16th European Headache Congress

Prof. Dr.

Chair

Prevalence of neck pain in migraine: A systematic review and meta-analysis

Abstract text (incl. figure legends and references) Background: Neck pain is a frequent complaint among patients with migraine and seems to be correlated with the headache frequency. Neck pain is more common in patients with chronic migraine compared to episodic migraine. However, prevalence of neck pain in patients with migraine varies among studies. Objective: To estimate the prevalence of neck pain in patients with migraine and non-headache controls in observational studies. Methods: A systematic literature search on PubMed and Embase was conducted to identify studies reporting prevalence of neck pain in migraine patients. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data was extracted by two independent investigators and results were pooled using random-effects meta-analysis. The protocol was registered with PROSPERO (CRD42021264898). Results: The search identified 2490 citations of which 30 contained relevant original population based and clinic-based data. Among these, 24 studies provided data eligible for the analysis. The meta-analysis for clinic-based studies demonstrated that the pooled relative frequency of neck pain was 77.0% (95% CI: 69.0–86.4) in the migraine group and 23.2% (95% CI:18.6–28.5) in the non-headache control group. Neck pain was more frequent in patients with chronic migraine (87.0%, 95% CI: 77.0–93.0) compared to episodic migraine (77.0%, 95% CI: 69.0–84.0). Neck pain was 12 times more prevalent in migraine patients compared to non-headache controls and two times more prevalent in patients with chronic migraine compared to episodic migraine. The calculated heterogeneity (I2 values) ranged from 61.3% to 72.0%. Conclusion: Neck pain is a frequent complaint among patients with migraine. The heterogeneity among the studies emphasize important aspects to consider in future research of neck pain in migraine to improve our understanding of the driving mechanisms of neck pain in a major group of migraine patients.

Epidemiology

Migraine

ePoster

Prof.

Professor

Characterizing Neck Pain With Headache in People With and Without Migraine: Results From the Chronic Migraine Epidemiology and Outcomes – International (CaMEO-I) Study

Abstract text (incl. figure legends and references) Objective: To characterize the frequency and burden of neck pain with headache (NPWH) among individuals with and without migraine. Methods: CaMEO-I was a prospective web-based survey conducted during 2021-2022 in Canada, France, Germany, Japan, United Kingdom, and United States. Respondents with ≥1 headache in the past year were divided into two groups: those meeting ICHD-3 migraine criteria based on a validated questionnaire and those with non-migraine headache (NMH). In both groups, NPWH was defined as reporting NPWH more than rarely. Within the migraine group, monthly headache days (MHDs), migraine-related disability (MIDAS), allodynia (ASC-12), depression and anxiety symptoms (PHQ-4), work productivity and activity impairment (WPAI), and acute treatment optimization (mTOQ) were evaluated in those with and without NPWH using validated measures. Results: NPWH was reported by a higher proportion of respondents with migraine (63.4% [UK]‒75.0% [Germany]) versus NMH (31.4% [UK]‒44.8% [Germany]; Figure 1A). Migraine respondents with NPWH were more likely to have higher MHDs than those without NPWH in all countries. Among migraine respondents, moderate to severe MIDAS scores (MIDAS ≥11) were reported more frequently among those with NPWH (35.6% [Japan]‒55.3% [Germany]) than those without NPWH (19.8% [Japan]‒42.3% [Germany]; Figure 1B). Depression and anxiety symptoms, and allodynia were greater in respondents with NPWH versus those without (Table). Impairment in daily activities and while at work, work time missed, and overall work impairment were higher among those with versus without NPWH. &quot;Poor&quot; to &quot;very poor&quot; treatment optimization was reported more frequently in those with versus without NPWH. Conclusions: NPWH occurred more frequently among respondents with migraine versus those with NMH. Among those with migraine, NPWH was associated with more frequent headaches and greater disability compared to those without NPWH. International differences will be discussed.

