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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Cephalalgia 15 (1995), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The spontaneous capricious course of cluster headache may give rise to some problems when treatment is being evaluated. This is one of several explanations for there being so few well-designed, randomized, double-blind clinical trials in cluster headache. The standard treatment of acute attacks of cluster headache is inhalation of 100% oxygen. In the prophylaxis of episodic cluster headache, ergotamine, verapamil, lithium, serotonin inhibitors and steroids are used. In chronic cluster, lithium is the drug of choice, but verapamil may also be tried. Recently, hyperbaric oxygen has been shown to immediately abort acute attacks, and it seems that it may also be useful in the prophylactic treatment. The introduction of the novel 5HT1 agonist sumatriptan as a symptomatic relief of cluster attacks represents further significant progress. Two randomized, double-blind, placebo-controlled, cross-over trials have shown sumatriptan 6 mg sc to be a rapid, effective and well-tolerated acute treatment for cluster headache attacks. Within 15 min of treatment, 74% of attacks on sumatriptan responded compared to 26% of placebo-treated attacks. Functional disability was also significantly improved. Increasing the dose to 12 mg did not offer significantly greater relief compared to sumatriptan 6 mg, but was associated with an increased incidence of adverse events. Interim analysis of 3 months of data from a recent multinational open trial comprising 138 patients having treated 6353 attacks with subcutaneous sumatriptan 6 mg revealed a headache relief in 96% of attacks treated. There was no evidence of an increased incidence of adverse events with frequent use of sumatriptan. No tachyphylaxis was seen over the 3 months, suggesting that sumatriptan is effective and well tolerated also in long-term acute treatment for cluster headache.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Bioavailability and rate of absorption of ergotamine were studied in eight cluster headache patients outside attacks. In a cross-over design, approximately 2 mg ergotamine tartrate was administered as effervescent tablets, suppositories, and from an inhalation device, with 0.25 mg intravenously as the reference. Ergotamine in plasma was measured by high performance liquid chromatography with fluorescence detection from 5 to 420 min. For all three routes of administration, a similar low (0.5–4.2%) bioavailability of ergotamine was estimated. Only inhalation of ergotamine resulted in early (at 5 min) peak concentrations of ergotamine in plasma and is therefore most likely to relieve the short-lived attacks of cluster headache. The inhalation route for ergotamine poses problems, however, and we suggest ways of improving the inhalation device.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : American Association for the Study of Headache/Blackwell Science Ltd
    Cephalalgia 15 (1995), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In the first three months of a 24-month open study to assess the safety and efficacy of subcutaneous sumatriptan 6 mg in the long-term acute treatment of cluster headache, 138 patients treated a maximum of two attacks daily each with a single 6 mg injection. A total of 6353 attacks were treated. Adverse events, reported in 28% of sumatriptan-treated attacks, were qualitatively similar to those seen in migraine long-term trials. Their incidence did not increase with frequent use of sumatriptan. There were no clinically significant treatment effects on vital signs, ECG recordings or laboratory parameters. Headache relief (a reduction from very severe, severe or moderate pain to mild or no pain) at 15 min was obtained for a median of 96% of attacks treated. There was no indication of tachyphylaxis, decrease in the speed of response, or increased frequency of attacks with long-term treatment. This study demonstrated that, in long-term use, subcutaneous sumatriptan 6 mg is a well-tolerated and effective acute treatment for cluster headache.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : Blackwell Science Ltd
    Cephalalgia 14 (1994), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cephalalgia Seven consecutive patients with acute retropharyngeal tendinitis underwent plain X-ray and magnetic resonance imaging (MRI) of the cervical spine. All seven had marked soft tissue swelling anterior to C1 and C2 on plain X-ray, and soft tissue calcification at this level was present in five of them. On MRI, there was markedly increased signal intensity on T2-weighted images in the acute phase and intermediate signal intensity on T1-weighted images, anterior to the level of C1 and C2, often extending as far down as C6. These changes correlated well with the soft tissue swelling seen on conventional X-ray of the cervical spine. The maximum mid-sagittal thickness of the soft tissues was significantly greater in the tendinitis patients (p 〈 0.001) than in 12 control subjects free of symptoms from the pharynx or the cervical spine. Treatment with non-steroidal anti-inflammatory drugs rapidly alleviated symptoms, and at follow-up MRI showed regression or complete restitution of the changes. In conclusion, MRI can visualize the edematous changes in the longus colli muscle and adds useful diagnostic information in suspected cases of acute retropharyngeal tendinitis.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : American Association for the Study of Headache/Blackwell Science Ltd
    Cephalalgia 14 (1994), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The circannual secretion of melatonin in 14 Swedish and 15 Italian patients suffering from episodic cluster headache was compared with 14 Swedish and 15 Italian healthy controls matched for sex and age. Overnight samples of urine were collected once a month from 8 to 14 months and kept at −20°C until analysed with RIA. The melatonin concentrations in nocturnal urine were permanently low in cluster headache and there was no consistent change of the melatonin concentration in relation to cluster periods occurring during the study. There was no definitive circannual or infraannual rhythmicity of melatonin in patients or controls. Multiple analysis of variance with repeated measurements showed a significant effect of disease (p 〈 0.05), but not of time. Sex, geographical location, age, and smoking also had significant effects (p 〈 0.001) on the melatonin concentrations. Lower melatonin levels in cluster headache patients than in controls may in part be related to a larger number of smokers in the patient group. The relation between tobacco use and melatonin should be further studied.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : Blackwell Science Ltd
