Republished: Aberrant cervical vasculature anastomosis as cause of neck pain and successful treatment with embolization technique

2016 ◽  
Vol 8 (11) ◽  
pp. e46-e46
Author(s):  
Lucy He ◽  
Travis R Ladner ◽  
Mark Cobb ◽  
J Mocco
Keyword(s):  
Pain Relief ◽  
Neck Pain ◽  
Successful Treatment ◽  
Endovascular Embolization ◽  
Neurologic Deficit ◽  
Occipital Artery ◽  
Complete Pain Relief ◽  
Arterial Trunk ◽  
Focal Neurologic Deficit

We report a patient with non-dermatomal radiating neck pain without focal neurologic deficit. Traditional workup could not identify an anatomic or biomechanical cause. Imaging showed a deep cervical vessel centered in the region of pain. Angiography later identified an aberrant anastomosis of this vessel with the occipital artery. Subsequent endovascular embolization of this arterial trunk resulted in complete pain relief.

scholarly journals https://painphysicianjournal.com/current

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. 335-348
Author(s):  
Nicholas Van Halm-Lutterodt
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Neck Pain ◽  
Functional Status ◽  
Spinal Stenosis ◽  
Local Anesthetic ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Epidural Injections ◽  
Significant Difference

Background: Chronic neck pain is reportedly considered the fourth leading cause of disability. Cervical interlaminar epidural injections are among the commonly administered nonsurgical interventions for managing chronic neck pain, secondary to disc herniation and radiculitis, spinal stenosis, or chronic neck pain of discogenic origin. Objectives: To systematically review the differences in the effectiveness of cervical epidural injections with local anesthetics with or without steroids for the management of chronic neck pain. Study Design: Systematic review and meta-analysis. Methods: A comprehensive search of the literature of randomized controlled trials (RCTs) that compared epidural injections with local anesthetic with or without steroids was performed, including a search of PubMed, EMBASE, and Cochrane databases for all years up to May 2019. Meta-analysis was done for pain relief based on the Numeric Rating Scale, functional status based on the Neck Disability Index, and opioid intake dosage. Results: Four studies met the inclusion criteria. A total of 370 patients were divided into 2 groups: the experimental group received cervical epidural injection with steroid and local anesthetic, and the control group received injection with local anesthetic only. Regrading pain relief, no significant difference was observed between both groups (weighted mean difference [WMD], –0.006; 95% confidence interval (CI), –0.275 to 0.263; P = 0.963; I2 = 0.0% at 12 months). There was also no significant difference in the improvement of the functional status (WMD, 0.159; 95% CI, –1.231 to 1.549; P = 0.823; I2 = 9.8% at 12 months). Similarly, there was no significant difference in opioid dosage (WMD, –0.093; 95% CI, –5.952 to 5.766; P = 0.975; I2 = 0.0% at 12 months). Limitations: Only a few studies on this premise were found in the literature. There was also a lack of heterogeneity of the included RCT studies. Conclusions: The addition of steroids to anesthetic injectates was not associated with better pain and functional score outcomes compared with anesthetic injectate alone in patients with chronic neck pain. Key words: Chronic neck pain, cervical radiculopathy, cervical disc disease, spinal stenosis, facet joint pathology, cervical epidural injections, steroid injections, local anesthetic injections, systematic review, meta-analysis, randomized control trial

Evaluation of Dorsal Column Stimulation in the Treatment of Chronic Pain

Neurosurgery ◽  
1978 ◽  
Vol 3 (3) ◽  
pp. 373-379 ◽  
Author(s):  
Ronald F. Young
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Dorsal Column ◽  
Electrode Placement ◽  
Intractable Pain ◽  
Technical Problems ◽  
Electrode Implantation ◽  
Complete Pain Relief ◽  
Cord Injury ◽  
Dorsal Column Stimulation