Interest in headache and other neurological subspecialties among neurology residents in Denmark: a nationwide survey

Abstract text (incl. figure legends and references) Introduction: Headache disorders constitute a leading cause of disability worldwide, but there is a consistent absence of awareness and educational activities for healthcare providers across regions. Thus, we found it timely to identify potential structural challenges and factors that may affect acquisition of knowledge of headache disorders and their management during residency. Methods: We conducted a nationwide cross-sectional survey of residents in neurology in Denmark including, but not limited to, questions on interest in neurological subspecialties and disorders, adequacy of training in headache disorders, exposure to headache disorders during training including time spent on headache disorders, exposure to specialist outpatient clinics, whether their hospital have a tertiary headache clinic, training in specific procedures (anesthetic blockade, e.g., greater occipital nerve blockade, and onabotulinumtoxinA for headache), and an estimate of proportion of cases with headache amongst patients managed in the last week. Results: The survey was distributed to 127 residents in Denmark between March 2022 to April 2022. Of these, 59 (47%) completed all questions of the survey. Headache disorders were the fourth most popular subspecialties amongst respondents (n= 15 [25%]). The mean number of hours spent in a course or a structured educational activity in headache disorders during residency was 12.1 (±12.9) hours. Half of respondents (n=27 [46%]) reported that they perceived their training in headache disorders to be inadequate. Conclusions: Even in Denmark, a country with excellent headache services, half of residents in neurology report an inadequate training despite a higher-than-average number of hours of structured educational activities.

Guidelines in headache

Characterizing opioid use in a Dutch cohort with migraine

Abstract text (incl. figure legends and references) Objective: To investigate opioids use among migraine subjects for treatment of their headache. Methods: We performed a cross-sectional study using a web-based questionnaire to assess opioid use in individuals with migraine. Primary outcome was to assess opioid use among migraine subjects for treatment of attacks in a large Dutch cohort. We also quantified opioid use (duration, type of opioids, prescriber) and compared between persons with episodic (EM) versus chronic (CM). Covariates were entered as categorical or continuous variables. Descriptive statistics, unpaired T-tests, Chi-square and Mann-Whitney U tests were used. Results: The E-questionnaire was sent to our large Dutch cohort of n=6577 migraine subjects, of whom n=4047 responded, and n=3712 completed the questionnaire (response rate 56%). In total 13% of participants reported to ever have used opioids for headache. In 46% of those who used an opioid this was on one occasion, but in 27% this was for &gt;1 month, and in 11% for &gt;1 year. The opioids were prescribed by physicians but 2% of opioid-users indicated that they had used without a prescription. The majority of prescribing physicians were general practitioners (46%), followed by neurologists (35%), other specialists (9%), and doctors at a first aid (8%). Opioids were reported to be prescribed for acute treatment in 63% of cases, in 16% as preventive treatment and in 21% as both acute and preventive medication. Opioid use was more often in those with CM compared with EM (22% and 12%, p&lt;0.001). Prolonged use was more often in those with CM versus EM (&gt; 1 month: 34% and 24%; p&lt;0.003). Conclusion: Despite the fact that opioids are not effective in migraine these medications are still prescribed, even up to 22% in those who suffer from chronic migraine. Of all opioid-users 2% did so without prescription. Education for doctors and migraine subjects, and providing multimodal pain management strategies are needed to reduce opioid use in persons with migraine.

The association of innate and adaptive immunity with migraine in The Rotterdam Study: a population-based cohort study

Abstract text (incl. figure legends and references) Objective: Within the multifactorial etiology of migraine, accumulating evidence suggests a role for the immune system. However, the specific contribution of innate and adaptive immunity to migraine remains unclear. Hence, we investigated the association of innate and adaptive immunity with migraine. Additionally, we explored the role of the balance between the two components in migraine. Methods: We measured white-blood-cell type based immunity markers and calculated their derived ratios using blood samples collected during interictal periods and assessed the prevalence of migraine using a structured interview with participants of the prospective population-based Rotterdam Study. We assessed neutrophil and platelet counts as a proxy for innate and lymphocyte count as a proxy for adaptive immunity. The balance between the two components was assessed by the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII). We investigated associations of blood cell counts, and their derived ratios with migraine using logistic regression models adjusting for age, sex and other variables. Results: Among 6593 participants (mean age 65.6 ± 11.2 years, 56.7 % female), 995 (15.1%) had migraine. We found no association between neutrophil (Odds Ratio [OR] per standard deviation increase 1.02 95% Confidence Interval [CI] 0.94-1.10), platelet (OR 1.01 CI 0.93 – 1.09) or lymphocyte counts (OR 1.01 CI 0.93 – 1.09) and migraine status. Similarly, no associations were observed between NLR (OR 1.01 CI 0.94 – 1.09), PLR (OR 1.00 CI 0.93 – 1.08) and SII (OR 1.01 CI 0.94 – 1.09) and migraine status. In the analyses with migraine subgroups, a significant association was observed between the platelet count and migraine with aura (OR 1.17, CI 1.01 – 1.35). Conclusion: Our results do not support the involvement of innate and adaptive immunity in migraine. Platelet count and migraine with aura relationship needs further investigation.

