• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.89-92
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• 2015

Rheumatoid arthritis (RA) is a chronic inflammatory disease involving multiple joints. The cervical spine is often affected, and cases involving atlantoaxial joint can lead to instability. Anterior atlantoaxial subluxation in RA patients can lead to posterior neck pain or occipital headache because of compression of the C2 ganglion or nerve. Here, we report the successful treatment of a RA patient with occipital radiating headache using pulsed radiofrequency therapy at the C2 dorsal root ganglion.

• 국제물리치료학회지
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• 제9권3호
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• pp.1564-1570
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• 2018

The International Headache Society (IHS) has validated cervicogenic headache (CGH) as a secondary headache type that is hypothesized to originate due to nociception in the cervical area. CGH is a common form of headache and accounts for 15% to 20% of all chronic and recurrent headaches. CGH is commonly treated with manual and exercise therapy. To date, no studies have isolated only one manual intervention in an attempt to determine its effectiveness. In this case study we present a 28-year-old patient with right upper cervical (UC) and occipital pain who responded well to a single manual intervention technique. This technique was applied in isolation for the first three visits and two therapeutic exercises prescribed on the fourth and fifth visit. In total, manual and exercise intervention occurred over 8 visits at which point in time the patient was discharged with no UC motion impairments, an NPRS rating of 0, a NDI and HDI demonstrating a 100% improvement and a 37% improvement in FOTO score. The traction based manual intervention and two therapeutic exercises prescribed for this patient were successful in relieving UC pain and CGH. At six months follow up, the patient was still symptom free.

• Physical Therapy Rehabilitation Science
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• 제11권3호
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• pp.321-328
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• 2022

Objective: The purpose of this study was to investigate the effect of neck stabilization exercise combined with vibroacoustic sound on patients with chronic neck pain and tension-type headache. Design: Two group pre test - post test design. Methods: 36 patients participated. Headache impact test-6(HIT-6), numerical rating scale(NRS) and muscle characteristics were measured at pre-post test. Participants divided into vibroacoustic sound group(VSG, n=18), control group(CG, n=18). VSG performed neck stabilization exercise and vibroacoustic sound stimulation. CG performed neck stabilization exercise. Both groups participated 3 times a week for a total of 4 weeks. Results: NRS showed a significant difference before and after intervention in both groups (p<0.05). HIT-6 showed a significant difference before and after intervention in the VSG group (p<0.05). Muscle tone showed a significant difference before and after intervention in the experimental group (p<0.05). There was no significant difference in muscle stiffness and muscle elasticity before and after the intervention in both groups (p>0.05). Conclusions: Based on the results of the study, it is thought that sonic vibroacoustic sound can be established as an effective treatment tool through a study applied to various diseases and symptoms.

• 근관절건강학회지
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• 제4권2호
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• pp.163-176
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• 1997

Chronic fatigue syndrome Is a syndrome of unknown etiology and pathophysiology characterized by severe, chronic, debilitating fatigue as main symptom and numerous additional symptoms such as joint and muscle pain, headache, sleep disturbance. According to recent researches, it was suggested that chronic fatigue syndrome was developed by disturbance of interaction between neuropsychiatric system and immune system due to environmental factors and stress. Many patients experience gradual improvement but complete recovery from disorderd state is rare. There was no research elucidating the exact pathogenetic mechanism of chronic fatigue syndrome, so there was no established treatment. Several controlled studies about treatment was reported, but its results was not effective in all patients with chronic fatigue syndrome. For chronic fatigue syndrome, a comprehensive approach to physical, psychological, and social aspects is needed.

• Journal of Korean Neurosurgical Society
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• 제55권2호
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• pp.89-91
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• 2014

Chronic encapsulated intracerebral hematoma (CEIH) is a rare cerebrovascular disease that behaves as a slowly expanding lesion with a gradual onset. It is well established that CEIH is associated with arteriovenous malformations; however, CEIH associated with cavernous malformation (CM) is extremely rare. We herein report a case of CEIH associated with CM, and discuss its pathogenesis. A 12-year-old female was admitted to our hospital because of a one week history of progressive headache and nausea. Brain computed tomography scan and magnetic resonance imaging showed an intracerebral hematoma surrounded by edema in the right frontal lobe. One week later, her headache and nausea worsened, and a brain computed tomography scan revealed the enlargement of hematoma. A right frontal craniotomy was performed. The capsule, mass, and hematoma were totally removed. Histological examination confirmed the diagnosis of CEIH associated with CM. Immunohistochemical analysis revealed increased expression of vascular endothelial growth factor (VEGF) and the VEGF receptor-1 in the endothelium and fibroblasts. Our findings suggest that the activated VEGF pathway might have positively contributed to development of CEIH in the present patient.

