Unusual Headache Disorders.

PURPOSE OF REVIEW: Unusual headache disorders are less commonly discussed and may be misdiagnosed. These headache disorders frequently have a benign natural history; however, without reassurance, therapeutic education, and treatment, they can negatively affect the health and function of patients. RECENT FINDINGS: This article reviews the clinical features, diagnosis, workup, and proposed treatments for several unusual headache disorders including primary cough headache, primary headache associated with sexual activity, primary exercise headache, cold-stimulus headache, primary stabbing headache, nummular headache, hypnic headache, and headache attributed to travel in space. Exploding head syndrome is also discussed, which is a sleep disorder commonly confused with a headache disorder. SUMMARY: Unusual headache disorders are usually benign, yet without the correct diagnosis can be very worrisome for many patients. Through greater awareness of these headache disorders, neurologists can evaluate and effectively manage unusual headache disorders, which offers significant benefits to patients and practice satisfaction to neurologists.

Pathophysiology of Sports-Related Concussion.

Concussion pathophysiology is complicated and involves numerous mechanisms, including excessive neurotransmitter release, metabolic derangements, neuroinflammation, cerebral blood flow changes, and axonal disruption. The initial biomechanical impact in a concussion results in abnormal function at the cellular level, which initiates a cascade of events that leads to microstructural changes and, in the minority of cases, more persistent, permanent damage.