Headache-related disability measured with Headache impact test-6 (HIT-6) Results from an Estonian population-based survey

Abstract text (incl. figure legends and references) Objective: The objective of this study was to use the HIT-6 questionnaire to measure the level of disability caused by various forms of headache disorders in Estonian adults, as well as to describe the relationship between HIT-6 score and characteristics including age, sex, BMI, education, urban vs rural habitat, smoking, and physical activity. Methods: From January 2016 to May 2017, a population-based random sample study was undertaken in Estonia. The HIT-6 questionnaire was used to assess headache-related burden. Results: The HIT-6 scores of 475 subjects were evaluated. Subjects with chronic headaches had higher HIT-6 scores than episodic headaches (60.7±9.7 and 52.6±8.9, respectively), and subjects with migrainous headaches had higher HIT-6 scores than non-migrainous headaches (56.3±8.4 and 50.1±8.8, respectively). Both differences were statistically significant. Age, sex, BMI, education, urban vs rural habitat, smoking, and physical activity had no significant effect of HIT-6 scores. Conclusion: The HIT-score is influenced by the diagnosed headache - episodic vs chronic and migrainous vs non-migrainous - and less so by socio-demographic factors.

Prof

Headache characteristics during Covid-19 pandemic and the armed conflict

Abstract text (incl. figure legends and references) Stress is the most significant trigger for many types of headaches. In the las two years people faced two major stressful event: Covid-19 pandemic and the armed conflict between Russia and Ukraine. The purpose of the study was to evaluate the influence of the pandemic and the war on the condition of patients who visit a specialized headache clinic. Methods. We performed retrospective analysis of medical records of all headache patients ≥16 yo who visited the University Headache Clinic from April 01 to June 30 in 2019, 2021 and 2022 was carried out. The diagnosis of the headache and comorbid mental disorders, was made according to the criteria of ICHD-3 (2018) and ICD-10. Results. The analysis included 849 people: 153 patients in 2019, 264 in 2021 and 432 in 2022. The migraine and tension type headache (TTH) characteristics did not change in 2021 and 2022 years compared with 2019 year. In 2021, the proportion of patients with generalized anxiety disorder has increased from 28,8% (24 patients) to 44,9% (119 patients), p=0,001. Proportion of patients with anxiety remains high in 2022 (43,6%, 179 patients). Proportion of patients with depression didn&quot;t differ significantly between 2019 (32%, 49 patients) and 2021 (28,7%, 76 patients) , p=0,5. In 2022, the proportion of patients with depression significantly increased from 28,7% (76 patients) to 43,9% (188 patients), p=0,0001, The main symptoms of depression were anhedonia, lack of internal energy, and feeling of guilt. The proportion of patients with a first depressive episode has increased significantly from 2,7% (7 patients) to 21,3% (31 patients), p=0,0001. Conclusions. Significant stressful events had an impact on comorbid psychiatric disorders in primary headache disorders. Covid-19 pandemic led to increase of comorbid anxiety and the war resulted in significantly increased comorbid depression among Russian headache patients

COVID and headache

Barriers and gaps in headache education: a national cross-sectional survey of neurology residents in Denmark

