A 56 year old, white female with a diagnosis of trigeminal neuralgia, unresponsive to medical therapy, received a sphenopalatine ganglion block using bupivacaine 0.5%. A total of ten treatments were given. The patient remained pain free as of 30 months after initial treatment. This treatment appears to be effective and deserves further study.
Surgical treatment of atlantoaxial instability resulting from Type II odontoid fracture has evolved in recent years with newer approaches offering the surgeon more options. Our experience with anterior odontoid screw fixation and transarticular C1-2 fusion has exposed us to complications, indications, and contraindications different from those of more traditional posterior arch fixation and fusion procedures. The value and versatility of these two approaches were recently demonstrated in one case: a patient with a Type II odontoid fracture was treated with anterior odontoid screw fixation, suffered a second injury with dislocation and neurologic deficit and responded well to transarticular C1-2 fusion with decompression. A description of our surgical technique and a comparison of the two procedures is presented.
A rare case of cervical pregnancy complicated by Clostridium perfringens septicemia is presented. The relationship of sepsis in association with cervical pregnancy is reviewed.
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