High cervical epidural neurostimulation for post-traumatic headache management.
نویسندگان
چکیده
Headache following head injuries has been reported for centuries. The majority of post-traumatic headache (PTH) patients will report resolution of their complaints within a few months from the time of the initial injury. PTHs can contribute to disability, lost productivity, and health care costs. In this article we discuss a 40-year-old male with a history of motor vehicle accident and basal skull fracture. The patient had no headache history prior to the accident. He presented with more than 3 years persistent daily headache. The patient described constant throbbing and stabbing quality headaches predominantly on the left hemicranium with constant facial pain. He denies having aura, nausea, or vomiting, but reported occasional neck tightness. An extensive workup was carried out under the direction of the patient's primary neurologist. Secondary to persistent intractable pain, the patient was referred to the pain clinic for further evaluation. As his headaches were resistant to all trialed strategies, we decided to turn our therapeutic focus toward electrical neuromodulation along with continuing multimodal medications and multidisciplinary approach. During 7 days of high cervical dorsal column electrical nerve stimulation trial, he reported almost 90% pain reduction and significant improvement on his quality of life. On 12 months follow-up after he underwent a permanent implant of high cervical dorsal column electrical nerve stimulation, he reported the same level of pain reduction along with 100% satisfaction rate. To the best of our knowledge, there have been no publications to date concerning the application of high cervical nerve stimulation for PTH.
منابع مشابه
Intracranial hypotension headache caused by a massive cerebrospinal fluid leak successfully treated with a targeted c2 epidural blood patch: a case report.
Cervical epidural steroid injections, administered either interlaminarly or transforaminally, are common injection therapies used in many interventional pain management practices to treat cervicalgia or cervicobrachial pain secondary to spondylosis or intervertebral disc displacement of the cervical spine. Among the risks associated with these procedures are the risk for inadvertent dural punct...
متن کاملAcute Cervical Subdural Hematoma with Quadriparesis after Cervical Transforaminal Epidural Block.
Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural inje...
متن کاملTiming of neuraxial pain interventions following blood patch for post dural puncture headache.
Post dural puncture headache (PDPH) is a common complication of interventional neuraxial procedures. Larger needle gauge, younger patients, low body mass index, women (especially pregnant women), and "traumatic" needle types are all associated with a higher incidence of PDPH. Currently, an epidural blood patch is the gold-standard treatment for this complication. However, despite the high PDPH ...
متن کاملNon-traumatic Causes of Brown-Sequard Syndrome: A Case Series and Clinical Update with Systematic Review.
Background: Brown-Sequard syndrome (BSS) is a rare neurological condition resulting from a hemisection injury to or unilateral compression on the spinal cord. The most common causes of BSS that are amenable to be treated surgically can be divided into traumatic and non-traumatic injuries. Traumatic injuries are often reported as the main cause of BSS. However, non-traumatic injuries of the spin...
متن کاملThe Role of the Cervical Spine in Sports Concussion and Post Traumatic Headache: Physiological and Anatomical Correlates
Sports related concussion has quickly become the most widely publicized neurological disorder with estimates ranging from 1.6 to 3.8 million affected individuals annually. The cervical spine plays a major role in concussion biomechanics. The cervical spine has also been implicated as playing a major role in triggering and maintaining migraine headache 1, 2 Patients with migraine especially chro...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Pain physician
دوره 17 4 شماره
صفحات -
تاریخ انتشار 2014