Abstract Dorsal column stimulation (DCS) was used in the treatment of chronic intractable pain in 51 patients. Twenty-five of the patients had back and leg pain secondary to the treatment of intervertebral disc disease; 11 had postoperative pain after general or thoracic surgical procedures. The remainder suffered pain related to multiple sclerosis, spinal cord injury, carcinoma, and peripheral vascular disease. Pain had been present for a mean of 24 months. Thirty-seven patients underwent DCS electrode placement by open laminectomy, and 11 had percutaneous epidural DCS electrode placement. Three patients first underwent epidural DCS electrode implantation and subsequently had DCS electrode implantation by laminectomy. No major complications were noted, although multiple lesser complications required 33 additional operative procedures for correction. Follow-up periods ranged from 12 to 67 months, with a mean of 38 months. Immediately after implantation. 47% of the patients reported that they had essentially complete pain relief, but 3 years later this had decreased to 8%. No patient followed for 4 years or longer reported complete pain relief. Thirty-three per cent of the patients discontinued the regular use of narcotics for pain relief after DCS electrode implantation. Unfortunately, only 16% were able to return to gainful employment or full physical activity after DCS. Based on these data and a review of the literature, the following conclusions are made: (a) assessment of success in the treatment of chronic pain is strongly dependent on the criteria used for patient evaluation: (b) with the criteria of this report, DCS is a relatively ineffective treatment for chronic pain; (c) epidural percutaneous DCS systems are no more effective than are those placed by laminectomy, and, because of technical problems with epidural systems (mainly lead breakage and migration), the latter may actually be less effective; and (d) at present DCS seems to play a minor role in the treatment of chronic intractable pain.

scholarly journals An acute ischemic stroke after multiple bee stings in an elderly patient

2013 ◽  
Vol 4 (2) ◽  
pp. 55-58
Author(s):  
Niranjan Mambally Rachaiah ◽  
Rajashekar Hirisave Kalegowda ◽  
Rashmi Bhadravathy Krishnaswamy
Keyword(s):  
Computed Tomography ◽  
Elderly Patient ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Complications ◽  
Neurologic Deficit ◽  
Allergic Reactions ◽  
Medical Sciences ◽  
Wasp Stings ◽  
Focal Neurologic Deficit

Although bee stings can cause local and systemic allergic reactions, neurological complications are rare. There are few reports of stroke following bee or wasp stings. We report a 70-year-old healthy man developed a focal neurologic deficit 5 hours after multiple bee stings, which was confirmed to be an acute ischemic stroke on computed tomography (CT) scan.DOI: http://dx.doi.org/10.3126/ajms.v4i2.7892Asian Journal of Medical Sciences 4(2013) 55-58

Long-term Follow-up of Patients Treated with Percutaneous Radiofrequency Thermocoagulation via the Foramen Rotundum for Isolated Maxillary Nerve Idiopathic Trigeminal Neuralgia

Pain Medicine ◽  
2019 ◽  
Vol 20 (7) ◽  
pp. 1370-1378 ◽  
Author(s):  
Bing Ran ◽  
Jun Wei ◽  
Qiong Zhong ◽  
Min Fu ◽  
Jun Yang ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Sagittal Plane ◽  
Ct Guided ◽  
Radiofrequency Thermocoagulation ◽  
Complete Pain Relief ◽  
Idiopathic Trigeminal Neuralgia ◽  
Foramen Rotundum ◽  
The Mean

Abstract Objective The purpose of this study is to evaluate the effectiveness and safety of percutaneous radiofrequency thermocoagulation (PRT) via the foramen rotundum (FR) for the treatment of isolated maxillary (V2) idiopathic trigeminal neuralgia (ITN) and assess the appropriate puncture angle through the anterior coronoid process to reach the FR. Methods Between January 2011 and October 2016, 87 patients with V2 ITN refractory to conservative treatment were treated by computed tomography (CT)–guided PRT via the FR at our institution. The outcome of pain relief was assessed by the visual analog scale (VAS) and Barrow Neurological Institute (BNI) pain grade and grouped as complete pain relief (BNI grades I–III) or unsuccessful pain relief (BNI grades IV–V). Recurrence and complications were also monitored and recorded. The puncture angle for this novel approach was assessed based on intraoperative CT images. Results Of the 87 treated patients, 85 (97.7%) achieved complete pain relief, and two patients (2.3%) experienced unsuccessful pain relief immediately after operation. During the mean follow-up period of 44.3 months, 15 patients (17.2%) experienced recurring pain. No severe complications occurred, except for hypoesthesia restricted to the V2 distribution in all patients (100%) and facial hematoma in 10 patients (11.5%). The mean puncture angle to reach the FR was 33.6° ± 5.7° toward the sagittal plane. Discussion CT-guided PRT via the FR for refractory isolated V2 ITN is effective and safe and could be a rational therapy for patients with V2 ITN.

