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occipital neuralgia

Soliman Oushy, Lucas P Carlstrom, William E Krauss
BACKGROUND AND IMPORTANCE: Transverse ligament cysts (TLC) are rare, surgically complex lesions arising posterior to the odontoid process of C2. Direct compression of the cervicomedullary junction is a devastating consequence of untreated lesions. We report the first case of spontaneous TLC regression without surgical intervention. CLINICAL PRESENTATION: A 75-yr-old woman presented to an outside hospital with acute episodes of left face and upper extremity numbness...
March 5, 2018: Neurosurgery
Song Cao, Bangyong Qin, Yi Zhang, Jie Yuan, Bao Fu, Peng Xie, Ganjun Song, Ying Li, Tian Yu
OBJECTIVE: Herpes zoster (HZ) can develop into postherpetic neuralgia (PHN), which is a chronic neuropathic pain (NP). Whether the chronification from HZ to PHN induced brain functional or structural change is unknown and no study compared the changes of the same brains of patients who transited from HZ to PHN. We minimized individual differences and observed whether the chronification of HZ to PHN induces functional and pain duration dependent grey matter volume (GMV) change in HZ-PHN patients...
2018: American Journal of Translational Research
Giacomo Tondo, Fabiola De Marchi, Daniela Mittino, Roberto Cantello
Occipital neuralgia (ON) is characterized by severe pain in the occipital region due to an irritation of the occipital nerves. Traumatic injuries, mass or vascular compression, and infective and inflammatory processes could cause ON. The dislocation of a nerve/muscle/tendon, as can happen in malformations such as the Chiari I malformation (CIM), also can be responsible. Usually, headaches associated with CIM and ON are distinguishable based on specific features of pain. However, the diagnosis is not easy in some cases, especially if a clear medical history cannot be accurately collected...
November 29, 2017: Curēus
Muhammad Farhan Khaliq, Tanureet Kochar, Molly John
Varicella virus is a neurotropic virus that can reactivate later in life to cause zoster or shingles. Typically, it affects elderly, immunocompromised population. We report an unusual case of an immunocompetent young adult presenting with occipital headache and zoster rash, without preherpetic and postherpetic neuralgia, who was diagnosed with varicella meningitis on Polymerase chain reaction (PCR). He was treated with intravenous acyclovir and later discharged on famciclovir. Diagnosis of varicella meningitis is difficult in the absence of typical features of zoster rash and requires high index of suspicion...
January 5, 2018: BMJ Case Reports
Adrian Kastler, Arnaud Attyé, Caroline Maindet, Benjamin Nicot, Emmanuel Gay, Bruno Kastler, Alexandre Krainik
No abstract text is available yet for this article.
December 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
Hui Xiang, Guangyong Wu, Jia Ouyang, Ruen Liu
OBJECTIVE: To compare the efficacy and complications of microvascular decompression (MVD) by complete neuroendoscopy versus microscopy for 213 cases of trigeminal neuralgia (TN). METHODS: Between January 2014 and January 2016, 213 patients with TN were randomly assigned to the neuroendoscopy (n = 105) or microscopy (n = 114) group for MVD via the suboccipital retrosigmoid approach. All procedures were performed by the same neurosurgeon. Follow-up was conducted by telephone interview...
December 16, 2017: World Neurosurgery
David Ledingham, Cecilia Cappelen-Smith, Dennis Cordato
Crowned dens syndrome is a rare presentation of calcium pyrophosphate deposition disease. It is characterised by severe occipital pain and neck stiffness. Acute presentations are typically accompanied by fever and an inflammatory response and hence can be misdiagnosed as polymyalgia rheumatica or meningitis. Chronic relapsing presentations may be misdiagnosed as cervicogenic neck pain or occipital neuralgia. We present a patient who presented with a chronic relapsing form of crowned dens syndrome and discuss the epidemiology, typical presentation and management of this eminently treatable condition...
