Migraine-like headache attributed to a causative disorder: primary migraine or secondary headache with a migraine-like phenotype?
Abstract
BACKGROUND: Migraine-like headaches can accompany or be the initial manifestation of many neurological disorders. When a migraine-like headache develops or worsens in the presence of another neurological disorder, there is often uncertainty about whether the headache is true migraine (i.e., the primary headache) or is a secondary headache with migraine-like symptoms. To answer this question, we analyzed headache characteristics and the effect of treatment in several neurological disorders.
MATERIALS AND METHODS: The study was a retrospective analysis of five existing datasets collected by the authors: 1) 670 patients with acute ischemic cerebrovascular disease (550 patients with first-ever ischemic stroke, mean age 63.1 years, 46% females and 120 patients with transient ischemic attacks-TIA, mean age 56.1 years, 54.2% females); 2) 199 patients with intracranial saccular aneurysms (mean age 43.2 years, 52% females); 3) 77 patients with newly diagnosed definite idiopathic intracranial hypertension (IIH) (mean age 28.8 years, 96% females); 4) 169 patients with post-traumatic headache (PTH) attributed to mild traumatic brain injury (mTBI) (mean age 41.5 years, 52.1% females); 5) 59 patients with PTH followed prospectively with a focus on treatment response to prophylactic migraine medication (mean age 37.1 years, 78% females). Detailed information about headache characteristics and outcomes were collected.
RESULTS: Our results demonstrate that a headache phenotypically…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 670 participants or records.
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