Browsing by Subject "Headache"

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  • Tommiska, Pihla; Lönnrot, Kimmo; Raj, Rahul; Luostarinen, Teemu; Kivisaari, Riku (2020)
    Krooninen kovakalvonalainen verenpurkauma eli subduraalihematooma on yleinen neurokirurgista hoitoa vaativa sairaus. Sitä tulisi epäillä etenkin iäkkäillä potilailla, joiden yleistila on selittämättömästi heikentynyt. Taustalla on usein pään lievä vamma, joka johtaa hiljalleen kertyvään siltalaskimovuotoon kovakalvon ja lukinkalvon väliin. Merkittävimpiä riskitekijöitä ovat ikä, pään vamma, miessukupuoli, alkoholin liikakäyttö, antitromboottinen lääkitys, aivoatrofia ja kallonsisäisen toimenpiteen jälkitila. Tyypillisesti oireet ilmenevät viikkojen kuluttua, kun laajeneva hematooma alkaa painaa aivokudosta. Oireita ovat tasapainovaikeus, raajaheikkous, yleistilan heikkeneminen, päänsärky, sekavuus, puhehäiriö, muistin huononeminen, väsymys tai epileptinen kohtaus. Hoitona tehdään kallonporausleikkaus eli trepanaatio, jossa hematooma purkautuu ulos. Varhainen diagnoosi ennustaa hyvää hoitotulosta. Etenkin iäkkäillä potilailla kuolleisuus vuoden sisällä on varsin suuri.
  • Pyykko, Ilmari; Manchaiah, Vinaya; Farkkila, Markus; Kentala, Erna; Zou, Jing (2019)
    Objective: The aim of the present study was to evaluate complaints in people with Meniere's disease (MD) with and without migraine and headache to study the association between MD and Vestibular Migraine (VM). We believe this will help us understand if these two disorders represent a disease continuum in that they may share a common aetiology. Methods: The study used a retrospective design and included data of 911 patients with MD from the Finnish Meniere Federation database. The study participants had a mean age of 60.2 years, mean duration of disease of 12.6 years, and 78.7% of the participants were females. The questionnaire data comprised of both disease specific and impact related questions. The data were analyzed using the Mann-Whitney U test, the Kruskal Wallis H test, logistic regression analyses, and decision tree analysis. Results: Migraine and headache was reported by 190 subjects (20.9%) and 391 subjects (42.9%) respectively. We found that patients that could be classified as VM in the study (i.e., those with frequent vertigo spells associated with migraine) more often reported complaints of severe MD symptoms, had reduced health-related quality of life, suffered more from anxiety, had more neurological complaints, and experienced a reduced sense of coherence than the non-migraneous patients with MD. However, neither the decision tree analysis nor the logistic regression analysis could reliably discriminate VM from MD patients. Conclusion: Our study results confirm that MD is frequently associated with headache and migraine. In addition, results also indicate that migraine provokes the severity of MD. We suggest that MD and VM may share similar pathophysiological mechanisms. Hence, the future MD classification systems should include a category referred to as 'MD with migraine' that will include patients with VM. (C) 2019 Elsevier B.V. All rights reserved.
  • Karppinen, Atte (2020)
    Chiarin tyypin 1 epämuodostuma (CM1) on yleinen sattumalöydös pään ja kaularangan magneettikuvauksessa. Yleensä sen radiologisena kriteerinä pidetään vähintään 5 mm:n pikkuaivoherniaatiota. CM1:tä aiheuttavat useat tekijät, mutta suurimmalla osalla potilaista pikkuaivoherniaation syytä ei voida tunnistaa. Jos niska-aukko on ahtautunut, saattaa esiintyä oireita. Niistä tavallisin on takaraivolle paikantuva ponnisteluun ja rasitukseen liittyvä lyhytkestoinen päänsärky. CM1 on tavallisin syringomyelian aiheuttaja. Leikkaushoitoa tarjotaan yleensä oireisille potilaille. Parhaiten leikkaus auttaa tyypilliseen CM1:n kriteerit täyttävään päänsärkyyn ja syringomyeliaan. Lasten leikkaustulokset ovat hieman aikuisia paremmat. Oireettoman tai vähäoireisen CM1-potilaan ennuste on hyvä ilman leikkaustakin.
