• Journal of Acupuncture Research
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• 제28권2호
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• pp.165-172
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• 2011

Objectives : The objective of this case report was to observe the effect of musculoskeletal ultrasound-guided acupotomy therapy on posterior headache caused by traffic accident. Methods : Musculoskeletal ultrasound-guided acupotomy therapy was performed to two patients whose brain MRI or CT results were normal, but posterior headache did not improve with general eastern medical treatment. Results : One patient's VAS(visual analogue scale) of posterior headache was decreased for the first time after ultrasound-guided acupotomy therapy, and steadily reduced. The other patient's VAS was also decreased for the first time after musculoskeletal ultrasound-guided acupotomy therapy. Two patient's Korean HIT-6(Korean headache impact test-6) scores were decreased after one month. Conclusions : If general eastern medical treatment had little effect on traffic accident induced posterior headache, musculoskeletal ultrasound-guided acupotomy therapy can be applied.

• The Korean Journal of Pain
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• 제14권2호
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• pp.193-198
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• 2001

Background: Anterior atlantoaxial subluxation (AAS) is a frequent phenomenon in rheumatoid arthritis (RA). AAS compresses the C2 ganglion or nerve and is a cause of posterior neck pain or occipital headache. Methods: We selected RA patients that had developed posterior neck pain or occipital headache caused by AAS. AAS was diagnosed by an increase of ADI (atlantodental interval). A distance of 3 mm or more was considered significant. Patients with vertical subluxation or symptoms suggestive of myelopathy were excluded. Before C2 RF ganglionotomy, we proceeded with a C2 ganglion block or greater occipital nerve block used by local anesthetics. For C2 RF ganglionotomy, the patient was placed in the supine position on a fluoroscopic table. A 100 mm, 4 mm active tip electrode was chosen. Following sensory stimulation at 0.2 to 0.6 V, the lesion was performed at a temperature of $60^{\circ}C$ to $65^{\circ}C$ for 60 sec. We followed up the patient after 6 months later. Results: All cases were female and the average duration of RA was 8.5 years. The duration of posterior neck pain or occipital headache was 1-8 months. The average ADI was 4.2 mm and the McGregor index was 3.3 mm on the average. In all cases, the score on the 4 point Likert scale was 4 (pain free) during the follow-up period. Conclusions: We found that the occipital headache or posterior neck pain caused by AAS in rheumatoid arthritis patients was alleviated over a short term follow up. C2 RF ganglionotomy is suggested as an effective palliative treatment for AAS in RA patients.

• Journal of Oral Medicine and Pain
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• 제17권2호
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• pp.19-25
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• 1992

The pressure pain thresholds of head and neck muscles of patients suffering from tensiontype headache220, all female, ages ranged from 13 to 50 years (28.4$\pm$9.6) and 39 healthy controls, all female, ages ranged from 14 to 46 years (24.4$\pm$9.2) were recorded by the electronic algometer (Electyronic Algometer Type I, Somedic, Stockholm, Sweden). And the obtained results were as follows : 1. The pressure pain thresholds of patient group were lower than those of controls in superior sternocleidomastoid muscle, middle sternocleidomastoid muscle, and trapezius insertion muscle (P<0.001) 2. The pressure pain thresholds of patient group were not different from those of controls in anterior temporal, middle temporal, posterior temporal, deep masseter, anterior masseter, inferior masseter, medial pterygoid, posterior digastric, splenius capitus and upper trapezius muscle (P>0.05). 3. Seventy-one percent of tension-type headache patients had more than one muscle, of whicb pressure pain threshold was lowered significantly (less than mean of control - 1.5SD). 4. The pressure pain thresholds of head and neck muscles should be considered as a criterion for the diagnosis of tension-type headache.

• The Korean Journal of Pain
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• 제6권1호
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• pp.105-108
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• 1993

A myofascial syndrome due to continuous muscle contraction with the trigger point at the upper lateral edge of the nuchal muscles where they attach to the occipital bone is frequently seen in daily pain clinic practice. The Tienchu syndrome is a myofascial condition of the posterior neck region with a trigger point at the Tienchu acupoint(B10). When advanced, occipital neuralgia and muscle contraction headache follow. Therefore, a Tienchu block and/or occipital nerve block with local anesthetic combined with a small dose of steroid is a most effective therapeutic method for many patients who complain of posterior headache or posterior neck pain.

