title: Joint hypermobility and headache: the glue that binds the two together--part 2.
abstract: BACKGROUND
  Past studies have reported that connective tissue disorders (CTDs) are more common in patients with specific types of headache disorders.
  
  
  OBJECTIVE
  The objectives of this study are (1) to review and critique the clinical studies reporting an association between joint hypermobility, CTDs and headache and (2) to postulate mechanisms though which CTDs might predispose to headache disorders.
  
  
  METHODS
  PubMed was searched for relevant articles with search terms that included joint hypermobility, Ehlers-Danlos syndrome, Marfan syndrome, and specific headache disorders. A narrative review was performed of these articles as well as those identified from the bibliography of these articles.
  
  
  RESULTS
  Case reports and case control studies confirm an association between CTDs and migraine, coat-hanger headaches, carotid arterial dissections, intracranial hypotension, Arnold Chiari malformations-type 1, cervical spine disorders, and temporomandibular joint disorders.
  
  
  CONCLUSIONS
  Observational cross-sectional studies suggest that the prevalence of CTDs is increased in patients with specific types of headache disorders. It is unknown if the CTDs directly cause these headaches disorders or are associated with them through other mechanisms.
authors: Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA.
authors: Vincent T
authors: VT
authors: Martin
authors: Derek
authors: D
authors: Neilson
mesh_terms: D003240:Connective Tissue Diseases / Q000150:complications / Q000175:diagnosis; D003430:Cross-Sectional Studies; D004535:Ehlers-Danlos Syndrome / Q000150:complications* / Q000175:diagnosis; D006261:Headache / Q000209:etiology*; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000175:diagnosis; D008382:Marfan Syndrome / Q000150:complications* / Q000175:diagnosis; D064887:Observational Studies as Topic
keywords: Ehlers-Danlos syndrome; Marfan's syndrome; connective tissue disorder; headache; joint hypermobility syndrome; migraine