Department of Headache

Established in November 2019, the Department of Headache of the Neurology Center of Beijing Tiantan Hospital, Capital Medical University, and the Headache Research Center of the National Clinical Medical Research Center for Neurological Diseases are the first specialized center in China with primary headache and related secondary headache as the primary diagnosis and treatment and clinical research objectives. The team is composed of specialized physicians engaged in headaches, with Dr. Yonggang Wang, the chief physician, as the leader of the discipline. Currently, there are three physicians with senior titles. Dr. Yonggang Wang is currently a professor of neurology at Capital Medical University and a supervisor of doctoral students and has undertaken five projects of the National Natural Science Foundation of China as the leader, among which two are under research. At present, the department has opened five types of clinics: headache specialist clinic, special needs clinic, brain white matter lesion and headache consultation, pituitary tumor and headache consultation, and international department clinic, which can meet the needs of different patients respectively. Relying on the robust resources of Beijing Tiantan Hospital Neurology Center, the Department of Headache integrates various medical resources and devotes itself to platform construction, promotion of treatment technology, and scientific research related to headache diseases; from the perspective of headache diseases as a whole, it constantly improves the clinical treatment level and provides advanced, comprehensive, reasonable and effective high-level medical services for headache patients.

Headache is one of the most common complaints in neurology outpatient clinics and one of the common reasons for emergency patients to visit the clinic.

The team focuses on the following aspects of headaches:

1. clarifying the diagnosis of recurrent headaches and the possible causative factors and preventing and controlling episodic headache diseases.

2. Long-term chronic headache causes great suffering to patients, especially those who overuse pain medication, which increases the economic burden on families and society. The team is committed to clarifying the diagnosis and treatment of chronic headaches and focusing on sleep disorders, mood and emotional disorders associated with chronic headaches.

3. The incidence of headaches in adolescents is increasing yearly, and it is one of the significant problems for adolescents and their parents. Moreover, most headaches in adolescence continue into adulthood, negatively impacting the quality of life and causing economic losses. Therefore, the team will improve the related examination for the corresponding treatment, prevention, and control.

4. Cerebral white matter lesions occur in people of all ages and are accompanied by headaches. The department has established a clinic for white matter lesions and headaches. Through joint consultations with specialists in white matter lesions, the team tries to identify risk factors that cause white matter lesions and prevent and treat headaches.

5. Patients with pituitary tumors often have headaches before or after surgery. The team cooperates with neurosurgeons to analyze the cause, diagnosis, and treatment of headaches related to pituitary tumors.

6. The diagnosis, differential diagnosis, and treatment of rare primary headaches are carried out in collaboration with the latest diagnostic standards of the International Headache Society.

Consultation information: Patients can register for appointments in various forms, such as Beijing Titan Hospital APP appointments, kiosk appointments, on-site registration, 114 telephone appointments, doctor's workstation consultation appointments, discharge follow-up appointments, online (www.bjguahao.gov.cn) appointments, and community two-way referral appointments. When making an appointment, patients should select the Department of Headache under the Department of Neurology to make an appointment.

Monday: Morning Special Needs Clinic - Consultation Center - Cerebral Leukoaraiosis and Headache (Prof. Yonggang Wang, Prof. Yilong Wang)

Afternoon: Special Needs Clinic - Neurology Prof. Yonggang Wang

Tuesday: Morning Special Needs Clinic-Consultation Center-Pituitary Tumor Related Headache

(Prof. Yonggang Wang, Dr. Siyuan Chen, Dr. Shengtian Wu)

Wednesday: Morning Special Needs Clinic - Neurology Dr. Xueying Yu, Deputy Chief Physician

Friday: Morning Special Needs Clinic - Neurology Dr. Yaqing Zhang, Deputy Chief Physician

Specialists in the Department of Headache:

Prof. Yonggang Wang specializes in the diagnosis and treatment of primary headaches (migraine, tension-type headache, cluster headache), complex headaches (drug overuse headache, new daily persistent headache), adolescent headaches, and secondary headaches, as well as comprehensive drug treatment of dizziness, mood, and sleep disorders in combination with headache and other neurological diseases.

Dr. Xueying Yu specializes in treating migraine, tension-type headaches, cluster headaches, painkiller overuse headaches, peripheral neuropathy, myopathy, motor neuron disease, trigeminal neuralgia, facial nerve, facial spasm, cerebral small vessel disease, and neurogenetic disease.

