Han Christoph Diener

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..Consideration of these new anticoagulants will improve clinical decision-making...

..Current textbook knowledge states that patients with chronic migraine and medication overuse should be withdrawn from acute medication before initiating preventive drug therapy...

..This Review discusses the evolution of our understanding of chronic migraine, including its epidemiology, pathophysiology, clinical characteristics and treatment options...

..The new oral anticoagulants substances show similar results in secondary as in primary stroke prevention in patients with AF and will on the long run replace warfarin...

..Through nonmedicinal and medicinal prophylactic measures, the frequency and intensity of the migraine attacks can be reduced. Keeping a headache diary for documentation is essential...

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..Regarding pain-free at 2 h sumatriptan was most effective...

..No unusual or unexpected safety risks emerged. These findings demonstrate that TPM 100 mg/d is effective in migraine prophylaxis. TPM 100 mg/d and PROP 160 mg/d exhibited similar efficacy profiles...

..The authors analyzed these data to identify factors predicting response (headache relief and pain-free response) to sumatriptan...

..Butterbur was well tolerated. This small trial indicates that butterbur may be effective in the prophylaxis of migraine...

..The benefit of clopidogrel over ASA is amplified in high-risk patients. Proof of concept for the benefit of clopidogrel in addition to ASA in patients with coronary manifestations of atherothrombosis was provided by the CURE trial...

..With over 20,000 patients randomized, and utilizing a 2 x 2 factorial design, PRoFESS is the largest stroke trial to investigate the prevention of recurrent stroke...

..The more rare forms of nonsymptomatic headache include paroxysmal hemicrania and trigeminal neuralgia, in the prevention of which carbamazepine, phenytoin or oxcarbazepine have proven of value...

..The study showed that administration of effervescent ASA leads to remission of the migraine symptoms nausea, photophobia and phonophobia, reduces migraine headache and is comparable to sumatriptan...

..These results indicate that pain afferents from the lower cervical roots can converge on the cervical trigeminal nucleus and the nucleus caudalis...

..Withdrawal therapy is the only treatment for this disorder and clear restriction of monthly doses is the central requirement for successful prevention...

..We aimed to assess whether addition of aspirin to clopidogrel could have a greater benefit than clopidogrel alone in prevention of vascular events with potentially higher bleeding risk...

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..To show results of a prespecified pooled analysis of the studies SPORTIF III (open-label) and SPORTIF V (double-blind), to assess the homogeneity of the results and to explore subgroup analyses and adverse events...

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..The combination of aspirin plus clopidogrel is not more effective than clopidogrel alone but carries a higher bleeding risk. None of the antiplatelet agents is able to reduce mortality...

..4 in favour of MIG-99 (P = 0.0049). Adverse events possibly related to study medication were 9/107 (8.4%) with MIG-99 and 11/108 (10.2%) with placebo (P = 0.654). MIG-99 is effective and shows a favourable benefit-risk ratio...

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..This review summarizes and analyzes clinical data of aspirin in the treatment of acute migraine attacks with respect to the different galenic formulations...

..placebo. No safety issues were identified. This study demonstrates that sachets offer patients suffering from migraine pain a more effective treatment with a faster onset of analgesia when compared with tablets...

..Ibuprofen, immunoglobulins, and antibiotics might lead to aseptic meningitis. Drug-induced headaches are seen after use of nitroglycerine, calcium channel blockers and immunoglobulins...

..To investigate the efficacy and tolerability of almotriptan 12.5 mg in migraine patients who respond poorly to sumatriptan 50 mg...

..An early treatment study suggests that treatment of mild headache is associated with unusually high sustained pain-free rates and a tolerability profile that is equivalent to placebo...

..Combined analysis demonstrates that E40 has superior efficacy versus S100 across all clinically relevant outcomes...

..placebo (all P < 0.01). Thus, eletriptan and sumatriptan are efficacious in difficult-to-treat patients at high risk for non-response to triptans...

..Phase II and early phase III trials indicated an improvement in neurological outcome, whereas a final large randomized and placebo controlled trial did not show superiority versus placebo...

