The Postconcussion Syndrome and Posttraumatic Headaches in Civilians, Soldiers, and Athletes.

Posttraumatic headaches are one of the most common and controversial secondary headache types. After a mild traumatic brain, an estimated 11% to 82% of people develop a postconcussion syndrome, which has been controversial for more than 160 years. Headache is estimated as present in 30% to 90% of patients after a mild head injury.

Clinical features of new daily persistent headache: A retrospective chart review of 328 cases.

Objective: To describe the clinical features of new daily persistent headache (NDPH) at an outpatient neurology clinic with a subspecialty interest in headache in Houston, Texas.

Methods: A retrospective chart review was performed by a neurologist subspecialty certified in headache medicine of all patients seen from September 1, 2011 through February 28, 2020 (8.5 years) with a provisional diagnosis of NDPH and abstracted charts meeting criteria for primary NDPH.

A brief diagnostic screen for cluster headache: Creation and initial validation of the Erwin Test for Cluster Headache.

Objective: To use 1) newly generated data, 2) existing evidence, and 3) expert opinion to create and validate a new cluster headache screening tool.

Methods: In phase 1 of the study, we performed a prospective study of an English translation of an Italian screen on 95 participants (45 with cluster headache, 17 with other trigeminal autonomic cephalalgias, 30 with migraine, and 3 with trigeminal neuralgia). In phase 2, we performed a systematic review in PubMed of all studies until September 2019 with diagnostic screening tools for cluster headache.

Primary Empty Sella.

Primary empty sella (PES) syndrome is a misnomer as it is not a syndrome but a radiological finding with possible endocrine abnormalities. No specific headache type has been shown to be caused by PES. Endocrine screening may be considered for asymptomatic persons with PES.

Gluten-Free Diet and Migraine.

Migraine is common in celiac disease (CD) and usually improves on a gluten-free diet (GFD). The benefit for people impacted by migraine without CD is poorly evidenced. A GFD may have adverse health consequences and is expensive.

Medico-Legal Aspects of Concussion.

Concussion and the sequelae have been controversial medico-legal issues for over 150 years. The following topics which are also important in clinical practice are discussed: definitions of concussion, neuroimaging, onset and prognosis of headaches, cognitive impairment, cognitive rehabilitation, post-traumatic stress disorder, and risk of later development of dementia.

The Very Important Person (VIP) and the Headache Medicine Physician.

Headache medicine specialists often treat VIPs but little is known about whether these encounters are different than with other patients. Questions considered include who is a VIP, should you treat a VIP like any other patient, and what are the challenges and advantages? A non-random sampling of comments is presented from headache medicine specialists. Eleven principles are presented to consider in these encounters.

Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence-Based Guideline.

Objective: To provide updated evidence-based recommendations about when to obtain neuroimaging in patients with migraine.

Methods: Articles were included in the systematic review if they studied adults 18 and over who were seeking outpatient treatment for any type of migraine and who underwent neuroimaging (MRI or CT). Medline, Web of Science, and Cochrane Clinical Trials were searched from 1973 to August 31, 2018.

Diagnostic Testing for Migraine and Other Primary Headaches.

Most primary headaches can be diagnosed using the history and examination. Judicious use of neuroimaging and other testing, however, is indicated to distinguish primary headaches from the many secondary causes that may share similar features. This article evaluates the reasons for diagnostic testing and the use of neuroimaging, electroencephalography, lumbar puncture, and blood testing.

Raynaud's Phenomenon Associated With Calcitonin Gene-Related Peptide Monoclonal Antibody Antagonists.

Two cases are reported of migraineurs who reported Raynaud's phenomenon (RP) exacerbated while taking monoclonal antibodies to the calcitonin gene-related peptide (CGRP) ligand (fremanezumab and galcanezumab) and 1 case of new onset RP while taking the CGRP receptor antagonist (erenumab). The prevalence of primary and secondary RP, causes of secondary RP, co-morbidity with migraine, and medications which might induce or exacerbate RP are reviewed. The pathophysiology of how CGRP monoclonal antagonists might exacerbate or induce RP is discussed.

Negative Online Patient Reviews in Headache Medicine.

Patients commonly use online reviews in selecting a new physician. There have been no studies of online reviews of headache medicine physicians. To better understand headache medicine physicians' attitudes and opinions about negative reviews, 2 negative patient reviews were posted to the Southern Headache Society online discussion group and comments were requested.

A Survey of Neurologists on Postconcussion Syndrome.

Background And Objectives: Postconcussion syndrome (PCS) has been controversial for more than 150 years. As there have not been any surveys of PCS among neurologists in the United States since 1992, another was performed using most of the prior items to assess current opinions and practices and whether there have been any changes since 1992.

Methods: Two hundred and eighty-nine neurologists attending the Texas Neurological Society 20th Annual Winter Conference continuing medical education meeting in 2017 were supplied the survey instrument with registration materials.

Sports and Headaches.

In the United States, up to 3.8 million people per year have sports-related mild traumatic brain injury frequently followed by a variety of headaches. Headaches associated with sports (exertional, weightlifter's, and external compression headache) are also reviewed.

Incidental Findings and Normal Anatomical Variants on Brain MRI in Children for Primary Headaches.

When MRI scans of the brain are obtained for evaluation of primary headaches in children, incidental findings and anatomical variants are commonly present. After a review of the prevalence, 11 types are presented.