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Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:610-611; doi:10.1136/jnnp.2007.132647
Copyright © 2008 by the BMJ Publishing Group Ltd.

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Letters

Heat stress disorders and headache: a case of new daily persistent headache secondary to heat stroke

C Di Lorenzo1,2, A Ambrosini1, G Coppola2,3, F Pierelli1,2

1 Headache Clinic, IRCCS INM Neuromed, Pozzilli, Italy
2 University Centre for Adaptive Disorders and Headache (UCADH), and Department of Neurology and ORL, and University Centre for Adaptive Disorders and Headache (UCADH), University of Rome "La Sapienza", Polo Pontino, Latina, Italy
3 GB Bietti Eye Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy

Correspondence to:
Dr C Di Lorenzo, Headache Clinic, IRCCS INM Neuromed Via Atinense, 18–86077–Pozzilli (IS), Italy; cherub@inwind.it

The first 150 words of the full text of this article appear below.

The most severe condition among the group of heat stress disorders is heat stroke (HS). It may be divided into two forms: classic and exertional. The former is due to environmental heat exposure and characterised by hyperthermia (above 40°C) and neurological dysfunction (headache, delirium, convulsions and coma). Exertional HS affects subjects performing strenuous exercise in heat environmental conditions and is characterised by more severe symptoms than the classic form. Residual neurological defects have been reported in up to 20% of exertional HS survivors.1

Although headache is reported among HS symptoms, the International Classification of Headache Disorders-second edition (ICHD-II) did not report secondary forms from heat exposure.2

Here we report the case of a patient who developed a headache clinical picture, fulfilling the diagnostic criteria for new daily persistent headache (NDPH) after an exertional HS.


*   Case report
 
A 45-years-old Caucasian woman came to our outpatient headache clinic with a history of chronic . . . [Full text of this article]







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