..In addition, no significant differences between the three treatments were found with regard to safety: all three treatments were generally well-tolerated and safe...

..001) at 2 h. Adverse events were generally mild or moderate and transient. This randomised trial shows that oral eletriptan is more efficacious in the acute treatment of migraine than oral Cafergot and is well tolerated...

..Recently anti-epileptic drugs (valproic acid, gabapentin, topiramate) were evaluated for the prophylaxis of migraine. The use of botulinum toxin is under investigation...

..4 mg for pain free at 2 h. The difference, however, was small and clinically not important. For alniditan, a dose-dependent adverse event relationship was seen. The safety profile of alniditan 1.4 mg was similar to that of sumatriptan...

..DP did not result in a higher number of cardiac events, e.g., angina pectoris, myocardial infarction or death. The combination of ASA plus DP was superior to either drug alone in the prevention of strokes...

..Alniditan 2 mg, administered via the intranasal route, was effective in relieving migraine headaches in over two-thirds of the patients at 1 h...

..Acetylsalicylic acid is better tolerated than metoprolol. Using a strict responder criterion ASA showed a responder rate comparable with the placebo rate in the literature...

..To study the safety and efficacy of the low-molecular-weight heparin certoparin, we performed a randomized, double-blind, dose-finding multicenter trial in patients with acute ischemic stroke (Therapy of Patients With Acute Stroke [TOPAS])...

..5 mg followed by a daily intravenous dose of 10 mg lubeluzole for 5 days in acute ischemic stroke patients...

..It will be replaced by clopidgrel which has a better safety profile. Anticoagulation with an INR between 3.0 and 4.5 is too dangerous. Whether anticoagulation with lower INR is safe and effective is not yet known...

..New drugs in migraine treatment include substance-P antagonists, nitric oxide synthetase inhibitors and calcitonin gene-related peptide antagonists...

..Many other substances have been investigated in chronic daily headache. All trials were underpowered and, therefore, recommendations concerning possible efficacy are not possible...

..These studies may have important implications for the future of chronic migraine management, suggesting that detoxification prior to initiating prophylactic therapy may not be required in all patients if MO is present...

..03), and a borderline significant difference in responders (40% vs. 25%, P = 0.07). The incidence of adverse events was similar between treatments. This study indicates that telmisartan might be effective in migraine prophylaxis...

..Nonpharmacologic treatment also plays an important role in migraine prevention. New medical care structures such as integrated headache care provide better support for patients with migraine, particularly those with chronic migraine...

..The efficacy of aspirin or magnesium is still under evaluation...

..Nonpharmacologic treatment also plays an important role in migraine prevention. New medical care structures such as integrated headache care provide better support for patients with migraine, particularly those with chronic migraine...

..Headache intensity and improvement of headache after 2 h were not different in the four treatment groups. Therefore, it is concluded that this oral substance-P antagonist in the doses used here is not effective...

..Therefore, selection of patients who might benefit from antiplatelet therapy other than aspirin is important...

..The putative neuroprotective effects of antiplatelet compounds and the angiotensin II receptor antagonist telmisartan were investigated in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial...

..Few data on the efficacy of opioid drugs in the treatment of migraine are available. They seem to be effective but carry the risk of dependency and may cause drug-induced headache...

..Patients with > 70% stenosis of the internal carotid artery and TIA or minor stroke receive carotid endarterectomy in combination with aspirin. Stroke risk is reduced between 20 and 65% by these measures...

..Transient ischemic attacks (TIA) can also lead to headache. The pathophysiology of headache associated with acute ischemic stroke includes edema, hemorrhagic transformation, and changes in the trigeminovascular system...

..6%, sumatriptan 37.8%). In conclusion, subcutaneous sumatriptan and lysine acetylsalicylate i.v. are effective treatments for patients suffering from migraine attacks. Sumatriptan is more effective, but resulted in more adverse events...

..Since attentional and working memory functions are supposed to modulate preparatory processes, differences between the patient subgroups are suggested to result from the more pronounced cognitive impairments in the right-lesioned group...

