• Title/Summary/Keyword: Vascular Pain

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Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

  • Cho, Tack-Geun;Nam, Taek-Kyun;Park, Seung-Won;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.284-286
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    • 2011
  • Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

A Review of Occupational Therapy Approach for Complex Regional Pain Syndrome (복합부위통증증후군의 작업치료적 접근에 관한 고찰)

  • Choi, Yoo-Im;Park, Soo-Hyun
    • The Journal of the Korea Contents Association
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    • v.10 no.1
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    • pp.286-294
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    • 2010
  • Complex Regional Pain Syndrome(CRPS) is a chronic neruopathic pain syndrome, most frequently encountered after trauma, nerve injury, fracture, cerebral vascular accident(CVA), spinal injury, and surgery to a limb, and affected by diverse factors such as disease process, intervention method, and other biopsychosocial components. Occupational therapy as a multidisciplinary treatment approach may be potentially useful when simultaneously targeting such biological, psychological, and social components. Biological treatment can focus on increasing functional use of extremity for promoting independence. Psychological intervention can include relaxation/biofeedback training and cognitive-behavioral treatments, and social approach can focus on recreational therapy and vocational rehabilitation. Occupational therapy will encourage functional restoration, pain management, and regaining of psychological components with collaboration between different disciplines.

Temporomandibular Disorder Caused by Periapical Abscess of Third Molar (제 3 대구치의 치근단 농양으로 인한 측두하악장애)

  • Cho, Eunae;Kwon, Jeong-Seung;Ahn, Hyung-Joon;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.143-147
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    • 2013
  • Mouth opening limitation is generally caused by masticatory muscle or temporomandibular joint pain, disc dislocation without reduction, adhesion or ankylosis of the temporomandibular joint, and muscle contracture. But otorhinolaryngologic disease, neurologic and vascular disease, tumor, inflammation and infection may cause pain and mouth opening limitation which mimics temporomandibular disorders. Re-evaluation for possibilities of inflammation, infection and tumor should be in cases that do not show symptom improvement or appear with continuous aggravation despite of proper treatment. In this case, we report of medial pterygoid muscle pain and mouth opening limitation caused by periapical abscess of third molar spread to the pterygomandibular space.

Experience with the Application of Magnetic Resonance Diagnostic Analyser and Stellate Ganglion Block -A case of facial palsy- (자기공명분석기와 성상교감신경절 차단요법을 병용한 안면신경마비의 치험)

  • Kwak, Su-Dal;Kim, Il-Ho;Cha, Young-Deog;Jin, Hee-Cheol;Lee, Jeong-Seok;Kim, Jin-Ho;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.69-73
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    • 1994
  • A 37 years old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and stellate Ganglion block(SGB). SGB is effective in treatment of facial palsy resulting from abolishing cerebral vascular spasm and increasing cerebral blood flow. Short daily period of exposure to appropriate MRA can also modulate the balance of autonomic nervous system that are responsible for sympathetic overflow resulting the edema and poor circulation on the course of the facial nerve. It was seemed that recovery of facial palsy by application of both MRA and SGB was faster than by SGB only.

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Pseudoaneurysm Originating from the Lateral Femoral Circumflex Artery after Retrograde Intramedullary Nailing of a Distal Femur Shaft Fracture (원위 대퇴골 골절에서 역행성 골수 정 시행 후 발생한 외측 대퇴 회선 동맥 기원의 가성동맥류)

  • Yu, Jeongseok;Lee, Beom-Seok;Kim, Han-Bit
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.535-539
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    • 2021
  • Vascular complications following a femoral fracture are rare but can result in serious issues. Several case studies have reported pseudoaneurysms occurring after direct trauma or the insertion of a proximal femoral nail in the case of a proximal femoral fracture. The authors encountered an 85-year-old patient treated with retrograde intramedullary nail fixation for a distal femur fracture and suffered a decrease in the hemoglobin level, swelling, and pain on the 9th day after surgery. The authors initially attributed the temporary hematoma and pain to ordinary postoperative processes. On the 16th day after surgery, a pseudoaneurysm originating from the descending branch of the lateral femoral convolutional artery was diagnosed and treated by percutaneous vascular embolization. After the procedure, the hemoglobin level increased, and the swelling and pain decreased.