• Journal of Oral Medicine and Pain
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• 제35권2호
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• pp.123-133
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• 2010

6개월간 경희대학교 치과병원 구강내과에 내원한 환자 중 두개주변압통과 관련된 긴장성 두통으로 진단된 총 48명(남자 11명, 여자 37명)과 측두하악장애에 기인한 두통으로 진단된 총 37명(남자 4명, 여자 33명)을 대상으로 하여 특징적 통증강도, 기능 제한 점수, 만성통증척도, 우울증 정도, 비특이적 신체 증상 등급, 하악기능과 관련된 기능제한에 대한 설문지(RDC/TMD Axis II한글판)를 통한 조사 후 다음과 같은 성적을 얻었다. 1. 특징적 통증 강도는 두개주변압통과 관련된 긴장성 두통 군에서 평균 49.937, 측두하악장애에 기인한 두통 군에서 평균 55.577를 나타냈으나 통계적으로 유의미한 차이는 없었다. 2. 기능 제한 점수는 두개주변압통과 관련된 긴장성 두통 군에서 평균 1.77, 측두하악장애에 기인한 두통 군에서 평균 2.32를 나타냈으나 통계적으로 유의미한 차이는 없었다. 3. 만성통증척도는 두개주변압통과 관련된 긴장성 두통 군에서 평균 2.02, 측두하악장애에 기인한 두통 군에서 평균 2.41를 나타냈으나 통계적으로 유의미한 차이는 없었다. 4. 우울증 정도는 두개주변압통과 관련된 긴장성 두통 군에서 평균 1.150, 측두하악장애에 기인한 두통 군에서 평균 1.049를 나타냈으나 통계적으로 유의미한 차이는 없었다. 5. 통증포함 비특이적 신체 증상 등급은 두개주변압통과 관련된 긴장성 두통 군에서 평균 1.117, 측두하악장애에 기인한 두통 군에서 평균 1.095를 나타냈으나 통계적으로 유의미한 차이는 없었다. 6. 통증비포함 비특이적 신체 증상 등급은 두개주변압통과 관련된 긴장성 두통 군에서 평균 0.939, 측두하악장애에 기인한 두통 군에서 평균 0.946을 나타냈으나 통계적으로 유의미한 차이는 없었다. 7. 하악기능과 관련된 기능제한은 두개주변압통과 관련된 긴장성 두통 군에서 평균 0.377, 측두하악장애에 기인한 두통 군에서 평균 0.387을 나타냈으나 통계적으로 유의미한 차이는 없었다. 두개주변압통과 관련된 긴장성 두통군과 측두하악장애에 기인한 두통군의 비교시 집단에 따른 척도점수의 평균에는 두 집단 사이에는 통계적으로 유사함이 관찰되었다. 이는 두개주변압통과 관련된 긴장성 두통과 측두하악장애에 기인한 두통이 임상적으로 유사한 축 II (Axis II)양상을 보인다는 것을 의미하며, 긴장성 두통의 일부분은 측두하악장애와 관련이 있다고 추론된다. 향후 긴장성 두통 진단시 측두하악장애에 대한 접근이 요구된다고 하겠다.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.215-221
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• 2020

