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Refractory chronic cluster headache : a consensus statement on clinical definition from the European Headache Federation

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Abstract
Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years. Eighty-five investigators reached by email. Proposed criteria were in the format of the International Classification of Headache Disorders III-beta (description, criteria, notes, comments and references). Following this evaluation eight drafts were prepared before the final. Twenty-four (28.2%) international investigators commented during two rounds. Refractory CCH is described in the present consensus as a situation that fulfills the criteria of ICHD-3 beta for CCH with at least three severe attacks per week despite at least three consecutive trials of adequate preventive treatments. The condition is rare, but difficult to manage and invasive treatments may be needed. The consensus addresses five specific clinical and paraclinical diagnostic criteria followed by three notes and specific comments. Although refractory CCH may be not a separate identity these specific diagnostic criteria should help clinicians and investigators to improve patient's quality of life.
Keywords
Refractory chronic cluster headache, Chronic cluster headache, Invasive treatments, SLEEP-APNEA, EPIDEMIOLOGY, METAANALYSIS

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MLA
Mitsikostas, Dimos D, Lars Edvinsson, Rigmor H Jensen, et al. “Refractory Chronic Cluster Headache : a Consensus Statement on Clinical Definition from the European Headache Federation.” JOURNAL OF HEADACHE AND PAIN 15 (2014): n. pag. Print.
APA
Mitsikostas, D. D., Edvinsson, L., Jensen, R. H., Katsarava, Z., Lampl, C., Negro, A., Osipova, V., et al. (2014). Refractory chronic cluster headache : a consensus statement on clinical definition from the European Headache Federation. JOURNAL OF HEADACHE AND PAIN, 15.
Chicago author-date
Mitsikostas, Dimos D, Lars Edvinsson, Rigmor H Jensen, Zaza Katsarava, Christian Lampl, Andrea Negro, Vera Osipova, et al. 2014. “Refractory Chronic Cluster Headache : a Consensus Statement on Clinical Definition from the European Headache Federation.” Journal of Headache and Pain 15.
Chicago author-date (all authors)
Mitsikostas, Dimos D, Lars Edvinsson, Rigmor H Jensen, Zaza Katsarava, Christian Lampl, Andrea Negro, Vera Osipova, Koen Paemeleire, Aksel Siva, Dominique Valade, and Paolo Marteletti. 2014. “Refractory Chronic Cluster Headache : a Consensus Statement on Clinical Definition from the European Headache Federation.” Journal of Headache and Pain 15.
Vancouver
1.
Mitsikostas DD, Edvinsson L, Jensen RH, Katsarava Z, Lampl C, Negro A, et al. Refractory chronic cluster headache : a consensus statement on clinical definition from the European Headache Federation. JOURNAL OF HEADACHE AND PAIN. 2014;15.
IEEE
[1]
D. D. Mitsikostas et al., “Refractory chronic cluster headache : a consensus statement on clinical definition from the European Headache Federation,” JOURNAL OF HEADACHE AND PAIN, vol. 15, 2014.
@article{5785130,
  abstract     = {Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years. Eighty-five investigators reached by email. Proposed criteria were in the format of the International Classification of Headache Disorders III-beta (description, criteria, notes, comments and references). Following this evaluation eight drafts were prepared before the final. Twenty-four (28.2%) international investigators commented during two rounds. Refractory CCH is described in the present consensus as a situation that fulfills the criteria of ICHD-3 beta for CCH with at least three severe attacks per week despite at least three consecutive trials of adequate preventive treatments. The condition is rare, but difficult to manage and invasive treatments may be needed. The consensus addresses five specific clinical and paraclinical diagnostic criteria followed by three notes and specific comments. Although refractory CCH may be not a separate identity these specific diagnostic criteria should help clinicians and investigators to improve patient's quality of life.},
  articleno    = {79},
  author       = {Mitsikostas, Dimos D and Edvinsson, Lars and Jensen, Rigmor H and Katsarava, Zaza and Lampl, Christian and Negro, Andrea and Osipova, Vera and Paemeleire, Koen and Siva, Aksel and Valade, Dominique and Marteletti, Paolo},
  issn         = {1129-2369},
  journal      = {JOURNAL OF HEADACHE AND PAIN},
  keywords     = {Refractory chronic cluster headache,Chronic cluster headache,Invasive treatments,SLEEP-APNEA,EPIDEMIOLOGY,METAANALYSIS},
  language     = {eng},
  pages        = {4},
  title        = {Refractory chronic cluster headache : a consensus statement on clinical definition from the European Headache Federation},
  url          = {http://dx.doi.org/10.1186/1129-2377-15-79},
  volume       = {15},
  year         = {2014},
}

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