..The highest adherence rate is noticed for aspirin and oral anticoagulation. After one year, very few patients stopped taking stroke preventive medication...

..Parametric use of the SF-36 PF could further improve outcome measurement by considering individual treatment effects...

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..Another ongoing trial is currently investigating the possible benefit and side effects of aspirin plus ER-DP versus clopidogrel in secondary stroke prevention...

..SAINT I and II were randomized, placebo-controlled, double-blind trials to investigate the efficacy of NXY-059 in patients with AIS...

..hospitalized with TIA/IS to stratify the risk of recurrent stroke according to the Essen Stroke Risk Score (ESRS) and of future cardiovascular events according to the ankle brachial index (ABI) as a marker of generalized atherosclerosis..

..These techniques provide the opportunity for improved stroke trials in terms of enrollment speed, treatment effect size or both...

..In this article we aim to elucidate the relationship between patent foramen ovale, cryptogenic stroke and migraine...

..The aim of the present study was to examine the safety and tolerability of a new and higher dosage regimen that would enable acute stroke patients to achieve and maintain neuroprotective plasma concentrations...

..Triptans are not identical and migraine sufferers respond differently to different triptans. Few studies have evaluated the efficacy of switching triptans in migraine patients who have shown poor response to another agent...

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..Limb flexion reflex areas probably reflect efferent reflex modulation as well as sensory inputs from the stimulus itself and/or the reflex response...

..We will review the literature on the association between migraine with patent foramen ovale, stroke, and coronary heart disease...

..It focuses on imaging of viral encephalitis, including that caused by exotic and emerging viruses, and on imaging in immunodeficient patients...

..We therefore developed prognostic models for functional dependence and death after 100 days in a large cohort of stroke patients...

..This study provides representative data on onset and severity of early neurological and medical complications as well as possible predictors for early recurrent cerebral ischemia following acute ischemic stroke...

..No major disturbances in acquisition or discrimination of various sensory sequences were observed in the group of cerebellar patients. Sequence learning may be impaired only in tasks with significant motor demands...

..We assessed the effects of discontinuation of topiramate after a treatment period of 6 months...

..In conclusion, vermal lobule VI extending to ipsilateral paravermal areas appears to be involved in control of the unconditioned eyeblink response...

..4+/-5.4 versus 47.7+/-17.9% of ipsilateral hemisphere, P=0.042). Our results demonstrate that the combination of angiography and MR-imaging is useful to further evaluate rt-PA treatment of thromboembolic stroke...

..Normal latencies and sequence activation indicate intact neural pathways mediating the ASR in FD. Impaired habituation of the ASR points towards a reduced inhibition of acoustic stimuli in FD...

..In view of the high prevalence and relapse rate, it is necessary to establish a structured post-treatment programme for patients after the acute withdrawal phase, which considers the predictors for relapse...

..However, only sparse fMRI offers the opportunity to apply stimuli and record further biosignals free of scanner-related artifacts during intervals without image acquisition...

..Although capacities for intensive monitoring of patients with stroke are still limited, patients at risk for early neurologic worsening are poorly defined...

..While several models have been developed to predict mortality following intracerebral hemorrhage (ICH), the functional outcome and its predictors in surviving patients have been poorly investigated so far...

..A short critical evaluation at the end of selected reviews should encourage the reader to further reading of studies of interest...

..As conditions become more difficult, left-lateralized homologue areas activate...

..77). CONCLUSIONS: Almotriptan 12.5 mg is an effective and well-tolerated alternative for patients who respond poorly to sumatriptan 50 mg. A poor response to one triptan does not predict a poor response to other agents in that class...

..Despite therapy, the prognosis for long-term survival is very poor, especially in patients with AIDS...

..The aim of the present study was to examine movement-related potentials (MRPs) in patients in the "chronic" stage after cortical stroke with recovered hemiparesis compared with healthy control subjects...

..To describe the distribution of steno-occlusive disease and the associated rate of recurrence in patients with acute cerebral ischemia...