Background: Most non-pharmacological interventions for tension-type headache (TTH) focus on direct intervention in areas associated with headaches, with limited research exploring the indirect effects of interventions utilizing the fascia. Objectives: To investigate the effects of superficial back line (SBL) stretching and head-neck massage interventions on the range of motion (ROM) and neck disability index (NDI) of TTH. Design: Randomized controlled trial. Methods: The study participants were randomly allocated into three groups: SBL stretching group (n=9), head-neck massage group (n=9), and combined group (n=9). Prior to the intervention, measurements were taken for neck flexion ROM, straight leg raising test (SLRT) ROM, and NDI. The intervention consisted of 30-minute sessions conducted twice a week for 8 weeks. The second measurement took place 4 weeks after the intervention, followed by a third measurement conducted after an additional 4 weeks of intervention. Results: Comparing neck flexion ROM within each group, a significant increase was observed in the SBL stretching group after 8 weeks compared to before the intervention (P<.05). Regarding the comparison of SLRT ROM within each group, a significant increase was noted after 8 weeks compared to before the intervention in the SBL stretching, head-neck massage, and combined groups (P<.05). In terms of the comparison of NDI within each group, a significant decrease was observed in all three group after the intervention compared to before the intervention (P<.05). Conclusion: 8-week intervention involving SBL stretching, head-neck massage, and their combined application demonstrated effectiveness in improving neck flexion ROM, SLRT ROM, and the NDI for individuals with TTH.

Background: The muscles associated with tension-type headache (TTH) are connected to the scalp fascia, which is firmly attached to the superciliary ridge of the frontal bone. However, there is a paucity of data on treatments for TTH that directly target the scalp fasciae. Objectives: We aimed to validate a new manual therapy to treat TTH by applying myofascial relaxation techniques to the scalp and to examine the changes in quality of life and headache characteristics after treatment. Design: pretest-posttest control group design study. Methods: Total 24 participants with TTH (10 males, 14 females) participated in the study. Manual therapy group (MT) received standard manual therapy and scalp myofascial release technique group (SMT) received scalp myofascial release technique twice per week for 4 weeks. Brief Pain Inventory (BPI) and Headache Impact Test (HIT) for quality of life, headache frequency, duration, and Visual Analog Scale (VAS) for intensity were assessed at the pre- and post-treatment. Results: There was a significant improvement within groups in headache frequency (MT P<.05, SMT P<.001), duration (MT P<.05, SMT P<.01), VAS (MT P<.01, SMT P<.001), HIT (MT P<.001, SMT P<.001), and BPI (MT P<.001, SMT P<.001) between the pre- and post-treatment. Group differences were significant for headache duration (P=.027), but the others were not. MT and SMT reduced the impact of headaches on daily life. Also Headache frequency, duration, intensity, and BPI were improved. Conclusion: MT and SMT reduced the impact of headaches on daily life. Also Headache frequency, duration, intensity, and BPI were improved. It has been suggested that both MT and SMT can be used as a non-invasive treatment to treat the TTH, and to improve the quality of life.

The International Headache Society (IHS) has validated cervicogenic headache (CGH) as a secondary headache type that is hypothesized to originate due to nociception in the cervical area. CGH is a common form of headache and accounts for 15% to 20% of all chronic and recurrent headaches. CGH is commonly treated with manual and exercise therapy. To date, no studies have isolated only one manual intervention in an attempt to determine its effectiveness. In this case study we present a 28-year-old patient with right upper cervical (UC) and occipital pain who responded well to a single manual intervention technique. This technique was applied in isolation for the first three visits and two therapeutic exercises prescribed on the fourth and fifth visit. In total, manual and exercise intervention occurred over 8 visits at which point in time the patient was discharged with no UC motion impairments, an NPRS rating of 0, a NDI and HDI demonstrating a 100% improvement and a 37% improvement in FOTO score. The traction based manual intervention and two therapeutic exercises prescribed for this patient were successful in relieving UC pain and CGH. At six months follow up, the patient was still symptom free.