Consultation time: Wednesday morning

Location: Special Needs Clinic on the fifth floor of the outpatient building I

Medical service fee: 200 RMB

Dr. Yaqing Zhang specializes in diagnosing and treating migraine, tension-type headaches, cluster headaches, and other complex headaches, diagnosing, standardized treatment, and preventing cerebrovascular diseases.

Consultation time: Friday morning

Location: Special Needs Clinic on the fifth floor of the outpatient building I

Medical service fee: 200 RMB

White Matter Lesions and Headache Consultation

Cerebral white matter lesions are seen on MRI as dotted, linear, or lamellar hyperintensities under the cerebral cortex or around the ventricles and are usually described as "cerebral white matter demyelination," "intracerebral ischemic demyelination foci," or "cerebral white matter lesions," "They can occur at all ages, and the associated disease varies with each age group. The pathogenesis of cerebral white matter hyper signal is unknown. It is currently considered that it may be related to small vascular lesions in the brain, inflammatory diseases, and functional neurological disorders. Patients with leukoencephalopathy often have a combination of headache symptoms, including paroxysmal or persistent migraine or bilateral headaches, with or without aura, such as flashing lights, numbness, or limb weakness, which may precede or follow the leukoencephalopathy and may be familially inherited or sporadic. Patients with white matter lesions may also experience memory and calculation loss, anxiety, depression, insomnia or increased sleep, poor sleep quality, dizziness, unsteady walking, constipation, or sudden cerebral infarction or cerebral hemorrhage. The above symptoms can have a lasting and profound impact on patient's quality of life.

Beijing Tiantan Hospital, Capital Medical University, has opened a joint clinic on "cerebral white matter lesions and headaches," Prof. Yonggang Wang and Prof. Yilong Wang will jointly consult with patients.

Introduction of the joint consultation experts:

Professor Yilong Wang specializes in the comprehensive evaluation, diagnosis, and treatment of cerebral small vessel disease, including cerebral white matter lesions, lacunar cerebral infarction, new subcortical lacunar infarction, combined memory loss, anxiety and depression, and gait abnormalities.

Pituitary Tumor-related Headache Consultation

Patients with pituitary disorders, especially pituitary tumors, often suffer from various headache symptoms before and after treatment. Pituitary tumors account for approximately 16.5% of all intracranial tumors, with pituitary neuroendocrine tumors, or pituitary adenomas, accounting for most pituitary tumors. Pituitary tumors are pretty common in the general population. Meta-analyses estimate the prevalence of pituitary adenomas to be 16.7%, and autopsy and radiological estimates of prevalence to be 14.4% and 22.5%, respectively.

The pathogenesis of pituitary tumor-induced headache is unclear, but it mainly focuses on the mechanical effects of tumor growth on adjacent anatomy, the neuroendocrine effects of functional adenomas, increased pressure in the saddle, and genetic susceptibility.

Pituitary tumor-associated headaches present in a variety of ways, with chronic (46%) and episodic (30%) migraine accounting for the majority, followed by primary irritant headaches (27%), followed by transient unilateral neurogenic headaches with conjunctival congestion (SUNCT) (5%), cluster headache (4%), and persistent migraine (1%), and six cases (7%) with headache symptoms that IHS criteria could not classify.

Co-consultants Dr. Yonggang Wang, Chief Physician; Dr. Siyuan Chen, Deputy Chief Physician; Dr. Shengtian Wu, Deputy Chief Physician

Dr. Siyuan Chen is mainly engaged in the surgical treatment of craniocerebral tumors. He specializes in the minimally invasive microsurgical treatment of pituitary adenoma, craniopharyngioma, meningioma, Rathke's cleft cyst, and other saddle area diseases, as well as the comprehensive evaluation, diagnosis, and treatment of acromegaly and prolactinoma, and the surgical treatment of glioma and nerve sheath tumor.

Dr. Shengtian Wu specializes in the surgical treatment of intracranial tumors, endoscopic transnasal minimally invasive treatment of pituitary tumors, chordoma, and other skull base lesions; transnasal minimally invasive repair of the cerebrospinal fluid nasal leak; resection of auditory neuroma and meningioma; nerve sheath tumor resection, ventriculoperitoneal shunt.

