Spontaneous intracranial hypotension - Neurological symptoms, diagnosis, and outcome.

Background: Spontaneous intracranial hypotension (SIH) is a rare secondary headache disorder caused by spinal leakage of cerebrospinal fluid. Specialized treatment of SIH consists of epidural blood patches (EBPs), fibrin patching, endovascular sealing, and surgery. The aim of this paper was to characterize SIH patients identified at a tertiary headache center.

Management and Outcome of Pregnancy in Patients With Idiopathic Intracranial Hypertension: A Prospective Case Series Study.

Background And Objectives: Idiopathic intracranial hypertension (IIH) is a syndrome of increased intracranial pressure without an identifiable cause that mostly affects obese persons of childbearing age. In this prospective case series, we have evaluated the overall outcome of pregnancy and birth in participants with IIH and their newborn children. We also provide a proposal for the management of pregnant persons with IIH.

Phenotyping non-idiopathic pseudotumor cerebri syndrome - A prospective cohort study.

Objective: To identify the most frequent causes of secondary pseudotumor cerebri syndrome and compare phenotype, clinical presentation, and symptoms of secondary pseudotumor cerebri syndrome to the primary form of pseudotumor cerebri syndrome, idiopathic intracranial hypertension.

Methods: The study was a prospective cohort study including patients with new-onset pseudotumor cerebri syndrome. Diagnostic work up was standardized.

Airplane flights triggering spontaneous intracranial hypotension: Observations from the Danish headache centre.

Objective: Spontaneous intracranial hypotension (SIH) manifests as orthostatic headache, which can be confirmed by radiological signs of low intracranial pressure on magnetic resonance imaging of the brain. The most common mechanisms of SIH are ruptured meningeal diverticula, ventral dural tears and CSF-venous fistulas. SIH is associated with connective tissue disorders, and cases of SIH onset after trivial trauma have been reported.

[Spontaneous intracranial hypotensioncan be confused with subdural haematoma].

Spontaneous intracranial hypotension is a rare condition, but due to increased awareness and better diagnostics it is more frequently reported. This is a case report of a 52-year-old male with sudden onset of vertigo and orthostatic headache. Initial workup was negative, but over the following six months symptoms progressed and bilateral hygromas were identified.

Effectiveness and safety of erenumab in chronic migraine: A Croatian real-world experience.

Objective: To determine the real-world effectiveness and safety of erenumab after 6 months of treatment in chronic migraine patients with therapeutic resistance to multiple classes of prophylactic medication.

Methods: The patients were recruited from the Headache Outpatient Clinic of the University Hospital Centre Zagreb, Croatia between March 2019 and November 2019. All participants received erenumab 70 mg for 6 months.

Diagnosis of idiopathic intracranial hypertension - the importance of excluding secondary causes: A systematic review.

Background: Idiopathic intracranial hypertension is characterized by increased intracranial pressure without any pathological findings on neuroimaging, except for signs of high intracranial pressure. Before diagnosing idiopathic intracranial hypertension secondary causes of increased intracranial pressure should be excluded.

Objective: to characterize the phenotype of patients with secondary intracranial hypertension and to identify possible risk factors for secondary intracranial hypertension.

[Idiopathic intracranial hypertension].

Idiopathic intracranial hypertension (IIH) is a challenging disease characterized by an increase in intracranial pressure which occurs without any known cause. The disease is mainly seen in obese females of child-bearing age. While originally described as rare, the incidence is increasing in parallel with pandemic obesity, and clinicians in all fields are increasingly likely to meet patients with IIH.

[Intracranial hypertension secondary to systemic lupus erythematosus].

Systemic lupus erythematosus (SLE) is a diagnostically challenging autoimmune multisystem disease with intracranial hypertension as a rare initial clinical manifestation. This is a case report of a 27-year-old woman with a prior history of psychogenic non-epileptic attacks, intracranial hypertension, headache, visual impairment, papilloedema, and a BMI of 24 kg/m2. Upon acetazolamide treatment for intracranial hypertension and before the diagnosis of SLE was reached, the patient developed respiratory distress and metabolic acidosis, due to underlying SLE glomerulonephritis.

Dizziness and vertigo during the prodromal phase and headache phase of migraine: A systematic review and meta-analysis.

Objective: To assess the proportion of individuals who report dizziness and/or vertigo during the prodromal phase or headache phase of migraine.

Methods: The databases of MEDLINE and EMBASE were searched for studies on dizziness and/or vertigo during the prodromal phase or headache phase of migraine. Pooled relative frequencies were estimated using a random-effects meta-analysis.

Predictive role of presenting symptoms and clinical findings in idiopathic intracranial hypertension.

Background: The aim of the study was to evaluate the presenting symptoms and signs of idiopathic intracranial hypertension (IIH) in a large cohort of patients and to estimate their possible role in establishing the diagnosis of IIH.

