TelemEdiciNe-bAsed Cognitive TherapY for Migraines
Migraine HeadacheThe goal of this pilot study is to evaluate a bundle of implementation strategies at three Veteran Affairs Medical Centers (VAMCs) to facilitate the referral and adoption of a telehealth based, cognitive behavioral therapy program delivered by Health Psychologists for Veterans with chronic migraine to inform a future fully-powered hybrid type 2 effectiveness-implementation design. Veteran patients will be randomized to either the telehealth delivered CBT or usual care. Headache symptoms and severity will be reported using a VA text messaging application.
The Hemodynamic Effects of CGRP After Glibenclamide Administration in Healthy Volunteers
Hemodynamics of Cranial ArteriesHeadache1 moreTo investigate the hemodynamic effects of CGRP after glibenclamide administration.
The Hemodynamic Effects of PACAP38 After Glibenclamide Administration in Healthy Volunteers
MigraineHeadache1 moreTo investigate the hemodynamic effects of PACAP38 after glibenclamide administration.
Migraine Inducing Effect of Levcromakalim in Patients With Migraine With Aura
HeadacheMigraine1 moreTo investigate the migraine inducing effect of levcromakalim in patients with migraine with aura.
Postdural Punction Headache After Ceserian Section
Postdural Puncture HeadacheRegional Anesthesia Morbidity1 moreThe aim of this study is to compare the effect of spinal needle type on postdural puncture headache in patients who will undergo cesarean section. The main question[s] it aims to answer are: [Does spinal needle thickness affect postdural puncture headache?] [What is the response of patients who develop postdural puncture headache to treatment?] In cases accepting cesarean section operation under spinal anesthesia, different tables were used with spinal needles, and it will be questioned whether headache will develop in the first 15 days postoperatively. Postdural puncture headache after surgery will be described.
Promoting Patient-Centered Counseling to Reduce Inappropriate Diagnostic Tests
Unnecessary ProceduresLow Back Pain4 moreIn this study, the investigators will develop and evaluate a novel intervention using standardized patients (SPs) -- or actors playing the roles of patients -- to enhance physicians' patient-centered counseling skills regarding two frequently overused, potentially inappropriate services in primary care: magnetic resonance imaging (MRI) for acute low back pain and bone densitometry in women at low-risk for osteoporosis. The investigators will further evaluate whether intervention effects on physician patient-centeredness generalize to counseling regarding other costly, unnecessary diagnostic tests.
Use of Ibuprofen and Acetaminophen for Treatment of Acute Headache Post Concussion in Children
ConcussionHeadacheConcussions and headache are a significant problem for children and athletes. While headache generally resolves within 7-10 days; a significant proportion of children, 72-93% experience prolonged headache as a symptom of Post Concussion Syndrome (PCS). The prevailing clinical view is that mild head injuries resolve with little chance of complications. However, the reality is quite different. Concussion in children presents with a range of severity and results in both short and long-term physical, cognitive, emotional and behavioural sequelae known as PCS with varying times to resolution. To date there are no specific treatments for headache pain related to concussion. Physical and cognitive rest is the mainstay of initial concussion management. The number of children presenting to ED's with a history of concussion and headache is increasing. Presently there are no evidence based guidelines available to guide the medical team to effectively and consistently manage their headache. Our present standard of care is based on the CANCHILD concussion guidelines outlining the child's return to school and activity. Yet, our present standard of treatment is compromised and somewhat counterproductive if we are not treating the child's headache pain. Our pilot study ' An Open Label Randomized Control Pilot Study Examining Treatment of Headache In The Post-Concussive Youth' showed that routine administration of oral analgesia improves the child's headache symptoms and helps with school re-entry one week post injury, compared to a standard care group defined as non routine administration of pain medications.
Equity in Diagnostic Imaging Trial
HeadacheThis study will 1) Develop two interventions: a) an audit-feedback email intervention that provides clinicians with data on CT scan ordering practices by patient race; and b) a clinical decision support (CDS) message in the electronic medical record headache template; and 2) Compare the effectiveness of these 2 interventions in eliminating a previously observed Black-White disparity in CT scanning rates to rule out subarachnoid hemorrhage (SAH).
Blood Flow Within Active Myofascial Trigger Points Following Massage
Myofascial PainTension-type HeadacheThe physiological response at the myofascial trigger point (MTrP) to massage is not known, yet would provide important objective evidence for a treatment effect and clarify the resolution process of a MTrP.
Carbon Monoxide Headache Triggering Properties as Well as Effects on the Brain's Vessels and Blood...
Headache DisordersStudying Carbon monoxide effects on brain vessels in healthy volunteers with magnetic resonance imaging.