Clinical Experience with Vascular Surgery (혈관수술에 대한 임상적 고찰)

  • 김현경
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1570-1577
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    • 1992
  • The vascular surgery is the field that has developed in early 20 century and is progressing nowadays. Recent advance in surgical technique accompanying with excellent medical diagnosis and treatment, prompt angiographic usage, development of variable prosthetic material, and concomitant use of anti-coagulant have made remarkable results of vascular surgery. 83 cases of vascular surgery have been performed at Thoracic and Cardiovascular Surgery Department of Pusan National Unversity Hosaital since 1971 till 1990, for 20 years and their results are followed. Patient ductus arteriosus and Buerger`s disease were omited in this study. 1. The age distribution shows that the fifth and sixth decades are most frequently affected and mean age was 56.1 years old. Male to female ratio is 1: 2.32. 2. Among the 83 cases of all, number of occlusive vascular disease is 46 and that of aneurysmal disease is 33. 3. In clinical manifestation, most common symptom of occlusive disease is pulselessness and pain was next. Mass sensation is most commonly complained by patients of aneurysmal disease. 4. CT scan was more important in diagnosis of aneurysmal diseases and angiogram was more commonly used in occlusive diseases. 5. The common site of arterial occlusion was common iliac artery, femoral artery, aortic bifurcation, and external iliac artery, as its frequency rate. The most commonly affecting portion of aortic aneurysm was abdminal aorta, and descending thoracic aorta and femoral artery were next 6. Preoperative associated diseases were atherosclerosis[41 cases], hypertension[21 cases], valvular heart disease[11 cases], and diabetes mellitus[9 cases], etc, 7. Operative methods in ocllusive diseases were thrombectomy[36.9%], endarterectomy [10.9%], and bypass graft insertion[52.7%]. Among the bypass graft, Y-graft was used in 7 case, straight graft was used in 17 cases, and saphenous venous graft was used in 2 cases. 8. Postoperative complications were developed in 17 cases, and morbidity rate was 36. 9. Eleven patient were died within 1 month after operation, so operative mortality rate was 13.3%. 10. Duration of patency was beteween 7 and 58 months[average 27.5 months] in occlusive diseases and their 5-year patency rate was 56.3%. Duration of patency of aneurysmal disease was 20 months in aveage and their 5-year patency rate was 51.3%. 11. Patients of eleven cases of occlusive disease and two cases of aneurysmal disease required reoperation for variable reason. 12. 35 cases of patient have used anticoagulants: coumadin, ticlid, and persanthin-ASA combination.

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Post-Traumatic Avascular Necrosis of the Talus Treated by Vascular Pedicle Graft using Lateral Tarsal Artery (혈관경 이식술을 이용한 거골의 외상성 무혈성 괴사의 치료 - 2례의 예비보고 -)

  • Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Kee-Haeng;Choi, Moon-Gu;Kim, Yoon-Soo;Ko, Lak-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.50-55
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    • 1999
  • Avascular necrosis is a significant late complication of talar neck fracture. However, treatment for early stage avascular necrosis has been not established. Two patients with post-traumatic avascular necrosis of talus treated with vascular pedicle graft using lateral tarsal artery were reviewed to determine the efficacy of procedure. The procedure involved grafting the lateral tarsal artery and vein into a hole made in the talus through a anterolateral approach. Follow-up was 12 and 24 months respectively. Two patients had significant pain relief, improved function, no worsening of their radiologic staging. The results are promising enough to recommend consideration of this procedure in early stages of avascular necrosis.