Cerebrovascular Disease 2: Stroke (DRAFT)

2018 ◽  
Author(s):  
Tamara Kaplan ◽  
Tracey Milligan
Keyword(s):  
Cerebrovascular Disease ◽  
Neurologic Deficit ◽  
Definition Of ◽  
Focal Neurologic Deficit

The video in this chapter explores cerebrovascular disease, and focuses on stroke. It discusses the definition of stroke as a sudden focal neurologic deficit that persists for more than 24 hours, as well as ischemic strokes (embolic, thrombotic, or due to hypoperfusion), and intraparenchymal hemorrhagic strokes.

scholarly journals Pain relief and opioid usage in upper limb and neck pain patients after 10-kHz spinal cord stimulation treatment: subanalysis of USA studies

2020 ◽  
Author(s):  
Kasra Amirdelfan ◽  
Ricardo Vallejo ◽  
Ramsin Benyamin ◽  
Steven Rosen ◽  
Peter Kosek ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pain Relief ◽  
Neck Pain ◽  
Spinal Cord Stimulation ◽  
Opioid Consumption ◽  
Upper Limbs ◽  
Opioid Use ◽  
Scale Scores ◽  
Post Hoc ◽  
Pain Patients

Aim: It is argued that chronic pain patients who reduce/eliminate their opioids may have compromised pain relief. This study therefore aimed to analyze if reduced opioid consumption associated with 10-kHz spinal cord stimulation adversely affected pain relief. Methods: Post hoc analysis was performed on data from two prospective studies in subjects with upper limbs and neck pain conducted in USA. Results & conclusion: A 10-kHz spinal cord stimulation treatment was associated with reduction in mean visual analog scale scores for upper limbs and neck pain and mean daily opioid consumption. Pain scores decreased in subjects who decreased opioid use and in those who maintained/increased use. Opioid reduction and pain relief was also achieved in subjects taking >90 mg morphine equivalents of opioids at baseline.

scholarly journals ANCHOR surgeon views of patient selection and expectations for periacetabular osteotomy

2019 ◽  
Vol 6 (2) ◽  
pp. 109-116
Author(s):  
Adam I Edelstein ◽  
Karen Kaiser Tegel ◽  
Sara Shaunfield ◽  
Paul E Beaulé ◽  
John C Clohisy ◽  
...  
Keyword(s):  
Decision Making ◽  
Pain Relief ◽  
Shared Decision Making ◽  
Patient Selection ◽  
Periacetabular Osteotomy ◽  
Patient Expectations ◽  
Shared Decision ◽  
Complete Pain Relief ◽  
Expected Outcomes ◽  
Expectation Discrepancies

Abstract Preoperative expectations impact shared decision making and patient satisfaction. Surgeon views of patient selection, expected outcomes and patient expectations after periacetabular osteotomy (PAO) for treatment of acetabular dysplasia have not been defined. We assessed surgeon views of patient selection and expected outcomes after PAO. A sample of experienced PAO surgeons participated in semi-structured phone interviews assessing: (i) factors that determine patient candidacy for PAO; (ii) surgeon expectations for PAO outcomes; (iii) surgeon perceptions of patient expectations for PAO outcomes and (iv) surgeon perceptions of discrepancies in surgeon and patient expectations and approaches for reconciling these discrepancies. Twelve surgeons (77% of PAO-performing ANCHOR surgeons) participated. The factors most commonly mentioned in determining patient candidacy for PAO were: symptoms, radiographic findings, absence of arthritis and age. Only one-quarter of the sample mentioned patient expectations as a factor in determining patient candidacy for PAO. The most common surgeon expectations were: pain reduction, joint preservation, function with activities of daily living and return to desired activities. 58% of surgeons felt that surgeon and patient expectations align most of the time. Common expectation discrepancies included return to unrestricted activities and complete pain relief. Detailed discussion was the most commonly employed strategy to resolve expectation discrepancies. PAO surgeons felt that patient expectations of complete pain relief and return to unrestricted activities were misaligned with their own expectations. Development of an expectations survey may facilitate shared decision making.

Pudendal neuralgia due to solitary neurofibroma

1982 ◽  
Vol 56 (5) ◽  
pp. 732-733 ◽  
Author(s):  
Francesco Tognetti ◽  
Massimo Poppi ◽  
Giulio Gaist ◽  
Franco Servadei
Keyword(s):  
Pain Relief ◽  
Unusual Case ◽  
Clinical History ◽  
Pudendal Neuralgia ◽  
Content Type ◽  
Solitary Neurofibroma ◽  
Complete Pain Relief ◽  
Perineal Region ◽  
Fine Print

✓ An unusual case of pudendal neuralgia due to a solitary neurofibroma of the perineal region is described. The authors outline the long clinical history. There was complete pain relief after removal of the lesion.

Sign in / Sign up

Export Citation Format

Share Document