February 2018: Practical Neurology
Prachya Punyarat, K Daniel Riew, Benjamin T Klawson, Colleen Peters, Thamrong Lertudomphonwanit, Jacob M Buchowski
BACKGROUND CONTEXT: During placement of C2 pedicle and pars screws, intraoperative fluoroscopy is used so that neurovascular complications can be avoided, and screws can be placed in the proper position. However, this method is time consuming and increases radiation exposure. Furthermore, it does not guarantee completely safe and accurate screw placement. PURPOSE: To evaluate the safety of the C2 pedicle and pars screw placement without fluoroscopic or other guidance methods...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
James H Jones, Alison Brown, Daniel Moyse, Wenjing Qi, Lance Roy
BACKGROUND: Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. OBJECTIVE: We hypothesized that occipital neurostimulator (ONS) leads placed with ultrasonography combined with fluoroscopy would demonstrate increased survival rates and times when compared to ONS leads placed with fluoroscopy alone...
November 2017: Pain Physician
Sang-Mi Noh, Hyun Goo Kang
Occipital neuralgia is a common form of headache that is characterized by paroxysmal severe lancinating pain in the occipital nerve distribution. The exact pathophysiology is still not fully understood and occipital neuralgia often develops spontaneously. There are no specific guidelines for evaluation of patients with occipital neuralgia. Cervical spine, spinal cord, and posterior neck muscle lesions can induce occipital neuralgia. Brain and spine imaging may be necessary in some cases, according to the nature of the headache or response to treatment...
November 10, 2017: International Journal of Neuroscience
Qing Guan, Fei Xing, Ye Long, Zhou Xiang
Postoperative occipital neuralgia (PON) after upper cervical spine surgery can cause significant morbidity and may be overlooked. The causes, presentation, diagnosis, management, prognosis, and prevention of PON were reviewed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. English-language studies and case reports published from inception to 2017 were retrieved. Data on surgical procedures, incidence, cause of PON, management, outcomes, and preventive technique were extracted...
November 7, 2017: Neurosurgical Review
Arifumi Matsumoto, Kimihiko Kaneko, Toshiyuki Takahashi, Ichiro Nakashima, Kinya Hisanaga, Isao Nagano
A 65-year-old man initially developed numbness and hypesthesia in the right shoulder and brachial regions that disappeared within several months. MRI revealed a small lesion extending to a vertebral segment in the right dorsal region of the cervical spinal cord at the vertebral height of C2/3. About 15 months later, the intermittent lancinating pain identical to the right trigeminal and occipital neuralgia with pain and hypesthesia distributed in the right C2-C4 dermatome regions appeared. MRI revealed a new oval lesion with gadolinium enhancement in the right dorsal region of the cervical spinal cord at the vertebral height of C1, which was thought to involve the posterior column and lower part of the spinal tract nucleus of the trigeminal nerve...
November 25, 2017: Rinshō Shinkeigaku, Clinical Neurology
Tibor Valyi-Nagy, Jaivir S Rathore, Andrei M Rakic, Ranvir S Rathore, Paavani Jain, Konstantin V Slavin
We present a case of a 34-year-old right-handed Caucasian male with chronic occipital neuralgia refractory to medical therapies and minimally invasive pain procedures who underwent surgical cervical dorsal root ganglionectomy which completely relieved his headaches. The histopathological and immunohistochemical findings of the resected cervical dorsal root ganglia were consistent with active herpes simplex virus type 1 (HSV-1) infection causing ganglionitis. To the best of our knowledge, this case represents the first histopathologically proven HSV-1 cervical dorsal root ganglionitis in humans...
