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Cervicogenic headache (CEH) is a chronic, hemicranial pain syndrome in which the sensation of pain originates in the cervical spine or soft tissues of the neck and is referred to the head. Cervicogenic headache is a relatively common but often overlooked disorder. There is sufficient evidence to support this category and the existing diagnostic criteria are adequate. The purpose of this case report was to describe an intervention approach consisting of release and muscle energy techniques for an individual with cervicogenic headache. Clinical examination revealed myofacial trigger points in trapezius, sternocliedomastoid and upper cervical spine erectors. Visual analogue scale (VAS) identified severe pain. Range of flexion and rotation was reduced. Complete pain relief was seen following three times treatment sessions. The results indicating definite diagnosis and appropriate treatment of cervicogenic headache.

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Background and Objective: Post dural puncture headache (PDPH) is a relatively common complication in spinal anesthesia. Several regimens had explained for treatment of this problem. The aim of this study was to determine the effect of intravenous single dose of Aminophylline (1.5mg/kg/body weight) on the incidence of PDPH in cesarean section under spinal anesthesia. Materials and Methods: In a double blind randomized trial study, 120 patients undergone spinal anesthesia for the elective cesarean section in Motahhari hospital of Marvdasht in Fars province in south of Iran during 2008. After umbilical cord clamping 1.5mg/kg/body weight of Aminophylline injected slowly and intravenously in 60 patients. In placebo group (n=60) normal saline injected intravenously. At the 1st, 4th, 24th and 48th hour after surgery, PDPH in patients were evaluated. Results: The incidence of PDPH was significantly lower in cases compared with controls during the first 24 hours post operation (5% vs. 31.7%, P<0.001). Incidence of PDPH in case and control groups after 48 hours was 5% and 23.3% respectively (P<0.004). Conclusion: This study revealed that the intravenous single dose of Aminophylline (1.5mg/kg/body weight) significantly reduced PDPH after spinal anesthesia in cesarean section.

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Background and Objective: Millions of women in the world use oral contraceptive pills (OCPs). On the other hand %16 to %19 of women suffer from migraine and many of them have tension headaches. These women may wonder whether the consumption of OCPs is harmful for them. This study carried out to determine the effects of combined low estrogen oral contraceptive pills on migraine and tension headaches. Materials and Methods: This case control study was done on 344 women which reffered to health care centers in Mashhad, Iran during 2009. Case group include 244 women which consumed oral contraceptive for at least three month. 100 women without OCPs consumption were considered as control group. The criteria of International Headache Society for migraine and tension headaches were used to diagnose headache. The severity and the frequency of headaches before and after the consumption of OCP were recorded. Data was analyzed by Chi-Square, Fisher exat, Logestic regresion and Wilcoxon tests. Results: The frequency of migraine headache was 5% and 6% in case and control groups respectively. This different was not significant (OR=0.88, 95%CI: 0.3-2.69, P=0.804). The frequency of tension headache in cases and controls was 12% and 10%, respectively. This different was not significant (OR=1.26, 95%CI: 0.56-2.86, P=0.055). Conclusion: This study showed that the consumption of OCPs, has no effects on the advent of migraine and tension headaches and do not increase the rate and severity of the attacks.

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Background and Objective: Headache is one the most common compliant of patients and has different causes and the migraine and tension headaches are common. Personality is characteristics forming an individual distinctive manner. This study aimed to determine the frequency and association of different types of personality characteristics in patients with migraine and tension headaches. Materials and Methods: This descriptive-analytic study was done on 160 (12 male and 148 female) subjects with chief complaint of headache whome referred to 5th Azar clinics of Gorgan, Iran during 2007-08. Subjects were selected by simple random sampling and were examined by either a neurologist or psychiatrist patient with diagnosis migraine either of or tension headache were included. Selected patients evaluated by short form of Minnesota Multiphasic Personality Inventory (MMPI). Data were analyzed using SPSS-13 and Chi-Square test. Results: The mean age was 11.18±33.29 in women and 34.33±13.7 in men. 96 patients (60%) had tension headache and 64 (41.2%) had migraine. In tension headache, depressed personality (43.8%) and hysterical personality (16.4%) were more common but in migraine headache, depressed personality (48.9%) and paranoid personality (20%) were common but this difference was not significant. Conclusion: This study showed that there is no relation between personality characteristics with tension headach and migraine.

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The latest reported incidence of subarachnoid hemorrhage due to aneurysms and arterio-venous malformations (AVMs) is around 15 per 100,000 pregnancies. It is also the third leading cause of maternal death from non obstetric causes accounting for 12% of total mortality. A pregnant woman with 42 years old G5P4Lch4 had vaginal delivery in 12 Aug 2009. One week after delivery she was visited by General Physician due to headache. She was admitted with signs of dizinous, vomiting projectile and painful stimuli, hospital consciousness level 5 and coma. CT scan was demonstrated a massive bleeding inside the brain. Massive hemorrhage into the ventricle was detected following neurosurgery. She was dead due to cardiac arrest after 10 days. Based on this case report, woman with headache following delivery should be recommended for cerebral aneurysm.

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Background and Objective: Migraine is common worldwide. In recent years, vitamin D deficiency has been shown as a global health issue. This study was done to determine the relationship between serum levels of vitamin D with migraine. Methods: This descriptive - analytical study was carried out on 76 patients (21 males, 55 females) with migraine aged 10-61 years olds. Serum vitamin D level of each patient was measured. Adjustments were done for age, sex, waist circumference, body mass index (BMI), number of chronic diseases, and education level. The multiple linear regressions were done to determine the relationship between serum levels of vitamin D with migraine. Results: Vitamin D defeicincy was seen in 13.2 of patients.The weak positive association was shown between serum vitamin D with headache (P<0.05), but no significant association was found between serum vitamin D level with migraine severity. Conclusion: No significant association was seen between serum levels of vitamin D with migraine severity.