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Paul Gutterman and Honorio S. Bezier

T he onset and persistence of headache following myelography is a continual problem to physicians who perform this procedure. While the incidence of headache after diagnostic lumbar puncture varies from 18% to 32%, 17, 18 headache following myelography is reported in 31% to 44% of cases. 4, 16 An epidural injection of autologous blood has been reported to be an effective method of treating headache caused by a persistent cerebrospinal fluid (CSF) leak following diagnostic lumbar puncture and spinal anesthesia. 1, 3, 5, 6, 9 However, the use of an

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Rachid Assina, Christina E. Sarris, and Antonios Mammis

H eadache has been described as long as human history has been recorded, having made its way into myth, magic, theology, and medicine. It has touched ordinary, privileged, and famous people, baffling the minds of the earliest physicians, who eagerly sought for means to explain its occurrence and methods for its treatment. Its history can be traced back at least 4000 years to Mesopotamian ritual texts. 14 Headache was initially viewed as a spiritual entity rather than a symptom of various physical diseases. Scholars from numerous cultures and historical

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Tomohiro Inoue, Aaron A. Cohen-Gadol, and William E. Krauss

S pinal cord herniation is a rare but treatable cause of Brown—Séquard syndrome. It involves spontaneous herniation of the spinal cord through an anterior dural defect. 1, 2, 10 The pathogenesis of the initial dural defect is not well understood. 10 We report a unique case in which spinal cord herniation was preceded by a history of postural headaches. The role of spontaneous dural defects causing intracranial hypotension in relationship to spinal cord herniation will be discussed. Case Report History This 21-year-old man presented with a 2-year

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Ho Jun Seol, Kyu-Chang Wang, Seung-Ki Kim, Yong-Seung Hwang, Ki Joong Kim, and Byung-Kyu Cho

M oyamoya disease is characterized by the progressive occlusion of the internal carotid artery or its terminal branches, which is accompanied by the formation of extensive collateral vessels (“moyamoya” vessels) at the base of the brain. In children, the clinical presentation of moyamoya disease usually includes repeated TIAs 2, 14, 15 and the benefit of surgery for the ischemic type of moyamoya disease has been established. 2–4, 10, 15 Nonetheless, patients with moyamoya disease often complain of headache before surgery, after surgery, or in both periods

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Hiroki Kurita, Keisuke Ueki, Masahiro Shin, Shunsuke Kawamoto, Tomio Sasaki, Masao Tago, and Takaaki Kirino

H eadaches are a common symptom of cerebral AVMs, with a reported incidence varying from 3% 5 to 79.2%. 30 Several authors have suggested a causal relationship between the lesions and headaches because of the much higher incidence of headaches in patients with AVMs than in the general population 2, 30 and the overwhelming matching rate of the side of headache pain to the side of the AVM location. 22 There still exists, however, considerable disagreement on the frequency and outcome of headaches in patients with AVMs. 19, 23, 29 Such disagreements may stem

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Maria Fleseriu, Christine Yedinak, Caitlin Campbell, and Johnny B. Delashaw Jr

The prevalence of headaches associated with brain tumors has previously been reported as 48% for either primary or metastatic tumors. 7 The incidence of pituitary tumors continues to increase, and these lesions now represent the third most common primary or metastatic brain tumor. 7 Headaches are the most commonly reported symptom at presentation (in 33–72% of patients). 1 , 5 The reported prevalence of headache in the general population is up to 47% for general headaches, 13 10% for migraines, 13 38% for tension-type headaches, 13 and 4–5% for

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Rudolph J. Schrot, Jesna S. Mathew, Yueju Li, Laurel Beckett, Hyun W. Bae, and Kee D. Kim

H eadache is commonly associated with lower cervical spondylosis. Anterior neck surgery is associated with a significant reduction in headache. 10 14 19 20 22 25 Cervicogenic headache (International Headache Society [IHS] diagnosis 11.2.1) is defined according to strict criteria by the IHS and is thought to be referred from structures in the neck. 5 The putative mechanism for cervicogenic headache involves afferent sensory input conveyed through the upper cervical nerves (C1–3) that converge on the spinal trigeminal nucleus, causing referred cranial pain

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Amparo Wolf, Sandy Goncalves, Fateme Salehi, Jeff Bird, Paul Cooper, Stan Van Uum, Donald H. Lee, Brian W. Rotenberg, and Neil Duggal

P ituitary tumors are relatively common, with reported prevalence rates ranging from 10% to 22% and accounting for 10% to 15% of all intracranial tumors. 3 , 5 , 22 With the advent of neuroimaging, the incidental finding of pituitary adenoma has become much more frequent. Chronic headache is a common reason for undergoing neuroimaging. The incidence of headache in patients with pituitary adenomas has been reported to range between 33% and 72%. 1 , 6 , 23 The existence of any clear relationship between headaches, pituitary tumors, and surgical treatment

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Charles A. Sansur, John D. Heiss, Hetty L. DeVroom, Eric Eskioglu, Robert Ennis, and Edward H. Oldfield

P atients with Chiari I malformation either with or without syringomyelia often complain of headache and may experience syncope in association with coughing. 10 The presence of the cerebellar tonsils within the foramen magnum apparently predisposes these patients to headache aggravated by cough. It has been proposed that syringomyelia in patients with Chiari I malformation results from occlusion of the free pulsatile movement of CSF across the foramen magnum during the cardiac cycle. 2, 5 Within this proposed mechanism, the tonsils create a partially

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Wouter I. Schievink and M. Marcel Maya

P ost –dural puncture headache has been reported to occur in 1%–25% of children following a lumbar puncture, 1 , 4 , 6 , 8 a rate similar to that seen in adults. 2 , 3 , 7 Headache that persists in spite of bed rest, increased fluid intake, and even epidural blood patching, however, is rare. In this report we review our experience with children requiring surgical correction for persistent post–dural puncture headaches. We reviewed the medical records and imaging studies of all patients 19 years of age or younger who were evaluated for intracranial