Analysis of Primary Headaches Management in Poltava Regions

Delva, M. Yu.; Delva, I. I.

doi:10.36740/wlek202101123

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…До теперішнього часу в нашій державі недостатньо уваги приділяється проблематиці голо-вного болю серед неврологів та лікарів інших спеціальностей [7]. Цефалгія є одним з найчастіших ранніх симптомів COVID-19.…”

Section: вступunclassified

Headache and Covid-19: Etiopathogenetic Links, Diagnostic Features and Treatmetn Approaches

Іващенко¹,

Delva²

2023

Act. Probl. of the Modern Med.

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COVID-19 is a human respiratory disease caused by the SARS-CoV-2 coronavirus. However, in most cases, COVID-19 is accompanied by neurological involvement, leading to persistent consequences. Even individuals, both adults and children, with mild forms of the disease may experience recurrent neurological and neuropsychiatric symptoms following the acute phase and beyond. Headache is one of the most common early symptoms of COVID-19. Beyond being a clinical condition, it significantly impacts the quality of life and poses an economic burden on society. Throughout the ongoing COVID-19 pandemic, headache has emerged as a serious neurological symptom associated with SARS-CoV-2 infection and is even considered among its cardinal symptoms. In this review, we highlight the latest research publications on headache as a symptom of post-COVID syndrome based on data published over the past 3 years. The purpose of this study is to enhance the management of patients with post-COVID headache by analyzing studies investigating the prevalence, pathogenesis, and phenotypic characteristics of headache following COVID-19. By identifying existing challenges and seeking optimal solutions, we aim to optimize the care and treatment of patients experiencing post-COVID headache. Among the pronounced features of SARS-CoV-2 infection there is the ability to cause exacerbation (increased intensity, frequency, duration of headache attacks) or chronic headache in patients with a history of primary headache. In addition, patients with COVID-19 and a history of primary headache may develop a qualitatively new headache during the acute phase of the disease. To date, there are no specific treatments, and most clinicians treat headache after COVID-19 based on the similarity of the clinical phenotype to other types of primary headache. Given the significant negative impact of headache in COVID-19, additional research is needed to make informed choices about optimal treatment methods. Thus, the problem of headache in patients who have experienced COVID 19 is an urgent medical and social challenge that requires relevant modern knowledge for its timely diagnosis and effective management.

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Section: вступunclassified

Headache and Covid-19: Etiopathogenetic Links, Diagnostic Features and Treatmetn Approaches

Іващенко¹,

Delva²

2023

Act. Probl. of the Modern Med.

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“…Неконтрольований прийом лікарських препаратів з метою нівелювання нападів головного болю (ГБ) є загальною проблемою пацієнтів з первинним ГБ, наслідком чого в подальшому є розвиток абузусного ГБ (АГБ) [1,2]. Особливої актуальності це набуває в умовах, коли не лише серед сімейних лікарів, а навіть серед неврологів спостерігається недостатня обізнаність щодо менеджменту різних типів первинного ГБ [3].…”

Section: вступunclassified

Соціально-Демографічні Та Клінічні Характеристики Пацієнтів З Абузусним Головним Болем В Поєднані З Хронічним Головним Болем Напруги

Дельва¹,

Delva²,

Пінчук³

et al. 2021

Med. and Ecol. probl.

