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In order to study the frequency and characteristics of post-angiography headache, we interviewed 45 consecutive patients (mean age +/- SD = 57 +/- 15 years; M/F = 15/30) who underwent transfemoral cerebral angiography for: ischemic cerebrovascular disease (n = 33); suspected arteriovenous malformations (n = 4; one confirmed); suspected cerebral aneurysm (n = 5; two confirmed); and arterial dissection (n = 3; one confirmed and one was a follow-up study of a previously demonstrated dissection). Postangiography headache developed in 15 (33%) patients, 125 +/- 99 min after the completion of the study. It was unilateral in nine (60%) patients, homolateral to the usual side of migraine headache in two or three migraineurs, and pulsating in six (40%). Nausea, vomiting, photophobia, and phonophobia accompanied postangiography headache in 20%, 7%, 33%, and 20% respectively. Postangiography headache fulfilled the International Headache Society criteria for migraine without aura (except for the number of attacks) in 27% of patients. Patients with and those without postangiography headache were comparable in mean age, sex, and indication for angiography. Fifty-three percent (8/15) of patients with postangiography headache and 23% (7/30) of the non postangiography headache group reported prior recurrent headaches (P = 0.047, likelihood ratio chi-square). Postangiography headache has the characteristics of delayed arterial pain which may be related to a catheter-induced or contrast dye-induced release of vasoactive substances, notably nitric oxide and serotonin.

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The aim of this study was to establish the extent of use of complementary therapies in the maternity services in England and to determine the views of heads of midwifery to the integration of these therapies into midwifery practice. The questionnaire was sent to 221 heads of midwifery in all NHS maternity units in England. A response rate of 75% was achieved. Sixty four percent of the maternity units who responded provided a complementary therapy service in a variety of combinations to mothers, babies and staff. However, only 9% provided a service to all three groups. The four therapies offered most widely were massage, aromatherapy, reflexology and acupuncture. Attitudes were positive with 70% of respondents convinced of the benefits and 94% believing it important for them to be available in the NHS. Respondents felt that complementary therapies had an important role, particularly in relation to increasing consumer satisfaction, promoting normal childbirth, decreasing medical intervention and increasing midwives’ job satisfaction.