Background:Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain.Objects:This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone.Methods:Thirty subjects were assigned to either experimental group-1 (EG-1) to undergo suboccipital release combined with high-frequency diathermy (frequency: 0.3 MHz, and electrode type: resistive electronic transfer), or EG-2 to undergo suboccipital release alone, or the control group (CG) with no intervention, with 10 subjects in each group. The assessment tools included the headache impact test 6 (HIT-6), perceived level of tenderness, neck disability index, and neck mobility. Intervention was performed for 10 minutes, twice per week, for 4 weeks, and measurements were performed before and after the interventions.Results:The between-group comparison of the post-test values and changes between pretest and post-test showed significant differences for all parameters at p<.05, except for the left-to-right lateral bending range. In the post hoc test, EG-1 showed significant differences for the parameters in comparison with the CG, while no significant differences in the perceived tenderness level, on both temporal regions, were found between EG-2 and CG. Furthermore, the HIT-6 score and perceived tenderness level, in the right temporal region, showed significant differences between EG-1 and EG-2. In the within-group comparison, EG-1 and EG-2 appeared to be significantly different between pretest and post-test (p<.05), except for the perceived tenderness level in the right temporal region, with significance for the EG-1 group only (p<.05).Conclusion:These findings suggest that the suboccipital release technique may be advantageous to improve headache, tenderness, and neck function and mobility, with more favorable effects with the incorporation of high-frequency diathermy.

Headache is one of most common chief complaints of pediatric patients in emergency departments (ED). In this study, the character, duration, strength and location of headaches, as well as the results of brain imaging studies, were recorded. Seventy-four children (34 boys, 40 girls) visiting the ED of major hospitals in Cheongju were enrolled from October 1, 2013 to September 30, 2014. Ages of the children ranged from 3 to 18 years, with the mean age being 13 years. Four of them (5.4%) had trauma-related headaches. There were 34 migraines (45.9%), 27 tension headaches (36.5%), 3 secondary headaches (4.1%), 2 seizure-related headaches (2.7%), 1 headache with hydrocephalus (1.4%), 1 concussion (1.4%), and 1 headache with subdural hematoma (1.4%). The highest number of patients, 31 (41.9%), had symptoms for less than two hours, while 11 pediatric patients (14.9%) had symptoms for 2-4 hours, and the third-largest group, 10 patients (13.5%), had symptoms between 24 and 72 hours. Twenty-nine patients (39.2%) had one headache per month, 20 patients (27.0%) had 1 to 14 headaches per month, and 4 patients (5.4%) had more than 15 headaches per month. Children with migraine took a nonsteroidal anti-inflammatory drugs (NSAID, 34 patients; 45.9%), acetaminophen (19 patients; 25.7%), and Topiramate (1 patient; 1.4%). Average strength of headache was 7.37 ± 1.79. There were 23 children (31.1%) with headaches in the parieto-temporal area, 16 children (21.6%) in the occipital area, 9 children (12.2%) in the frontal area, 4 children (5.4%) in the global area, and 6 children (8.1%) in an uncertain location. There were 31 children (41.9%) with pulsating headaches, 18 children (24.3%) with squeezing headaches, 5 children (6.8%) with stabbing headaches, and 11 children (14.9%) with headaches of an uncertain nature. Thus, we suspect children visiting the ED had severe headaches.

The aim of this is to examine the effects of SSP therapy on the internal carotid arteries blood flow of 24 tension type headache patients(study group) and non tension type headache patients(control group), and on the reduction of their headaches, when applied to the acupuncture points. It stimulated the acupuncture point of headache 6 place with the SSP. It measured VAS and the blood flow of the internal carotid arteries with TCD. When the internal carotid arteries blood flow of study group and control group were compared by period, a significant difference was found in the 4th period(p<.05). When the Visual Analog Scale of study group and control group were compared by period, a significant difference was found in the 4th period(p<.05). The comparison of each measurement result of the internal carotid arteries blood flow of the study group found significantly increased. The comparison of each measurement result of the VAS of study group found significantly decreased. With regard to the control group, the VAS significantly decreased. The silver spike point low frequency electrical stimulation treatment, when applied to the acupuncture point, can significantly influence the internal carotid arteries blood flow of headache patients and can significantly reduce their headaches.