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Epidermoid Tumors in the Cerebellopontine Angle Presenting with Trigeminal Neuralgia

  • Son, Dong-Wuk;Choi, Chang-Hwa;Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.271-277
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    • 2010
  • Objective : The purpose of this study is to evaluate the clinical characteristics and surgical outcome of cerebellopontine angle (CPA) epidermoids presenting with trigeminal neuralgia. Methods : Between 1996 and 2004, 10 patients with typical symptoms of trigeminal neuralgia were found to have cerebellopontine angle epidermoids and treated surgically at our hospital. We retrospectively analyzed the clinico-radiological records of the patients. Results : Total resection was done in 6 patients (60%). Surgical removal of tumor and microvascular decompression of the trigeminal nerve were performed simultaneously in one case. One patient died due to postoperative aseptic meningitis. The others showed total relief from pain. During follow-up, no patients experienced recurrence of their trigeminal neuralgia (TN). Conclusion : The clinical features of TN from CPA epidermoids are characterized by symptom onset at a younger age compared to TN from vascular causes. In addition to removal of the tumor, the possibility of vascular compression at the root entry zone of the trigeminal nerve should be kept in mind. If it exists, a microvascular decompression (MVD) should be performed. Recurrence of tumor is rare in both total and subtotal removal cases, but long-term follow-up is required.

Expression of vascular endothelial growth factor in oral squamous cell carcinoma

  • Kim, Seok-Kon;Park, Seung-Goo;Kim, Kyung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.1
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    • pp.11-18
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    • 2015
  • Objectives: The goal of this study was to determine the correlation of clinicopathological factors and the up-regulation of vascular endothelial growth factor (VEGF) expression in oral squamous cell carcinoma. Materials and Methods: Immunohistochemical staining of VEGF and quantitative real-time polymerase chain reaction (RT-PCR) of VEGF mRNA were performed in 20 specimens from 20 patients with oral squamous cell carcinoma and another 20 specimens from 20 patients with carcinoma in situ as a controlled group. Results: The results were as follows: 1) In immunohistochemical study of poorly differentiated and invasive oral squamous cell carcinoma, high-level staining of VEGF was observed. Significant correlation was observed between immunohistochemical VEGF expression and histologic differentiation, tumor size of specimens (Pearson correlation analysis, significance r>0.6, P<0.05). 2) In VEGF quantitative RT-PCR analysis, progressive cancer showed more VEGF expression than carcinoma in situ. Paired-samples analysis determined the difference of VEGF mRNA expression level between cancer tissue and carcinoma in situ tissue, between T1 and T2-4 (Student's t-test, P<0.05). Conclusion: These findings suggest that up-regulation of VEGF may play a role in the angiogenesis and progression of oral squamous cell carcinoma.

Retrospective Study of Facial Nerve Block with O'Brien Method for Facial Spasm (안면경련 환자에서 O'Brien법을 이용한 안면신경 차단의 추적조사)

  • Kim, Chan;Kim, Sung-Mo;Lee, Hyo-Keun;Kim, Seung-Hie;Kim, Jeong-Ho;Kim, Boo-Seong
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.16-20
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    • 1997
  • Background : Hemifacial spasm commonly occurs on muscles about the eye, but may also involve or spread to the entire side of the face. There are many treatment for facial spasm, such as neuro-vascular decompression, local injection of Botulium toxin, facial nerve block at stylomastoid foramen, facial nerve block with O'Brien method. The present study was aimed to investigate the effects of facial nerve block with O'Brien method. Methods : Forty five patients with hemifacial spasm were treated by facial nerve block with O'Brien method from January 1996 to February 1997 We reviewed the charts, retrospectively. Results : Sex ratio was 1:1.7(17 male : 28 female patients). Most patients were 40~60 years old. Most patients well tolerated facial nerve block. Three patients failed to respond to the facial nerve block. We repeated the procedure within one week. Among the 45 patients who received nerve block, 35 received repeated block; 7 patients received second repeat block, 2 patients received third repeat block. After successful nerve block, all patients were free of spasm for 1 to 6 months. Average spasm-free period was 3.5 months. Conclusion : Although the spasm-free period was short, these results suggest facial nerve block with O'Brien method is a safe and comfortable method for treatment of facial spasm.

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