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Introduction. A study of medication overuse headache (MOH) can define the risk group for MOH in patients with primary headaches. The aim of the research is to study the socio-demographic, clinical and pharmacotherapeutic characteristics of patients with MOH and chronic tension-type headache (CTTH). Material and methods. We examined 28 patients with MOH in combination with CTTH and 34 patients with CTTH. MOH and CTTH were diagnosed according to the International Classification of Headache Disorders 3rd revision. Anxiety and depressive signs were assessed by the Hospital Anxiety and Depression Scale; abdominal obesity was determined using waist circumference. Quantitative values were presented as the median and the interquartile range. Quantitative samples were analyzed according to Mann-Whitney U-test, qualitative samples - according to Fisher's exact test. Differences at p <0.05 were considered significant. Results. Patients with MOH and CTTH had the following characteristics: female gender - 79%, age - 41.0 (33.0-49.5) years, familyless state - 54%, higher education - 25%, employment - 46%, smoking - 43%, anxiety signs - 71%, depressive signs - 75%, cervicalgia - 36%, lower back pain - 61%, arterial hypertension - 21%, diabetes mellitus - 7%, abdominal obesity - 46%, mild traumatic brain injury - 43%, headache intensity - 5.0 (4.0-6.3) points on a visual analog scale, duration of headache attacks - 7.0 (5.0-8.3) hours, age of CTTH onset - 31,5 (23,0-41,0) years, duration of CTTH - 9.0 (6,8-10,3) years, duration of MOH – 15.5 (8.3-20.8) months. Patients with MOH and CTTH compared to patients with CTTH were significantly younger, had a history of traumatic brain injury, had significantly more headache days per month. Patients with MOH and CTTH overused combined analgesics (47%), nonsteroidal anti-inflammatory drugs (32%), triptans with analgesics (21%). Abortive medications had been used on 23.0 (18.0-28.5) days a month, in form of 32.0 (27.3 -41.8) doses a month.

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“…До теперішнього часу більшість неврологів не обізнана в потрібному обсязі з принципами діагностики та лікування МІ, що перед усім пов'язано з недостатнім використанням міжнародних стандартів діагностики мігрені та інших типів первинного головного болю [5].…”

Section: вступunclassified

Клінічний Випадок Можливої Мігрені З Аурою, Ускладненої Мігренозним Інфарктом

Нікіфорова¹,

Саник²,

Дельва³

2021

Med. and Ecol. probl.

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We present a clinical case of ischemic stroke in a man with a new-onset migraine attack. Clinical case. A 25-year-old man was admitted to the acute cerebrovascular department due to severe throbbing headache in the left temporal area, vomiting, impaired vision on the right and numbness of the right leg. Complaints appeared abruptly in the form of scotoma in the right visual field. 20 minutes later, severe throbbing headache, nausea and numbness of the right leg developed. The event was preceded by sleep deprivation for 2 days. The patient’s mother has migraine with aura. Previously, the patient never had such attacks. On examination: right-sided homonymous upper-quadrant hemianopsia, hypoesthesia of the right leg. Brain MRI - focal hyperintensity at T2 and DWI in the left occipital region (acute ischemic stroke). The patient took aspirin at a dose of 300 mg for the first day, then 100 mg per day and valproic acid at a dose of 1200 mg per day. Two days after hospitalization, the patient experienced recovery of sensitivity in the right leg and regression of right-sided homonymous upper quadrant hemianopsia to small scotoma. The patient was discharged on the 5th day with a small right scotoma. It is recommended to continue taking aspirin 100 mg/day and valproic acid 1200 mg/day for the secondary prevention of migraine attacks and stroke. Discussion. The peculiarities of this case include the lack of history of migraine (at least 5 or more migrainous headache attacks) and the development of severe migraine attack with prolonged aura symptoms, which was triggered by sleep deprivation and eventually evolved into ischemic stroke. Conclusions. It is necessary to consider the possibility of ischemic stroke even in the cases of a new-onset migraine attack. If migrainous aura duration exceeds 60 minutes, it is necessary to perform a brain MRI to detect the early signs of cerebral ischemia.

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Analysis of Primary Headaches Management in Poltava Regions

Cited by 9 publications

References 9 publications

Headache and Covid-19: Etiopathogenetic Links, Diagnostic Features and Treatmetn Approaches

Headache and Covid-19: Etiopathogenetic Links, Diagnostic Features and Treatmetn Approaches

Соціально-Демографічні Та Клінічні Характеристики Пацієнтів З Абузусним Головним Болем В Поєднані З Хронічним Головним Болем Напруги

Клінічний Випадок Можливої Мігрені З Аурою, Ускладненої Мігренозним Інфарктом

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