  • Siewert, Katherine M.; Klarin, Derek; Damrauer, Scott M.; Chang, Kyong Mi; Tsao, Philip S.; Assimes, Themistocles L.; Smith, George Davey; Voight, Benjamin F.; Anttila, Verneri; Palta, Priit; Muona, Mikko; Kallela, Kaarlo Mikko; Koiranen, Markku; Lehtimäki, Terho; Sarin, Antti-Pekka; Wedenoja, Juho; Färkkilä, Markus; Artto, Ville; Kaunisto, Mari; Vepsäläinen, Salli; Kurki, Mitja Ilari; Hämäläinen, Eija Inkeri; Eriksson, Johan G.; Salomaa, Veikko; Heikkilä, Kauko; Männikkö, Minna; Hiekkala, Marjo; Kajanne, Risto; Kaprio, Jaakko; Aromaa, Arpo J.; Raitakari, Olli; Järvelin, Marjo-Riitta; Wessman, Maija; Palotie, Aarno (2021)
    Background: Nearly a fifth of the world's population suffer from migraine headache, yet risk factors for this disease are poorly characterized. Methods: To further elucidate these factors, we conducted a genetic correlation analysis using cross-trait linkage disequilibrium (LD) score regression between migraine headache and 47 traits from the UK Biobank. We then tested for possible causality between these phenotypes and migraine, using Mendelian randomization. In addition, we attempted replication of our findings in an independent genome-wide association study (GWAS) when available. Results: We report multiple phenotypes with genetic correlation (P < 1.06 × 10-3) with migraine, including heart disease, type 2 diabetes, lipid levels, blood pressure, autoimmune and psychiatric phenotypes. In particular, we find evidence that blood pressure directly contributes to migraine and explains a previously suggested causal relationship between calcium and migraine. Conclusions: This is the largest genetic correlation analysis of migraine headache to date, both in terms of migraine GWAS sample size and the number of phenotypes tested. We find that migraine has a shared genetic basis with a large number of traits, indicating pervasive pleiotropy at migraine-associated loci.
  • Valja, Auri; Tenhunen, Henni; Harno, Hanna; Mäkitie, Laura; Tanila, Tuomo; Lillrank, Paul (IOS PRESS, 2019)
    Studies in Health Technology and Informatics
    A digital service pathway for managing chronic headache has been designed in tertiary care in Finland. The digital tool facilitates self-management by providing exercises, information and messaging opportunities for patients. However, the largest potential benefits are in primary and occupational care. Thus, the purpose of this study was to explore the needs and requirements of primary and occupational care actors for better understanding of the context in the transfer of the service. The study was performed as a single embedded case study. The qualitative data was collected through semi-structured interviews with 16 informants from different organizations and analyzed with Gioia-methodology. This study gathers important empirical knowledge about the meaning of context and transferring digital health interventions from one context to another from clinician and management perspective. Nine key contextual differences were identified and six main expectations emerged.
  • Artto, Ville; Kallela, Mikko (2019)
  • Kallela, Mikko (2016)
    Migreeni on monimuotoinen ja monitekijäinen sairaus. Akuutti migreenikohtaus hoidetaan asetyylisalisyylihapolla, parasetamolilla, tulehduskipulääkkeillä tai -triptaanilla, tarvittaessa metoklopramidilla terästettynä. Migreenin estohoidossa kandesartaani on noussut beetasalpaajien rinnalle ensilinjaan, topiramaatti ¬osoittautunut tehokkaaksi toisen linjan lääkkeeksi ja botuliinitoksiinipistokset kroonisen migreenin uudeksi hoitovaihtoehdoksi. Amitriptyliini ja nortriptyliini ovat säilyttäneet asemansa varteenotettavina estolääkevaihtoehtoina. Migreenin yleisimmät komplikaatiot ovat status migrenosus, joka tarkoittaa yli 72 tunnin yhtäjaksoista -päänsärkyä, ja hoitoon liittyvän lääkepäänsäryn kehittyminen.
  • Kontulainen, Olli; Sainio, Markku; Sumela, Jarkko (2021)
    25-vuotias nainen hakeutui sairaalan yhteispäivystysvastaanotolle huimauksen, tykytyksen, päänsäryn ja raajojen hermokivun vuoksi. Samantyyppisiä kohtauksia oli ollut jo useita vuosia.
  • Hiltunen, Sini; Ruuskanen, Jori; Putaala, Jukka (2020)
    • Sinustromboosin diagnoosi on haastava monimuotoisen oirekuvan vuoksi. • Epäile sinustromboosia, jos potilaalla esiintyy voimakasta jatkuvaa päänsärkyä tai päänsärkyä yhdessä neurologisten oireiden kanssa. • Sinustromboosin, alaraajan laskimotukoksen ja keuhkoembolian riskitekijät ovat usein yhteiset.
  • Partanen, Jaakko; Ahmed, Abdirisak; Snäll, Johanna (2021)
  • Suomela, Jarkko; Artto, Ville (2019)
    Neurologin vastaanotolle saapui työterveyslääkärin lähettämänä 42-vuotias rakennusalalla työskentelevä mies pitkäaikaisen päänsäryn vuoksi. Särky oli vaikeutunut viime vuosina ja potilas arvioi sitä esiintyvän 25 päivänä kuukaudessa.
