Journal of observational pain medicine最新文献

英文中文

Stent-Mediated Redistribution of Cerebral Venous Outflow in the Treatment of Severe Intractable Headache: A Case Report. 支架介导的脑静脉流出再分布治疗严重顽固性头痛1例。

Journal of observational pain medicine

Pub Date : 2014-04-01

Nicholas Higgins, Frances Hall, John Pickard

We describe a patient with multiple symptoms but whose primary complaint was of headache, in whom no firm diagnosis was made in two years, who was resistant to all treatment, until a markedly asymmetrical cranial venous outflow came to be regarded, not as normal variant anatomy but as fundamental to the clinical problem. Deliberately altering this anatomy in favour of a more symmetrical arrangement by stenting a hypoplastic transverse sinus brought about an immediate, profound and sustained clinical improvement. This result challenges the existing consensus on what is acceptable as normal in respect of cranial venous outflow. It raises intriguing questions about the relationship between neurological symptoms and the vagaries of cranial venous outflow anatomy. It suggests there may be new opportunities in the investigation of chronic headache.

我们描述了一个患者，他有多种症状，但主要的主诉是头痛，在两年内没有明确的诊断，他对所有的治疗都有抗药性，直到一个明显不对称的颅静脉流出被认为不是正常的变异解剖，而是临床问题的根本。通过支架植入发育不全的横窦，故意改变这种解剖结构，使其更对称，这带来了立即、深刻和持续的临床改善。这一结果挑战了现有的共识是什么是可接受的正常颅静脉流出。它提出了有趣的问题，神经症状之间的关系和变幻莫测的颅静脉流出解剖。这表明慢性头痛的研究可能有新的机会。

引用次数: 0

Looking for idiopathic intracranial hypertension in patients with chronic fatigue syndrome. 寻找慢性疲劳综合征患者的特发性颅内高压。

Journal of observational pain medicine

Pub Date : 2013-04-01

Nicholas Higgins, John Pickard, Andrew Lever

Introduction: Headache is common in chronic fatigue syndrome, a condition of unknown cause in which there are no clinical signs. Fatigue is common in idiopathic intracranial hypertension, a headache condition of unknown cause in which the only clinical signs are those of raised intracranial pressure, signs which may be absent. Might, therefore, idiopathic intracranial hypertension be present in some patients diagnosed with chronic fatigue syndrome? Could the two conditions be related?

Patients and methods: From June 2007, patients attending a specialist clinic who fulfilled the diagnostic criteria for chronic fatigue syndrome and in whom headache was an especially prominent symptom were offered CT venography and lumbar puncture, looking for evidence of raised intracranial pressure.

Results: Of the 20 patients who accepted lumbar puncture, eight had pressures of 20 cm H₂O or greater, including three who had pressures of 25 cm H₂O or greater. Mean pressure was 19 cm H₂O.

Conclusions: Some patients with headache and a diagnosis of chronic fatigue syndrome have unrecognised and occult idiopathic intracranial hypertension. The possibility that the two conditions are related cannot be excluded.

简介:头痛常见于慢性疲劳综合征，这是一种病因不明、无临床体征的病症。疲劳常见于特发性颅内高压，这是一种原因不明的头痛症状，其唯一的临床症状是颅内压升高，而这些症状可能不存在。因此，可能特发性颅内高压存在于一些诊断为慢性疲劳综合征的患者中?这两种情况有关联吗?患者和方法:自2007年6月起，在专科诊所就诊的符合慢性疲劳综合征诊断标准且头痛为特别突出症状的患者行CT静脉造影和腰椎穿刺，寻找颅内压升高的证据。结果:在20例接受腰椎穿刺的患者中，8例压力为20cm H2O及以上，其中3例压力为25cm H2O及以上。平均压强为19 cm H2O。结论:一些诊断为慢性疲劳综合征的头痛患者有未被识别和隐匿的特发性颅内高压。不能排除这两种情况相互关联的可能性。

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