chronic daily headache (CDH), affecting 3-5% of the population, involves frequent headaches often mixed with migraine and tension-type features. Effective management requires a multimodal approach, including prophylactic medications and addressing comorbidities like medication overuse and psychiatric disorders.

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Chronic daily headache (CDH) affects 3-5% of the population, characterized by headaches occurring at least 15 days per month.
  • CDH often presents as a mix of migraine and tension-type headaches (TTH), with some cases being pure TTH or migraine.
  • Associated conditions like medication overuse headache (MOH) and psychiatric disorders complicate diagnosis and treatment.

Purpose of the Study:

  • To provide a comprehensive overview of chronic daily headache (CDH) diagnosis and management.
  • To highlight the importance of accurate diagnosis and ruling out organic etiologies.
  • To emphasize the multimodal treatment strategies for CDH.

Main Methods:

  • Review of existing literature and clinical guidelines for CDH.
  • Classification of CDH subtypes, including new daily persistent headache and hemicrania continua.
  • Discussion of diagnostic challenges and associated conditions.

Main Results:

  • Accurate diagnosis is critical, requiring exclusion of organic causes and recognition of complicating factors like head injury or MOH.
  • Psychiatric comorbidities, including depression and anxiety disorders, are common and require integrated treatment.
  • Prophylactic antimigraine medications (e.g., amitriptyline, topiramate) and botulinum toxin show effectiveness in reducing headache frequency.

Conclusions:

  • CDH management is multimodal, focusing on prophylactic medications, treating MOH, and addressing psychiatric comorbidities.
  • Patient education and a strong physician-patient relationship are essential for successful long-term management.
  • With appropriate treatment, up to 65% of patients may achieve long-term remission or significant improvement.