Abstract text (incl. figure legends and references) Background: A major barrier to adequate headache care is the relative lack of formal education and training of healthcare professionals. Concerted efforts should be made to pinpoint major gaps in knowledge in healthcare professionals to facilitate better educational policies in headache training. The aim of this study was to identify deficiencies and barriers in headache training among residents in neurology in Denmark. Methods: We conducted a national cross-sectional survey of residents in neurology in Denmark from April 2019 to September 2019. The survey included questions on participant demographics, knowledge of and barriers in headache disorders, guidelines and diagnostic tools usage, contact with primary and tertiary care, medication overuse, and non-pharmacological interventions. Furthermore, respondents were asked to provide a ranked list from most to least interesting for six sub-specializations/disorders, i.e., cerebrovascular disease, dementia, epilepsy, headache, multiple sclerosis, Parkinson's disease. Results: Sixty (40%) out of estimated a population of ~150 resident across Denmark accepted the invitation. Of these, 54/60 (90%) completed the survey. Although two-thirds, 35/54 (65%), of the respondents had prior formalized training in headache disorders, we identified gaps in all explored domains including diagnosis, management, and referral patterns. Particularly, there was an inconsistent use of guidelines and diagnostic criteria from the Danish Headache Society (2.74 (± 1.14)), the Danish Neurological Society (3.15 (± 0.86)), and the International Classification of Headache Disorders (2.33 (± 1.08)); 1: never/have not heard of, 4: always. Headache was ranked second to last out of six sub-specializations in interest. Conclusions: Overall knowledge on headache disorders amongst neurology residents in Denmark do not meet the expectations set out by national and international recommendations.

Post Covid Headache, in 510 cases presented in Regional Hospital Durres, Albania in period November 2020 - May 2022

Abstract text (incl. figure legends and references) Background: SARSCoV2 the virus responsible for the COVID19 pandemic had not only respiratory symptoms,but also neurological symptoms, and headache is a frequent complaint.Pathophysiology of headache in the context of COVID 19 has some mechanisms that can be involved in persistence of headache after acute stage of the disease. These mechanisms include systemic inflammation that can stimulate cytokine storm,can activate trigeminovascular system at the meninges,and in some patients this inflammatory response may be sustained after infection and can play role at post Covid headache. Methods:We have seen 510 patients that have been presented at emergency department and neurology consult at SRDwith headache after covid 19(2-10months after infections).15%of patients had severe covid infections with respiratory insuficience and have been recovered in hospital(76 patients)and85%(434 patients) have been treated ambulatory.the most of patients had bilateral frontal headache(52%)and holocranic headache(22%), and hemicranic migraine type(26%). Most of patients had oppressive pain,72%(367 patients)had moderate headache and 28%(143patients) had severe continous headache. Middle age of patients was52years old and65%were female(331)and 35%male(179) and mean time of headache was 3.6month from all patients 30%(153 patients) have been known with primary headache, and76%had migraine (116 patients,78 female,38 male),22%tensive type headache (34 patients, 20 female and 14 male) and2% had cluster headache (3patients were mens) .From all 510 of patients 45%(230) had also other post covid symptoms like dizziness,memory problems, insomnia,brain fog,depression and anxiouse state etc. Conclusions:The mechanisms of persistent headache for months after covid 19 infections means to be stimulate by inflammatory mechanisms with stimulation of the trigeminovascular system,andCGRP (calcitoni gene-related peptide) released by pulmonary endings nerve during viral infections may stimulate migraine.

Inpatient headache referrals to acute neurology service – a review of referral patterns.

Abstract text (incl. figure legends and references) Objective: Headache disorders constitute 20-30% of inpatient referrals to neurology services in UK. The aim of this study was to identify the headache phenotypes referred for inpatient neurology opinion. Methodology: All inpatient referrals to the neurology on call service at the Royal Preston Hospital in the year 2019 were reviewed. Cases were identified from the clinical database and categorised into primary and secondary types, according to the International Headache Society classification. Results: A total of 1114 inpatient referrals were made to neurology services in 2019, of which 255 cases were for a headache disorder (22.9%). Primary headache syndromes made up 158 cases (61.9%), with the remaining cases diagnosed as secondary headache (38.1%). Most primary headaches were diagnosed as migraines (82.3%) followed by tension-type headache (7.6%); 70 cases (44.3%) had a pre-existing diagnosis of primary headache disorder. The major cause of secondary headache was TIA/stroke and idiopathic intracranial hypertension (16.5% each) followed by subarachnoid haemorrhage (11.3%) and infection (7.2%). Both primary and secondary headaches were higher in females (70.0% &amp; 57.7%) compared to males (30.0% &amp; 42.3%). Majority of patients (74.2%) had been investigated with neuroimaging prior to the referral. Majority received both CT &amp; MRI scans (39.8%), followed by CT only (33.3%) and MRI only (15.7%); 11.2% of patients received no scan. Conclusion: These findings indicate that a significant proportion of patients with headache referred for inpatient neurology opinion have a primary headache disorder.

