Cervicogenic headache has a complex and poorly understood pathophysiology. Symptoms are typical and involve the C2 and C3 nerve roots. There are no specific recommendations for physical therapy, although occipital nerve block is a known pharmacological treatment. Some evidence suggests that hip rotation correction could aid in reducing cervical pain symptoms. The objective of this work is to evaluated the role of postural physiotherapy for hip rotation correction using the Maitland technique in patients with cervicogenic headache who underwent an occipital nerve block. In this retrospective, observational and uncontrolled study, patients were evaluated from January 2017 to February 2018. After diagnosis of cervicogenic headache they underwent anesthetic block, hip radiography with lower limb scanometry and cervical tomography, after which they were referred to physical therapy. The analog pain scale was used for evaluation at the time of diagnosis and after the proposed physiotherapy. Patients submitted to an occipital nerve block were divided into three groups: Group I (n = 15, physical therapy with Maitland technique) had an analog pain score of 1.6 after the physical therapy, Group II (n = 11, conventional physiotherapy) had an analog pain score of 3.7 after the physical therapy and Group III (n = 13, occipital nerve block only) had an analog pain score of 5.2 after the occipital nerve block. The results suggest that an occipital nerve block in combination with the Maitland technique is superior in patients with cervicogenic headache compared to nerve block only or blockade combined with non-specific physical therapy (p=0,013).

Cervicogenic headache is a clinical condition that has a direct impact on quality of life and labor productivity and its underdiagnosis and lack of consensus on the appropriate treatment aggravates even more the condition. This work aims to systematize the protocol that has the highest success rate so far, based on the study carried out in Pindamonhangaba, São Paulo, Brazil. The results demonstrated with the occipital block and Maitland physiotherapy were exceptional and its methodology will be carried out as performed during the study. Conclusion: Regardless of the substance used for the blockade, its combination with Maitland's physiotherapy was shown to be favorable and its description can help other professionals and also enable reproduction in other studies.

A disfunção temporomandibular (DTM) engloba anormalidades da articulação de mesmo nome e/ou músculos da mastigação que têm como provável sintoma mais comum a cefaleia. Dessa forma, este estudo buscou comparar a prevalência de cefaleia em pacientes com diagnóstico de DTM com a prevalência populacional de DTM. A razão de prevalências (RP) foi 0,17 (IC 95% 0,05-0,52; p<0,001). A principal explicação para este fenômeno foi o subdiagnóstico de DTM nestes pacientes, levando a problemas relatados na literatura como: abuso de analgésicos, maior sofrimento psicossocial, distúrbios do sono, como insônia e outras comorbidades. Portanto, profissionais de saúde que atendem pacientes com cefaleia devem considerar DTM como possível causa de dor para promover tratamento mais adequado ao paciente.

Introdução A Disfunção Temporomandibular (DTM) é uma anormalidade que engloba as articulações temporomandibulares e os músculos da mastigação, tendo como provável sintoma predominante a cefaleia. Sendo ela uma dor em pressão com acometimento da face e das têmporas.   Objetivos Demonstrar a prevalência de DTM na população da Vigésima Regional de Saúde do Paraná; traçar um perfil dos pacientes com diagnóstico de DTM; identificar a prevalência de cefaleia em portadores de DTM e correlacionar as duas patologias nos pacientes estudados.   Material e Métodos Estudo quantitativo e retrospectivo (2019 a 2020), com cálculo da razão de prevalência realizado na população atendida pelo CISCOPAR (neurologia, bucomaxilofacial e protesista), com verificação de prontuários de 3.175 pacientes. Utilizando como base metodológica o trabalho de Pereira et al (2018).   Resultados 296 pacientes apresentavam cefaleia descrita, sendo a maioria mulheres (73%) com idade entre 18 e 50 anos (57%). A prevalência de DTM diagnosticada é de 1,39% (44 pacientes) e a razão de prevalência (RP) de DTM associada à cefaleia é de 0,17 (IC 95% 0,05-0,52; p<0,001). No entanto, sinais e sintomas diretamente relacionados à DTM (dor durante a fala/mastigação, sono ruim, ansiedade, zumbido e sonolência excessiva diurna) foram relatados por 71 pacientes. Portanto, a prevalência de DTM obtida é inferior à média populacional de sintomas associados a DTM de 6,0% (p<0,001), assim como RP de DTM relacionada à cefaleia, também é estatisticamente inferior à média populacional (Sarnat & Laskin 1992), o que indica um possível subdiagnóstico dessa patologia. Visto que a presença de cefaleia é significativa na população atendida e poucos casos tiveram a DTM como hipótese diagnóstica.   Conclusão É fundamental o reconhecimento dos sinais e sintomas relacionados à DTM, garantindo um tratamento precoce e adequado para evitar os impactos negativos que essa disfunção pode causar na vida dos pacientes.

Rocky Mountain spotted fever is a tick-borne rickettsiosis. The main clinical signs and symptoms are fever, severe headache, rashes and myalgia. It is considered difficult to diagnose and underreported. The study aims to descriptively analyze the epidemiology of cases of Rocky Mountain spotted fever in Brazil from 2010 to 2021. This is a retrospective cohort study that statisticall analyzes the cases of spotted fever in Brazil between 2010 and 2020 through data obtained by the Information System of Notifiable Diseases. The proportions of spotted fever cases were calculated according to: sex, age, race/color, infection environment and evolution. There are 1967 cases were confirmed. The regions with the most cases were the Southeast (n%=72.24) and the South (n%=24). However, there are 4 deaths in the south while the lethality coefficient from the southeast is 47.78%. The most affected age group was 40-59 years old (n%=34.87), and 20-39 years old (n%=28.98). 71.17% of the cases are male. As for color/race, 60% of the cases are in whites. As for the infection environment, 35.23% are at home, 15.3% are at work, 26.13% are leisure places. The prevalence in males and the predominant age group 20-59 years can be linked to work activity, which leaves hem more exposed to ticks. The high numbers in adulthood can also be related to ecotourism. The lethality of the disease differs between the South and Southeast regions. One explanation for this phenomenon would be the different etiological agents, R. rickettsi, predominant in the Southeast, generating more severe clinical conditions.