Sub-Specialty Based Pearls to Help Team Physiatry Manage Headache-Sub-Specialty Based Pearls to Help Team Physiatry Manage Headache

Video Transcription

Video Summary

The video discusses two main topics: headaches related to COVID-19 and exercise as a treatment for post-concussive exertional headaches.<br /><br />Regarding COVID-19, headaches are a common symptom, affecting a significant percentage of patients. The SARS-CoV-2 virus attacks ACE2 receptors in the brain and blood vessels, leading to inflammation and changes in the immune system that can cause headaches. It is important to rule out secondary causes of headaches and manage them based on their type and location. Tension-related headaches can be managed with acetaminophen, NSAIDs, and myofascial treatments, while migraines may require triptans or other medications. Monoclonal antibodies targeting CGRP receptors have shown promise as treatments for migraines, with FDA-approved therapies available. Self-management strategies, such as lifestyle interventions and pharmacologic therapy, are also important for managing migraines.<br /><br />In terms of post-concussive exertional headaches, various factors can contribute to their development, including vestibular and ocular dysfunction, motion and gaze stabilization issues, dehydration, deconditioning, and autonomic dysfunction. Maintaining optimal cerebral blood flow is crucial for brain recovery after a traumatic brain injury. Exercise can be used both as a probe to understand symptoms and as a therapeutic treatment to improve cerebrovascular function. Mild to moderate intensity exercise can condition the cerebrovascular function and reduce symptoms. Protocols such as BULKY and the Buffalo Concussion Treadmill test have been used to gradually increase exercise intensity while monitoring symptoms. Exercise has been shown to help reduce concussion symptoms and potentially speed up recovery, but further research is needed to determine the optimal mode, duration, and intensity of exercise for treatment.<br /><br />No specific credits are granted in the summary.

Keywords

headaches

COVID-19

ACE2 receptors

inflammation

migraines

triptans

monoclonal antibodies

self-management strategies

post-concussive exertional headaches

cerebrovascular function

exercise as a probe

concussion symptoms