Primary Headaches – Underestimated problem in Armenia

Abstract text (incl. figure legends and references) Objectives According to data of WHO primary headaches have substantial burden on patients and their family life and also, they consist serious social-economic problem for all world. This is why many studies addressed toward investigation of different types of primary headaches. Aim Aim of our study was investigation of prevalence of different types of primary headaches (tension type, migraine, trigeminal-autonomic cephalalgias) between patient who addressed to neurologist because of headache. Material and Methods We included 150 patients (113 women/ 37 men) with different primary headaches (migraine, tension type and trigeminal-autonomic cephalgia"s) who addressed at Neurology department of 2-nd Medical Union. Age of participants was 18-60 years All patients was estimated by neurologist specialized in headache field and diagnosis was done according to ICHD 3 diagnostic criteria. Results Data analysis revealed that 90 (60%) has migraine, 47 (31%) tension type, 7 (5%) cluster headache, 4 (3%) paroxysmal hemicrania, 1 (1%) hemicrania continua and 1 (1%) SUNCT –syndrom. Main part of patient (91 patient) was adressed to doctors previously (68 from which adressed to neurologists) and unfortunatly main part of them was misdiagnosed. Conclusion All together our data a little bit different from such data of international studies, but we suppose that mean cause of this , that we used choosen population and not a random sample. By analyzing our data, we conclude that in our region there is serious underestimation of all types of primary headaches as among different specialists and also among people. Main part of patients didn"t receive correct diagnosis and further corresponding treatment for many years. We need to increase attention toward headaches and spread knowledges among people and specialists and realize more detailed investigations for estimation of real prevalence of different type of primary headaches in Armenia.

Epidemiological Investigation of Headache among Medical Students

Abstract text (incl. figure legends and references) Objective: to investigate associations between lifestyle, physical activity and headache in medical students. Methods: We conducted a survey of 192 students of Bukovinian State Medical University aged 19 to 26 years by using specially designed questionnaires on intake of meals, coffee, nonalcoholic and alcoholic drinks, smoking, and physical activity. By making a diagnosis were used the classification and diagnostic criterions created by International Headache Society, 2018. The intensity of headache was investigated by visual-analog scale. Results are expressed in numbers and percentage. Results: The availability of headache was founded by 157 (81.8%) students. Tension headache was evidenced most commonly (by 58.6% students), migraines – by 9.6% and other types of headaches (vascular, liquor-dynamic, neuropathological etc.) – by 31.8% students. The intensity of headache-syndrome was 50-60% (5-6 points) in accordance with visual-analogical scale. Most of students (89.2%) noticed negative influence of headache over their professional and daily activity. Level of physical activity assessment showed that only 6.3% of students did daily exercise, 26.0% did regular exercise twice-three times a week, 35.4% did not have any form of exercise; and the rest did mild to moderate form of exercise infrequently. The most common exercise was aerobic workouts: walking followed by running (38.7%), fitness (25.8%%), dances (19.3%) and swimming (6.5%). Low physical activity was associated with higher prevalence of tension headache. Conclusion: By means of the research we found high prevalence of headaches among medical students. Students with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks, while for migraine patients a low consumption of coffee should additionally be recommended. This problem needs further inquiry and active correction for improvement in quality of life, professional and personal succeeding of medical students.

Patients with headaches are common in Danish chiropractic practice

Abstract text (incl. figure legends and references) Question In Denmark, chiropractors treat patients with headaches but there is limited knowledge of how often patients seek care for headaches and what types of headaches are treated. The aims of this study were therefore i) to estimate the prevalence of consultations with headaches in chiropractic practice in Denmark, and ii) to investigate the headache types and diagnoses used. Methods Data were collected by Danish chiropractors who were invited by e-mail, social media, and a booklet. Participating chiropractors registered diagnosis on consecutive headache patients for 20 workdays during May and June 2022. For all headache patients, a novel logbook system was used to register the headache diagnoses as predefined by the International Headache Society together with age, and reason for consultation. Results In total, 67 chiropractors agreed to participate. The participants had an average of 18 headache and non-headache consultations per day and of these, 16% (SD 10) were patients with headaches. The mean age of the patients with headaches was 41.4 years (SD 14.4, range 5.5-90.3 years). Of the headache patients, 14% were classified as migraine, 62% as tension-type headaches, and 42% as cervicogenic headaches. Among patients with headaches, it was the primary reason for 42% of the consultations and the secondary reason for 54% (it was not reported for 4%). Conclusions On average, 16% of the consultations in Danish chiropractic practice concern patients with headaches, and for almost half of the headache patients, it was the primary reason for care seeking. There is limited knowledge of the types of treatments provided and the clinical course of headache patients in primary care. Therefore, it is paramount to explore the management and treatment provided in chiropractic practice and to investigate the clinical course and treatment pathways to the benefit of the patients.

