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Joel C. Morgenlander and Robert H. Wilkins

ipsilateral signs of autonomic dysfunction such as rhinorrhea or nasal congestion, increased lacrimation, ptosis, and miosis. Methysergide, corticosteroid preparations, and ergotamine tartrate are among the medications given prophylactically to prevent episodic cluster headache. Lithium carbonate, calcium channel blockers such as verapamil, and indomethacin are some of the drugs that are administered to prevent chronic cluster headache. Histamine desensitization is also used prophylactically with some success. Oxygen inhalation, ergotamine tartrate administration, and

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Claudia L. Craven, Roshini Ramkumar, Linda D’Antona, Simon D. Thompson, Lewis Thorne, Laurence D. Watkins and Ahmed K. Toma

not. 9 Due to the absence of any randomized controlled trials, it is unclear what the optimum management for LOVA is, with options including endoscopic third ventriculostomy (ETV), placement of a ventriculoperitoneal (VP) shunt, and even dural venous sinus stenting. 8–10 , 12 , 15 , 17 We hypothesize that the various symptomatic presentations represent different stages of decompensation and that identification of the various stages will aid management strategies. We performed a cluster analysis on a cohort of patients with chronic ventriculomegaly with the aim to

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Robert A. Morantz, John S. Neuberger, Larry H. Baker, Gary B. Beringer, Andrew B. Kaufman and Tom D. Y. Chin

exposure to specific chemical carcinogens, such as ethylnitrosourea and vinyl chloride. 10, 18 Living on a farm and/or exposure to farm animals has been noted as a risk factor. 18 There have also been reports of an excessive incidence of brain tumors among Swedish chemists and United States petrochemical, pharmaceutical, and rubber workers. 14, 21, 24, 25 One possible approach by which hypotheses as to risk factors may be generated involves the examination of any temporal or spatial clustering of primary brain tumors. While there have been reports, for example, of

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Arvind Rao, Ganesh Rao, David A. Gutman, Adam E. Flanders, Scott N. Hwang, Daniel L. Rubin, Rivka R. Colen, Pascal O. Zinn, Rajan Jain, Max Wintermark, Justin S. Kirby, C. Carl Jaffe, John Freymann and TCGA Glioma Phenotype Research Group

:// . We extracted “Overall Survival (months)” and “Overall Survival Status” for each patient. Further demographic information (sex, age, prior glioma status, and treatment history) was also obtained from the cBioPortal (or from the TCGA portal [ ]). Clustering Analysis To examine whether these image features stratify the cases in any clinically relevant manner, we hierarchically clustered them (using R package “cluster”) using Gower’s similarity metric with complete linkage. Gower’s distance is applicable for mixed (combination of

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Sérgio A. F. Dantas, Eduardo J. L. Alho, Juliano J. da Silva, Nilson N. Mendes Neto, Erich Talamoni Fonoff and Clement Hamani

H ypothalamic deep brain stimulation (DBS) has been used for more than a decade for cluster headache (CH). 5 , 7 , 9 , 18–20 , 28 , 29 As neuroimaging studies have shown hypothalamic activation during the attacks, 26 the modulation of local circuits and neural elements has been suggested as a potential therapeutic mechanism. 22 We have successfully treated a patient with CH using DBS and suggest that, in addition to a direct hypothalamic effect, this therapy may exert its actions through the modulation of fibers interconnecting the hypothalamus and brainstem

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Diana Abbott, Douglas Brockmeyer, Deborah W. Neklason, Craig Teerlink and Lisa A. Cannon-Albright

determine because of several factors, most notably the presence of asymptomatic individuals within the population, the discovery of incidental findings on imaging, and a “detection effect” in which patients might undergo MRI screening because a family member carries the CM-I diagnosis. As a result of these confounding factors, establishing a clear picture of the imaging indications in large data sets can be difficult. Many other studies of CM-I have reported familial clustering, co-occurrence in twins, and an overlap with a subset of known genetic syndromes, 2 , 12 , 14

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Hideyuki Kano, Douglas Kondziolka, David Mathieu, Scott L. Stafford, Thomas J. Flannery, Ajay Niranjan, Bruce E. Pollock, Anthony M. Kaufmann, John C. Flickinger and L. Dade Lunsford

C luster headache is a relatively rare periodic headache and facial pain syndrome that may persist for weeks or even months. Cluster headaches occur in 0.4% of the male population and < 0.08% of the female population. 20 Approximately 90% of patients with CH have an episodic disorder, while 10% have chronic CH. Chronic CH attacks vary, from closely spaced pain with remissions lasting no longer than 30 days, to continuous pain without remission lasting more than a year. 5 In contrast, episodic CHs are characterized by 1–3 attacks of periorbital pain per

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Tonje Haug Nordenmark, Tanja Karic, Cecilie Røe, Wilhelm Sorteberg and Angelika Sorteberg

rate of return to work. 23 Many suffer from excessive fatigue, 22 , 27 cognitive deficits, 15 and emotional problems. 37 A combination of these symptoms together with depressed mood and subtle cognitive impairments is often debilitating. 38 This cluster of symptoms may be called post-aSAH syndrome, but it has not previously been well described and no precise, simple tools have been established for the evaluation of these self-reported complaints. Complaints similar to those reported by aSAH patients are reported by individuals who have experienced mild traumatic

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Michael Sanders and Wouter W. A. Zuurmond

C luster headache (CH) has been described as an attack of severe, strictly unilateral pain located orbitally, supraorbitally, and/or temporally, lasting 50 to 180 minutes and occurring once every other day to as many as eight times per day. The attacks are associated with one or more of the following symptoms: conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, or eyelid edema. Attacks occur in series that last weeks or months (so-called cluster periods) separated by remission periods that usually

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Philip A. Starr, Nicholas M. Barbaro, Neil H. Raskin and Jill L. Ostrem

target region in voltage ranges only slightly higher than those used for therapeutic benefit. Ophthalmoplegia or skew deviation was the most consistent finding. Test stimulation in the present series did not evoke sympathomimetic responses (elevated blood pressure and pulse rate), unlike acute stimulation several millimeters more anterior at the Sano hypothalamic target. 7 Test stimulation more posteriorly in the PVGM has been reported to produce nystagmus and paralysis of upward gaze. 10 Conclusions Cluster headache is the most severe known primary headache