Methods: This prospective cohort study in two tertiary centers, the Danish Headache Center in Rigshospitalet-Glostrup and the Neurology Clinic of the Clinical Center of Serbia, included 286 patients referred by attending specialists for possible IIH evaluation. Patients were divided into two groups: one with confirmed IIH diagnosis and one with rejected IIH diagnosis.

Neurostimulation for the treatment of chronic migraine and cluster headache.

Small subsets of patients who fail to respond to pharmacological treatment may benefit from alternative treatment methods. In the last decade, neurostimulation is being explored as a potential treatment option for the patients with chronic, severely disabling refractory primary headaches. To alleviate pain, specific nerves and brain areas have been stimulated, and various methods have been explored: deep brain stimulation, occipital nerve stimulation, and sphenopalatine ganglion stimulation are among the more invasive ones, whereas transcranial magnetic stimulation and supraorbital nerve stimulation are noninvasive.

Bilateral Vertebral Artery Dissection - Multiple Artery Affection or Early Recurrence?

In a certain percentage of patients with craniocervical artery dissection, dissections affect multiple arteries. Some investigators consider that the dissections diagnosed as multiple might have occurred sequentially within a short time frame. We describe an oligosymptomatic patient with bilateral progressive vertebral artery dissection.

A boy with bilateral SUNA: A case report.

Background Short-lasting unilateral neuralgiform headache attacks (SUNA) is a primary headache characterized by frequent attacks of severe headaches in association with ipsilateral cranial autonomic features. SUNA is defined as a strictly unilateral pain and bilateral cases are very unusual, so secondary causes should be searched for vigorously if there are bilateral symptoms. Despite a number of therapeutic trials, effective management for the majority of SUNA patients is not available at present.

[Is the management of migraine and tension headache in Croatia satisfactory?].

According to the epidemiological study conducted in Croatia, 15% of the population suffer from migraine, 20.6% from tension-type headache and 2.4% from chronic headache.

Psychoneuroimmunologic aspects of skin diseases.

As mental and psychological issues are important in the development of many dermatologic diseases, these factors are of special interest in research. Psychoneuroimmunology is the study of interaction between psychological processes and the nervous and immune systems of the human body, and it was comprehensively described for the first time about 30 years ago. Communication between the mind and the skin involves the psycho-immuno-endocrine-cutaneous system, encompassing the activities of the brain, the immune system and the skin, with participation of different neuropeptides, interleukins, and immune system messengers.

Analysis of headache management in emergency room.

The aim of this study was to analyze the management of headache patients presenting to the emergency room (ER) at a university hospital in Zagreb. Retrospective analysis of all patients with headache was carried out during 2007. Patients were analyzed according to the diagnoses, diagnostic procedures, treatment and further referral.

Report of the Croatian Society for Neurovascular Disorders, Croatian Medical Association. Evidence based guidelines for treatment of primary headaches--2012 update.

These guidelines have been developed to assist the physician in making appropriate choices in work-up and treatment of patients with headaches. The specific aim of the Evidence Based Guidelines for Treatment of Primary Headaches--2012 Update is to provide recommendations for establishing an accurate diagnosis and choose the most appropriate therapy in the group of patients with primary headaches, based on a comprehensive review and meta-analysis of scientific evidence with regard to treatment possibilities in Croatia. These data are based on our previous Evidence Based Guidelines for Treatment of Primary Headaches published in 2005 and other recommendations and guidelines for headache treatment.

Management of patients with transient ischemic attack (TIA) at Sestre milosrdnice University Hospital Center.

Improved outcomes were observed in transient ischemic attack (TIA) patients after implementation of recommendations for stroke management and after multiple interventions such as public campaigns focused on raising awareness of stroke and reorganization of health services. The aim of this study was to describe reorganization of in-hospital services to improve the management of patients suspected of having TIA or stroke, and to validate these measures with patient outcomes. Data on 5219 patients examined between January 1 and December 31, 2008 at emergency neurology outpatient department were analyzed.

Microembolus detection by transcranial Doppler sonography: review of the literature.

Transcranial Doppler can detect microembolic signals which are characterized by unidirectional high intensity increase, short duration, random occurrence, and a "whistling" sound. Microembolic signals have been detected in a number of clinical settings: carotid artery stenosis, aortic arch plaques, atrial fibrillation, myocardial infarction, prosthetic heart valves, patent foramen ovale, valvular stenosis, during invasive procedures (angiography, percutaneous transluminal angioplasty), surgery (carotid, cardiopulmonary bypass, orthopedic), and in certain systemic diseases. Microembolic signals are frequent in large artery disease, less commonly detected in cardioembolic stroke, and infrequent in lacunar stroke.