May 2017: Case Reports in Neurology
Yu Wang, Pei-Lin Kan, Yuan-Feng Tao, Xiao-Yan Li, Xiao-Juan Yang, Gui-Ling Liang
Epicrania fugax (EF) was recently classified as a primary headache in the Appendix of the International Classification of Headache Disorders, third edition (ICHD-III). It is characterized by a paroxysmal pain rapidly radiating forward or backward along a linear or zigzag trajectory on the surface of the head. This article reports a 76-year-old woman who newly developed a paroxysmal EF-type pain distributed not only in the territories of the trigeminal and occipital nerves, but also in the territories of the cervical and thoracic nerves...
2017: Journal of Oral & Facial Pain and Headache
Joshua E Meyers, Kunal Vakharia, Joseph M Kowalski, Vassilios G Dimopoulos, John Pollina
OBJECTIVE: The authors describe a modified technique for placement of the C1 lateral mass screw using a Steinmann pin as a guide. This technique minimizes dissection and provides atlantoaxial stabilization during arthrodesis. METHODS: In our technique, a nonthreaded 1.6-mm spade-tip Steinmann pin is placed into the lateral mass of C1 to serve as a guide over which a powered drill is used for screw insertion. Perioperative data were collected for consecutive patients who underwent a C1-2 arthrodesis that involved the modified technique between March 2010 and July 2016...
December 2017: World Neurosurgery
L Hwang, R Dessouky, Y Xi, B Amirlak, A Chhabra
BACKGROUND AND PURPOSE: MR imaging of peripheral nerves (MR neurography) allows improved assessment of nerve anatomy and pathology. The objective of this study was to evaluate patients with unilateral occipital neuralgia using MR neurography and to assess the differences in greater occipital nerve signal and size between the symptomatic and asymptomatic sides. MATERIALS AND METHODS: In this case-control evaluation using MR neurography, bilateral greater occipital nerve caliber, signal intensity, signal-to-noise ratios, and contrast-to-noise ratios were determined by 2 observers...
November 2017: AJNR. American Journal of Neuroradiology
Basem Ishak, Till Schneider, R Shane Tubbs, Valerie Gimmy, Alexander Younsi, Andreas W Unterberg, Karl L Kiening
BACKGROUND: Various surgical techniques have been described for treating odontoid instability and achieving effective stabilization. The earliest technique to be described proposed a C1 lateral mass entry point including neurectomy of the C2 nerve roots to ensure hemostasis. Because C2 neurectomy remains controversial, preservation of the C2 nerve root as described in Goel-Harms technique can lead to intractable occipital neuralgia and significant blood loss. The aim of this study was to modify the Goel-Harms technique with a high C1 lateral mass screw entry point to enhance overall intraoperative safety...
November 2017: World Neurosurgery
Young Bok Lee
No abstract text is available yet for this article.
July 2017: Korean Journal of Pain
Yin-Shun Zhang, Jian-Xiang Zhang, Qing-Guo Yang, Wei Li, Hui Tao, Cai-Liang Shen
BACKGROUND CONTEXT: Surgical treatment for unstable atlas fractures has evolved in recent decades from C1-C2 or C0-C2 fusion to motion-preservation techniques of open reduction and internal fixation (ORIF). However, regardless of a transoral or a posterior approach, the reduction is still not satisfactory. PURPOSE: The article describes and evaluates a new technique for treating unstable atlas fractures by using a monoaxial screw-rod system. STUDY DESIGN: This is a retrospective study...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
Fuxiang Chen, Fuyong Chen, Zhanfang Shang, Yuan Shui, Guorong Wu, Chen Liu, Zhangya Lin, Yuanxiang Lin, Lianghong Yu, Dezhi Kang, Wei Tao, Yongjie Li
OBJECTIVE: The central mechanisms underlying postherpetic neuralgia (PHN) pain remains unknown. The primary purpose of this study was to identify microstructural white matter changes closely related to the PHN pain by means of diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) analysis. METHODS: DTI data of the brains were obtained from 8 PHN patients and 8 healthy controls (HC) that were matched in age, gender, and educational level. DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were separately compared between the two groups using TBSS analysis to detect subtle microstructural changes...
July 17, 2017: Neuroscience Letters
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