Background and Purpose—The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audienc...

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Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

The 3rd edition of the International Classification of Headache Disorders (ICHD-3) may be reproduced freely for scientific, educational or clinical uses by institutions, societies or individuals. Otherwise, copyright belongs exclusively to the International Headache Society. Reproduction of any part or parts in any manner for commercial uses requires the Society’s permission, which will be granted on payment of a fee. Please contact the publisher at the address below. International Headache Society 2013–2018. Applications for copyright permissions should be submitted to Sage Publications Ltd, 1 Oliver’s Yard, 55 City Road, London EC1Y 1SP, United Kingdom (tel: þ44 (0) 207 324 8500; fax: þ44 (0) 207 324 8600; permissions@sagepub.co.uk) (www.uk.sagepub.com). Translations

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition

https://bic.berkeley.edu/sites/default/files/Rossi_09_TMS%20safety%20review.pdf

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research

OBJECTIVE — To systematically review the incidence of posttransplantation diabetes (PTD), risk factors for its development, prognostic implications, and optimal management. RESEARCH DESIGN AND METHODS — We searched databases (MEDLINE, EMBASE, the Cochrane Library, and others) from inception to September 2000, reviewed bibliographies in reports retrieved, contacted transplantation experts, and reviewed specialty journals. Two reviewers independently determined report inclusion (original studies, in all languages, of PTD in adults with no history of diabetes before transplantation), assessed study methods, and extracted data using a standardized form. Meta-regression was used to explain between-study differences in incidence. RESULTS — Nineteen studies with 3,611 patients were included. The 12-month cumulative incidence of PTD is lower (10% in most studies) than it was 3 decades ago. The type of immunosuppression explained 74% of the variability in incidence (P 0.0004). Risk factors were patient age, nonwhite ethnicity, glucocorticoid treatment for rejection, and immunosuppression with high-dose cyclosporine and tacrolimus. PTD was associated with decreased graft and patient survival in earlier studies; later studies showed improved outcomes. Randomized trials of treatment regimens have not been conducted. CONCLUSIONS — Physicians should consider modification of immunosuppressive regimens to decrease the risk of PTD in high-risk transplant recipients. Randomized trials are needed to evaluate the use of oral glucose-lowering agents in transplant recipients, paying particular attention to interactions with immunosuppressive drugs. Diabetes Care 25:583–592, 2002

A systematic review of the literature

Theta Burst Stimulation of the Human Motor Cortex

Headache and sleep obviously show several clinical links, and even in antiquity good sleep was thought to be a cure for headache and bad sleep was said to be a trigger for headache. In the paper by Lateef and co-workers (1), a particular aspect of these links has been investigated: the comorbidity of poor sleep, in particular different types of insomnia, with headache (separately for headache in general, migraine without aura, migraine with aura). The authors show that headache in general, but not specifically migraine without or with aura, is associated with an approximately twofold increased risk for insomnia. This confirms previous studies which also linked sleep disturbances to headache in general (2). The authors further speculate about the underlying reason for this association in three ways. It might be that subjects with headache have a pathophysiology leading to both headache and insomnia; it might be that sleep disturbances are a trigger for headache in general; and it might be that headache induces insomnia. The strength of this study lies in the large representative population-based patient sample, which were interviewed in the United States with a focus on one specific sleep disturbance, namely insomnia. However, the interview questions for migraine and in particular for the migraine aura were not very specific, and it is doubtful whether the different headache diagnoses are completely reliable (e.g. some aura subtypes were not included). Furthermore, the study defined increased daytime sleepiness as one aspect of insomnia, wheres it is classified as hypersomnia in the International Classification of Sleep Disorders (ICSD) (3) and might not only be a result of insomnia in the night but a result of other sleep disorders. The obvious links between headache and sleep have increasingly become part of headache rather than of sleep research. From a systematic point of view, we can differentiate the following aspects:

https://journals.sagepub.com/doi/pdf/10.1177/0333102410392072

Headache and sleep: the missing links.

To investigate the possible association between migraine and left-handedness, we enrolled 100 patients with a diagnosis of migraine according to the International Headache Society diagnostic criteria and 100 age- and sex-matched control subjects into a case-control study. Handedness was determined by the Edinburgh Handedness Inventory. There was no significant difference in the frequency or grade of left-handedness between the two groups. Additionally, we pooled our data with those from five similar studies, which did not alter the result. Thus, neither our study nor the meta-analysis support Geschwind and Behan's hypothesis of an association between migraine and left-handedness.

Migraine and left-handedness are not associated. A new case-control study and meta-analysis.

Headache or pain in the face or neck attributed to the carotid or vertebral artery was not recognized as a special type of pain until the concept of carotidynia occurred in the 1960s. Carotidynia has long been assumed as an entity until modern imaging techniques showed that pain localized in the carotid region could most often be related to injury of the artery or other symptomatic causes. These causes include headache due to arterial dissection, which has been described as a true pain originating from the vessel structure itself and which has also been attributed to a comorbidity of migraine and cervical artery dissection. Furthermore, headache starting after endarterectomy, carotid angioplasty headache, headache attributed to intracranial endovascular procedures, and angiography headache have been listed among the headache and pain syndromes due to changes of the cervical arteries. It is still not clarified whether carotidynia is a specific idiopathic disease or whether the previous descriptions of carotidynia just resembled symptomatic causes of carotid pain.

Headache attributed to carotid or vertebral artery pain

Objective: It is unknown whether interactions between HIV infection and the safety of botulinum toxin A (BTX) exist. Methods: We studied eight patients with HIV infection who were treated with BTX every three months for up to nine years. All patients were on antiretroviral treatment. The efficacy and safety of BTX were evaluated. Results: Indications for BTX treatment (including off-label use), dosage of BTX, and frequency of application did not differ as compared to non-HIV infected patients. BTX treatment was effective in all HIV infected patients during a long-term observation period without loss of efficacy and without clinically relevant side effects. Only one of the eight patients showed mild side effects due to BTX, and no clinical signs of antibody development were noted. We also observed no signs of interaction with antiretroviral treatment. CD4+ cell count and viral load remained stable during the observation period. Conclusions: We conclude that BTX treatment is safe and effective in the treatment of HIV infected patients who suffer also from a condition which can be treated by BTX. It is a therapeutic option in addition to oral medication for HIV infected patients.

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Stefan Evers

Papers

Headache and sleep: the missing links.

Migraine and left-handedness are not associated. A new case-control study and meta-analysis.

Headache attributed to carotid or vertebral artery pain

Botulinum Toxin A Treatment in HIV Infected Patients—A Long-Term Observational Study

Botulinum toxin for migraine treatment