Multidisciplinary clinical assessments

Migraine Should Be First Focus on Headache Education in the Middle East, Asia, and Africa: A subgroup analysis of the Head-MENAA Study

Abstract text (incl. figure legends and references) and the Head-MENAA study group Question Migraine is one of the most common disorders that cause disability and affects 12-15% of the general population. Migraine alone is responsible for almost 3 % of disabilities attributable to a specific disease worldwide. We aim that determine how much the global burden of migraine is reflected in headache clinics in Turkey, the Middle East, Asia, and Africa and to define the differences between regions in this study. Methods In this cross-sectional multicenter international study, sixty-eight headache specialists from 12 countries evaluated headache patients who applied to neurology clinics. Researchers recruited patients on different weekdays selected by the research randomizer program for five consecutive weeks in April and May. Researchers used the Head-MENAA study questionnaire and ICHD-3 criteria when they evaluated patients. Results A total of 3454 headache patients were admitted out of 12043 who applied to neurology clinics on chosen days. While 15.6% of the patients who applied to the outpatient clinic had migraine, 53.2% of the headache patients had migraine. 82.5% of migraineurs were female; the mean age was 39.8±12.57 years. Migraine with aura was observed in 10.9%, chronic migraine in 26.3%, complications of migraine in 0.6%, probable migraine in 4.8%, and episodic syndromes that may be associated with migraine in 2% of migraineurs. The mean total pain duration of the patients was 6.27±8.76 years and the pain duration in the last month was 12.02±9.97 days. The differences by region are also summarized in Table 1. Conclusion According to our study, migraine is the most common primary headache type among the patients who applied to neurology clinics. This burden of disease; is an entity that needs to be resolved and be faced by neurologists and the health system. The directive of our study is substantial in terms of giving a status report to plan the issues that should be done at every step, from education to medical applications in the control process of the disease. Keywords: Head-MENAA study, migraine, global burden, neurology clinics, education

Visual aura in non-migrainous headache: a population study

Abstract text (incl. figure legends and references) Question: Although aura symptoms usually have been described in association with migraine, their occurrence has been observed with other types of headaches. Studies analyzing the aura in migraine show that visual aura (VA) represents 98% of the symptoms. Nevertheless, no study has reported VA in non-migrainous headache in a population-based setting. Methods: The present study used the baseline data of the Circannual Change in Headache and Sleep study, which was a nation-wide and population-based survey. We defined migraine and probable migraine as migrainous headache by combining them. Therefore, non-migrainous headache was defined as a headache case other than migrainous headache. VA was assessed using the self-administered visual aura rating scale which is a validated instrument for assessing VA. Results: Of 3,030 participants, 1,431 (47.2%) and 507 (16.7%) were classified as having non-migrainous and migrainous headaches during the previous year, respectively. VA was reported in 406 (20.9%) participants with headache. The prevalence of VA was significantly lower in non-migrainous headache than that in migrainous headache (26.0% [132/507] vs. 14.5% [207/1431], p&lt;0.001). The prevalence of VA did not significantly differ between women and men (14.6% [110/751] vs. 14.3% [97/680], p=0.837). Headache days/month (median and 25-75% percentiles, 2.0 [0.4-5.0] vs 2.0 [1.0-3.0], p&lt;0.001) and disability (migraine disability assessment, 6.0 [3.0-16.0] vs. 2.0 [0.0-7.0], p&lt;0.001) were significantly higher in non-migrainous headache with VA than those without VA. Conclusions: VA was prevalent among participants with non-migrainous headache. Some clinical characteristics of non-migrainous headache with VA were more severe than those in non-migrainous headache without VA

Poster session 19

Termin

Chair

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