title: Headache in chronic cocaine users: A cross-sectional study.
abstract: BACKGROUND
  Headache is one of the most common symptoms after cocaine use.
  
  
  METHODS
  We investigated headache frequency and characteristics and the correlation between headache and acute cocaine intake in a cross-sectional study in a consecutive series of chronic cocaine users.
  
  
  RESULTS
  Participation rate was 94.1%. Of the 80 subjects enrolled, 72 (90%) reported current headaches, in most cases migraine or probable migraine without aura. Of these 72, 29 (40.3%) had a headache history, whereas 43 (59.7%) reported de novo headache after beginning to use cocaine. After acute cocaine use, a large percentage of users reported headache attacks: 86.2% of previous headache sufferers (migraine or probable migraine without aura in all cases) and 93% of de novo headache sufferers (migraine/probable migraine without aura = 35; episodic tension-type headache = three patients; cocaine-induced headache= two patients). Most subjects reported that when they used cocaine headaches worsened.
  
  
  CONCLUSIONS
  Chronic cocaine use frequently seems to worsen or induce headache with migraine or migraine-like characteristics, probably owing to a serotoninergic and dopaminergic system impairment. In headache sufferers, especially those with migraine headaches, clinicians should enquire into possible cocaine use.
authors: Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Italy.
authors: Luisa
authors: L
authors: Fofi
authors: Drug Addiction Service, 20th District, UOS Municipio 17, ASL RME, Italy.
authors: Valerio
authors: V
authors: Orlandi
authors: National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Italy.
authors: Nicola
authors: N
authors: Vanacore
authors: Drug Addiction Service, 20th District, UOS Municipio 17, ASL RME, Italy.
authors: Maria C
authors: MC
authors: Mizzoni
authors: Drug Addiction Service, 20th District, UOS Municipio 17, ASL RME, Italy.
authors: Alba
authors: A
authors: Rosa
authors: Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Italy.
authors: Cinzia
authors: C
authors: Aurilia
authors: Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Italy.
authors: Gabriella
authors: G
authors: Egeo
authors: Drug Addiction Service, 20th District, UOS Municipio 17, ASL RME, Italy.
authors: Pietro
authors: P
authors: Casella
authors: Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Italy piero.barbanti@sanraffaele.it.
authors: Piero
authors: P
authors: Barbanti
keywords: Headache; chronic; cocaine; cocaine-induced headache; disability; migraine