• 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.

• The Korean Journal of Pain
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• 제22권1호
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• pp.88-91
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• 2009

Skull base osteomyelitis is a rare but life-threatening complication of inflammation of the ear. The authors present a case of skull base osteomyelitis of unknown etiology in a non-diabetic patient who presented with unilateral posterior neck and occipital headache mimicking cervicogenic headache.

• The Journal of Korean Physical Therapy
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• 제15권1호
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• pp.196-209
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• 2003

The aim of study was compared with the possible role of cranial artery in headache pathogenesis each 2 group (group I : ultrasound therapy alone, group II : myofascial release therapy alone)- divided each 5 tension- type headache patients. Each group were applied ultrasound therapy for 5 minuets and myofascial release therapy for 15 minuets in occipital portion. The study carried out to determine the effects of ultrasound and myofascial release on the cranial arteries velocity from November 11, 2001 to March 29, 2002 the objects were 10 patients who having the tension-type headache at H-hospital. Transcranial doppler ultrasonograpy(TCD) is new non-invasive applicable method to evaluate flow velocities of intrans cranial and extracranial cerebral arteries. TCD was peformed with standard method to measure the Mean Flow Velocity(MFV) of the middle and posterior cerebral arteries, the vertebral arteries.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.364-366
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• 2015

Supratentorial dermoid cysts are uncommon to develop in the cavernous sinus. We present a ruptured dermoid cyst of the cavernous sinus extending into the posterior fossa. The patient was a 32-year-old female who complained occipital headache, blurred vision, and tinnitus over 4 years. Brain magnetic resonance (MR) imaging revealed an enhanced tumor in the right cavernous sinus extending into the right temporal base and the posterior fossa with findings of ruptured cyst. Surgical resection was performed, and pathological findings were confirmed to be a dermoid cyst. We report a second case with ruptured dermoid cyst of the cavernous sinus extending into the posterior fossa.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.206-209
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• 2006

Objective : Traditionally, standard access to the posterior fossa was a suboccipital craniectomy. After introducing the technique and benefit of posterior fossa craniotomy, several surgeons have used this procedure to manage various pathologies in posterior fossa in children. Though this approach offers several advantages over conventional suboccipital craniectomy, the elevation of bone flap is not easy in adult because of the irregular contour of inner bone surface and tight adhesion of dura to the skull. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks for a safe and quick performance in adult. Methods : We report on our series of twenty-five adult patients who underwent craniotomy for posterior fossa pathologies between 2002 and 2005. The maximal follow-up period was 4 years. Results : None of the patients complained of persistent headache and no CSF leaks have occurred postoperatively. We have encountered only two cases of transient subcutaneous CSF retention after craniotomy. Three-dimensional reconstruction of the CT scan confirmed the well-fitted suboccipital bone contour after craniotomy. And patients were satisfied with the cosmetic results. Conclusion : This method is safer and simpler. It restores normal anatomical planes and improves protection of the contents of the posterior fossa. The authors recommend craniotomy as an alternative method of access to the posterior fossa in all age groups.

• The Korean Journal of Pain
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• 제12권2호
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• pp.231-234
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• 1999

Until several years ago we didn't think seriously about cervical problems as a cause of headaches, but since the publication of articles by Bogduk et al they have gotten more attention. Cervical headaches are associated with movement abnormalities of the structures of the neck such as cervical nerve roots, discs, joints and soft tissues. Considering this, we thought that the atlanto-axial joint could be one of the causes of these headaches. Headaches originating from this joint can be recognized by the fact that the pain worsens with rotation of the head in the horizontal plane. Pain can also be referred to the frontal area or around the orbit. We did atlanto-axial joint blocks using a posterior approach on 10 patients who suffered from this type of headache. The results were promising with 9 out of 10 patients showing more than 50% improvement on the numeric rating scale. There were no serious complications observed. We concluded that the atlanto-axial joint block can be an effective procedure in treating this specific type of headache.