  • Suomela, Jarkko; Artto, Ville (2019)
  • Kraemer, Yvonn; Mäki, Kaisa; Marinkovic, Ivan; Nybo, Taina; Isokuortti, Harri; Huovinen, Antti; Korvenoja, Antti; Melkas, Susanna; Harno, Hanna (2022)
    Background Post-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized. Methods This is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records. Results At one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW. Conclusions Risk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.
  • Laurell, Katarina; Artto, Ville; Bendtsen, Lars; Hagen, Knut; Haggstrom, Johan; Linde, Mattias; Soderstrom, Lars; Tronvik, Erling; Wessman, Maija; Zwart, John Anker; Kallela, Mikko (2016)
    Aim To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors. Methods In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013 to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%. Results Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% (p Conclusion PS are experienced by a majority of migraineurs. More severe migraine is associated with a higher burden of PS. Since the material was not entirely representative of the general population of migraineurs, caution should be exercised in generalizing the results.
  • Artto, Ville; Mononen, Jani; Heldt, Henna (2016)
  • Mäkitie, Laura; Korja, Miikka; Kangasniemi, Marko; Kallela, Mikko; Forss, Nina; Niemelä, Mika; Lindsberg, Perttu J. (2016)
  • Masina, Riccardo; Ansaripour, Ali; Benes, Vladimir; Berhouma, Moncef; Choque-Velasquez, Joham; Eide, Per Kristian; Fedorko, Stepan; Fleck, Steffen; Hernesniemi, Juha; Koziarski, Andrzej; Majovsky, Martin; Podgorski, Andrzej; Schroeder, Henry; Teo, Charles; Unterberg, Andreas W.; Yeung, Jacky T.; Kolias, Angelos; Santarius, Thomas (2022)
    Background To examine published data and assess evidence relating to safety and efficacy of surgical management of symptomatic pineal cysts without hydrocephalus (nhSPC), we performed a systematic review of the literature and meta-analysis. Methods Following the PRISMA guidelines, we searched Pubmed and SCOPUS for all reports with the query 'Pineal Cyst' AND 'Surgery' as of March 2021, without constraints on study design, publication year or status (PROSPERO_CRD:42,021,242,517). Assessment of 1537 hits identified 26 reports that met inclusion and exclusion criteria. Results All 26 input studies were either case reports or single-centre retrospective cohorts. The majority of outcome data were derived from routine physician-recorded notes. A total of 294 patients with surgically managed nhSPC were identified. Demographics: Mean age was 29 (range: 4-63) with 77% females. Mean cyst size was 15 mm (5-35). Supracerebellar-infratentorial approach was adopted in 90% of cases, occipital-transtentorial in 9%, and was not reported in 1%. Most patients were managed by cyst resection (96%), and the remainder by fenestration. Mean post-operative follow-up was 35 months (0-228). Presentation: Headache was the commonest symptom (87%), followed by visual (54%), nausea/vomit (34%) and vertigo/dizziness (31%). Other symptoms included focal neurology (25%), sleep disturbance (17%), cognitive impairment (16%), loss of consciousness (11%), gait disturbance (11%), fatigue (10%), 'psychiatric' (2%) and seizures (1%). Mean number of symptoms reported at presentation was 3 (0-9). Outcomes: Improvement rate was 93% (to minimise reporting bias only consecutive cases from cohort studies were considered, N= 280) and was independent of presentation. Predictors of better outcomes were large cyst size (OR= 5.76; 95% CI: 1.74-19.02) and resection over fenestration (OR= 12.64; 3.07-52.01). Age predicted worse outcomes (OR= 0.95; 0.91-0.99). Overall complication rate was 17% and this was independent of any patient characteristics. Complications with long-term consequences occurred in 10 cases (3.6%): visual disturbance (3), chronic incisional pain (2), sensory disturbance (1), fatigue (1), cervicalgia (1), cerebellar stroke (1) and mortality due to myocardial infarction (1). Conclusions Although the results support the role of surgery in the management of nhSPCs, they have to be interpreted with a great deal of caution as the current evidence is limited, consisting only of case reports and retrospective surgical series. Inherent to such studies are inhomogeneity and incompleteness of data, selection bias and bias related to assessment of outcome carried out by the treating surgeon in the majority of cases. Prospective studies with patient-reported and objective outcome assessment are needed to provide higher level of evidence.
  • Nybo, Taina; Toivanen, Veera; Isokuortti, Harri; Ylinen, Aarne; Melkas, Susanna (2018)
    Lievän ja keskivaikean aivovamman jälkeen työhönpaluun ennuste on hyvä. Oireiden pitkittymisen riski on tärkeää tunnistaa varhain, jotta tukitoimet voidaan kohdentaa ja käynnistää oikea-aikaisesti.
  • Hollmén, Maria (2020)