Objective: Tension-type headaches usually occur with temporomandibular disorder, which increases the risk of the chronic tension-type headaches. This study was conducted to investigate the effect of additional temporalmandibular therapy compared to cerivcal joint therapy for tension-type headaches with pericranial tenderness. Design: Randomized controlled trial. Methods: Forty-one patients with chronic tension-type headaches and pericranial tenderness were randomized into the 3 groups, such as the temporomandibular joint therapy group (TMJT group, n=14), cervical manual therapy group (CMT group, n=14) and conservative therapy group (CT group, n=13). All patients were assessed at baseline and after each intervention during the three sessions. The participants in the TMJT group received the temporomadibular joint treatment and cervical manual therapy for 30 minutes, once a week, for 3 weeks. The participants in the CMT group received the cervical manual therapy, and those in the CT group received modalities during same time period. The outcome measurements used were the intensity of headaches measured on the Visual Analogue Scale (VAS), quality of life measured with the Headache Impact Test (HIT-6), and function of the cervical spine using the Neck Diability Index (NDI). Results: The TMJT group that received temporomandibular joint treatment and cervical manual therapy showed a significant decrease in VAS, HIT-6, and NDI compared with the other 2 groups (p<0.05). Conclusions: This study suggected that temporomandibular joint treatment combined with cervical manual therapy was more effective for the chronic tension-type headaches with pericranial tenderness than the usual cervical therapy alone.

• The Korean Journal of Pain
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• 제33권3호
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• pp.275-283
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• 2020

Background: Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. Methods: The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson's coefficient. Results: The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the P < 0.001), while the ADC values were significantly higher (P = 0.003, P < 0.001, and P = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 (P < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = -0.420, P = 0.037 and r = 0.531, P = 0.006, respectively) was found. Conclusions: DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.

• 대한한의학회지
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• 제31권5호
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• pp.41-59
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• 2010

Objective: Headache is one of the most common symptoms in primary medical care. The purpose of this study was to support medical treatment by consideration of a new CTTH (chronic tension-type headache) oriental medical diagnosis index. Methods: An Oriental medical diagnosis questionnaire was administered to a CTTH group, migraine group and normal group. The result was classified by using LDA, CART, factor diagnosis and tested in comparison with the original diagnosis. Also, weighting method based on expert opinions was done. Results: 1. The result analyzed by using LDA has an accuracy of 93.9% in comparison with the original diagnosis. 2. High accuracy showed when the test was performed with about 35 significant questions and four questions selected based on SPSS Wilks' lambda. 3. There was accuracy of 90.9% when differentiation was performed by using CART compared with original diagnosis. 4. 10 factors has a high initial value after factor analysis, consisting of questions to the similar differentiation. 5. Diagnosis formula of headache was made by using weighting method based on expert opinions. Conclusion: Oriental medical diagnosis questionnaires make it possible to classify headaches significantly. The study about weighting method of CTTH can make it possible to classify symptoms more accurately.

• Journal of Acupuncture Research
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• 제22권3호
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• pp.93-104
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• 2005

2004년 2월말부터 7월말까지 경희의료원 동서 통증센터를 내원한 만성두통환자 92명을 대상으로 8주간 침치료와 침치료에 신경블록요법을 병행 치료하여 다음과 같은 결과를 얻었다. 1. 한방치료군의 경우, VAS 평균수치는 치료 전, 중(4주), 후(8주) 각각 8.50, 5.84, 및 5.50으로 치료 전에 비해 치료 한 달 후부터 유의하게 개선되었다(ANOVA, p<0.05). BPI 점수의 경우 일상생활, 기분, 및 여가생활은 치료 전에 비해 치료 한 달 후부터 유의하게 개선되었으며(p<0.05), 대인관계 및 수면의 경우 치료 전에 비해 치료 두 달부터 유의하게 개선되었다 (p<0.05, Table 2). 2. 동서협진치료군의 경우 VAS 평균수치는 치료 전, 중(4주), 후(8주) 각각 8.26, 4.91, 및 3.60으로 치료 전에 비해 치료 한 달 후부터 유의하게 개선되었다(ANOVA, p<0.05). BPI 점수의 경우 역시 일상생활, 기분, 여가생활, 대인관계, 및 수면 모두 치료 전에 비해 치료 한 달 후부터 유의하게 개선되었다(p<0.05, Table3). 3. 한방치료군과 동서협진치료군 간의 치료 4주와 8주 후의 VAS와 BPI 점수의 변화를 비교 해 보면 치료 4주후는 두 군 간의 차이가 없었으며(p>0.05), 8주 후에는 VAS와 BPI 중 여가생활, 대인관계, 수면에서 EW group이 E group과 비교하여 유의성 있게 개선되었다 (p<0.05, Table 4).