The pituitary tumor-related headache clinic is the first in China to achieve collaborative neurological-surgical cooperation to diagnose and treat patients' symptoms with pituitary tumor-related headaches and improve preoperative and postoperative quality of life.

Consultation time: Tuesday morning

Location: Special Needs Clinic on the fifth floor of the outpatient building I

Medical service fee: RMB 500

Research Projects

Scientific research projects:

1. Project No. 91849104, National Natural Science Foundation of China, "The role and mechanism of RBM8a-mediated Wnt signaling in regenerating neurons during aging", RMB 500,000, 2019.01 - 2021.12

2. Project No. 31770800, National Natural Science Foundation of China, "Study on the mechanism of endogenous hydrogen sulfide affecting cerebrovascular development in zebrafish," RMB 550,000 2018.01-2021.12

Three projects have been closed.

1. Project No. 81571329, National Natural Science Foundation of China, "Candidate gene screening, molecular network analysis and functional validation of major depression in Han Chinese population", RMB 684,000 2016.01-2019.12

2. Project No. 31240001, NSFC Special Fund Grant, "Trpc3/6 mediates Neuregulin-1-induced calcium inward flow involved in peripheral Schwann cell myelination" RMB 150,000, 2012.06-2013.05;

3. Project No. 31271140, National Natural Science Foundation of China, "The regulation mechanism of Wnt/β-catenin pathway by microglia in neural stem cell nests and its mechanism in the pathogenesis of multiple sclerosis," RMB 800,000, 2013.01-2016.12;

Basic Research

1. Mechanistic study of the neurovascular unit and migraine onset

2. Study on the neurobiological mechanism related to chronic headache

2. Study on the genetic mechanism of primary headache occurrence

Clinical research

1. Cohort study of unclosed foramen ovale and the occurrence of migraine.

2. Clinical study of clinical pharmacological treatment protocols for chronic migraine or drug overuse headache withdrawal painkillers.

4. A clinical cohort study of migraine and other primary headaches in China.

3. A clinical study of preventive pharmacotherapy for menstrual-related migraine in China.

4. A clinical observational cohort study of migraine onset and related prophylactic drug use in adolescents in China.

5. Clinical cohort establishment of new daily persistent headache (NDPH) and possible clinical drug studies.

6. Clinical studies on functional magnetic resonance, vascular permeability, brain magnetic and electroencephalographic activity, and brain oxygen levels in various types of primary headaches in exploring mechanisms.

Construction of headache discipline alliance

Based on the platform of Beijing Tiantan Hospital, the headache discipline alliance will gradually radiate from the tertiary hospitals to the primary hospitals to guide headache-related diagnosis and treatment in the lower hospitals and, at the same time, conduct various academic exchanges to improve the level of headache diagnosis and treatment and scientific research. The headache discipline alliance is a consortium formed between medical institutions with specialty collaboration to carry out various activities and promote the construction and development of the discipline. The department guides headache-related treatment in lower-level hospitals. It establishes remote consultation to improve headache diagnosis and treatment; establishes a headache academy to train doctors on headache-related knowledge and standardizes headache diagnosis and treatment; carries out headache-related multicenter basic and clinical research to drive the development of headache disciplines in lower hospitals.

The construction of the headache discipline alliance provides four platforms for discipline development:

· collaborative development platform for discipline construction

· efficient utilization platform for medical resources

· homogeneous improvement platform for medical quality and scientific enhancement platform for hospital management

At the same time, the alliance will realize "four sharing," including expert sharing, clinical sharing, scientific research sharing, and teaching sharing, and promote the synchronous improvement of medical teaching and research of the alliance members.

Continuing Education

For more details, please refer to the enrollment chapter of the Neurology Center of Beijing Tiantan Hospital.

Postgraduate Admissions

Prof. Yonggang Wang, as the supervisor of doctoral students at Capital Medical University, currently enrolls one master's degree student and one doctoral student per year and can enroll 1-2 postdoctoral students. Therefore, students who are interested in headaches are welcome to apply!

Department of HeadacheEstablished in November 2019, the Department of Headache of the Neurology Center of Beijing Tiantan Hospital, Capital Medical University, and the Headache Research Center of the National Clinical Medical Research Center for Neurological Diseases are the first specialized center in China with primary headache and related secondary headache as the primary diagnosis and treatmen…