The purpose of this study was to identify the effects of manipulation on the velocity of cerebral blood flow and level of pain in cervicogeinc headache patients. The velocity of cerebral blood flow of 30 cervicogeinc headache patients(male=15, female=15, age=24.00±3.60) and 33 normal subjects(male=15, female=18, age=23.27±3.00) was compared. The 30 cervicogeinc headache patients were divided into suboccipitalis relaxation group, cervical manipulation group, and placebo group, and each were given different interventions. The velocity of cerebral blood flow and pain level was measured before intervention, and 1, 2, 3 weeks after intervention. The velocity of cerebral blood flow was measured with the Transcranial Doppler(TCD), and pain level was measured with visual analog scale(VAS). Blood flow velocity of middle cerebral artery in cervicogeinc headache patients was slower than those in healthy subjects. Physical therapy intervention did not have significant effect on velocity of cerebral blood flow, but slowly decreased at intervention for pain level increased. The suboccipitalis relaxation group and cervical manipulation group showed significant effect in decreasing pain level compared to the placebo group(p＜.05). Directly applied manipulation therapy in the neck area not only has effect on joint of cervical and soft tissue but also on blood vessels and nerves which pass the neck area, and because of those results of manual therapy seems to help recovery.

본 연구의 목적은 국내 인구대비 약 70-80% 의 두통환자가 있다는 통계에 근거를 두고 그 중 두통의 원인이 눈에 있는 경우가 어느 정도인지뜰 알아보는데 있다. 연구 방법은 여러 사례들을 수집하여 정리하였다. 눈이 두통의 원인이 되는 경우는 예상과 탄리 적은‘ 전체 두통 환자의 약 5% 정도룹 차지하였다. 특히 근시， 원시. 난시 등의 끊전이상을 교정하지 않아서 오는 두통‘ 부풍시성 두통. 조젤과 양안시 기능 이상으 로 인해서 나타나는 두통의 경우는 그 중에서 아주 낮은 값을 나타내었다. 만성두통 의 대부분은 경도이며， 긴장성(근수축성)두똥이 대부분이었다. 근시. 원시. 난시， 노안 등쓸 교정하지 않아서 오는 두똥은 긴장성 두통. 조절성 두똥-이며 전두부나 측두부에 만성적인 가벼운 두통이 나타나며 시간이 지날수록 악화되었다. 경도의 난시의 경우 에 뚱현파 함께 두풍의 정도가 심했으며， 꽉히 사난시의 경우가 더 심했다. 부동시‘ 조전파 양안시 기능 이상도 안정피로플 엘으키는데， 전두부와 측두부에 만성적인 두 팡틀 일으키며 크게 심해지지는 않았다. 끊절이상의 미 교정만이 두통의 원인으로 볼 수는 없고， 실제로 잘못 조제된 안경 이 1+ 콘택트렌즈가 두통을 유발할 수도 있으므로 첼저한 시력검사틀 통한 정확한 처 방이 이푸어져야 한다.

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinic-radiologic syndrome characterized by severe headache and reversible multifocal arterial constrictions that resolve within 3 months. RCVS can be either spontaneous or related to a trigger, such as vasoactive drugs. The authors present the case of a 53-year-old woman who presented with recurrent thunderclap headache. Initial computed tomography angiography demonstrated segmental vasoconstriction of bilateral anterior cerebral arteries. Fourteen days after, initial vasoconstriction was improved as determined by follow up CT angiography. Our patient had recurrent thunderclap headache for a considerable time (around 24 months). However, although she visited many hospitals, the headache was not controlled by any treatment. Fortunately, she did not have any neurological complication and her symptoms relieved after nimodipine treatment. Clinicians should be aware of possible RCVS when a patient has recurrent thunderclap headache for a protracted period.