    Cephalalgia 15 (1995), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fifteen-thousand-five hundred adults (³20 years) in a rural district in Ethiopia with a population of 250 000 were studied for chronic headache. Door-to-door survey was performed by trained lay health workers using a questionnaire with a high degree or reliability and validity. The 1-year prevalence of migraine headache was 3.0% (4.2% for females and 1.7% for males) with the peak age specific rate in the fourth decade. Migraine headache was about three times more common in females than in males at any decade. Two-thirds of migraine sufferers had rather frequent attacks. The most frequent trigger factors were emotional stress (90%), changes of weather (78%), physical exhaustion (75%), and smell (70%). Migraine with aura was rare. Family occurrence of migraine in first-degree relatives was 30%. The 1-year prevalence of chronic tension-type headache was 1.7%, while cluster headache was found to be extremely rare. Compared to similarly performed surveys, the prevalence of migraine among rural Ethiopians was less than among Nigerian Africans.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Liquorpulsationen werden bei 4 Patienten mit okkultem Hydrozephalus registriert, bei denen der 3. Ventrikel durch eine Ektasie der A. basilaris komprimiert war. Sechs andere Patienten mit Hydrozephalus, ohne Ektasie der Hirngefäße, dienten als Kontrollserie. Es wurden simultane intraventrikuläre und lumbale Druckmessungen durchgeführt. Während Respirator-Beatmung wurden zwei Veränderungen des Liquordruckes beobachtet, atemsynchrone Druckschwankungen und kleinere pulssynchrone Druckschwankungen. Die letzteren hatten das Aussehen einer arteriellen Pulsdruckkurve. Die intraventrikulären pulssynchronen Druckwellen waren in der Gruppe der Patienten mit Ektasie der A. basilaris fast signifikant höher (P〈0,05). Die Relation zwischen der ventrikulären und der lumbalen Pulswellenhöhe war in dieser Gruppe signifikant größer (P〈0,01). Die Ergebnisse lassen vermuten, daß die Pulsationen von ektatischen Hirngefäßen, die dem Ventrikelsystem nahegelegen sind, ursächlich zur Entstehung des okkulten „Normaldruck“-Hydrozephalus beitragen können.
    Abstract: Résumé Les pulsations du liquide cérébro-spinal (=L.C.R.) ont été enregistrées chez 4 patients atteints d'hydrocéphalie occulte, et dont le troisième ventricule était comprimé par une artère basilaire ectasique. On a utilisé comme témoins 6 patients atteints d'hydrocéphalie sans ectasie des artères cérébrales. On a enregistré simultanément la pression intraventriculaire et la pression lombaire. Les variations de la pression du L.C.R. observées pendant la respiration avec masque furent de deux sortes: à savoir celles qui étaient synchrones de la respiration, et les petites variations synchrones avec le pouls, ces dernièrés ayant la forme d'une courbe de pulsation de pression artérielle. L'amplitude de la pression synchrone pouls-intraventriculaire était presque sensiblement plus grande dans le groupe avec ectasie de l'artère basilaire (P〈0,05). Le rapport de l'amplitude des pulsations ventriculaires et des pulsations lombaires était sensiblement plus grand dans ce groupe (P〈0,01). Ces résultats montrent que les pulsations provenant de vaisseaux ectasiques adjacents au système ventriculaire contribuent peut-être à l'apparition d'une hydrocéphalie occulte à «pression normale».
    Notes: Summary The cerebrospinal fluid (CSF) pulsations were recorded in 4 patients with occult hydrocephalus, in whom the third ventricle was compressed by an ectatic basilar artery. Six patients with hydrocephalus without ectasia of the cerebral arteries were used as controls. Simultaneous intraventricular and lumbar pressure recordings were made. The variations in CSF pressure observed during respirator-breathing were of two kinds, i.e., those synchronous with respiration, and those small variations synchronous with the pulse, the latter having the shape of an arterial pressure pulse curve. The intraventricular pulse-synchronous pressure amplitude was almost significantly greater in the group with ectasia of the basilar artery (P〈0.05). The ratio of the ventricular to the lumbar pulse amplitude was significantly greater in this group (P〈0.01). The results suggest that pulsations from ectatic vessels adjacent to the ventricular system may contribute to the occurrence of occult “normal pressure” hydrocephalus.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 24 (1971), S. 71-77 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two patients with aneurysms at the termination of the basilar artery deforming the third ventricle had a clinico-radiological picture of communicating hydrocephalus. Both patients underwent ventriculo-atrial shunt operations. Case 1 died 3 months after the operation. Autopsy revealed atrophic changes of the mammillary bodies and basal ganglia. In Case 2 paroxysmal increases of CSF-pressure (plateau-waves) were recorded during the operation. Slight clinical improvement was observed as compared with the preoperative condition. The significance of these findings are discussed in relation to the syndrome of adult “normal pressure” hydrocephalus.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Italian journal of neurological sciences 20 (1999), S. S1 
    ISSN: 1126-5442
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 8 (1975), S. 337-341 
    ISSN: 1432-1041
    Keywords: Carbamazepine ; carbamamazepine-10,11-epoxide ; pharmacokinetics ; induction of metabolism ; man
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Carbamazepine (Tegretol®) was administered orally to four patients as a single dose, and one week later three times daily for 15–21 days. The plasma half-lives of the drug were shorter in all patients after multiple doses (20.9±5.0 hours) than after the initial single dose (35.6±15.3 hours). During multiple doses the plasma concentrations of the metabolite carbamazepine-10,11-epoxide followed those of the parent drug. The steady-state plasma concentrations expected during multiple doses were calculated from the pharmacokinetic parameters obtained in the single dose studies. The calculated levels were higher (17.2±7.2 µg/ml) than the observed maximal concentrations (8.4±1.6 µg/ml on day 4), which were obtained 3–4 days after starting the multiple doses. The levels tended to decrease further during the experimental period. The results suggest that carbamazepine induces its own metabolism in man.
    Type of Medium: Electronic Resource
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