Publications by authors named "Emil Smilkov"
Background: Spontaneous intracranial hypotension (SIH) is a rare secondary headache disorder caused by spinal leakage of cerebrospinal fluid. Specialized treatment of SIH consists of epidural blood patches (EBPs), fibrin patching, endovascular sealing, and surgery. The aim of this paper was to characterize SIH patients identified at a tertiary headache center.
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- Treatment options for trigeminal neuralgia in multiple sclerosis patients, including surgery, show limited effectiveness and high complication risks, prompting the need for assessment of outcomes and complications related to neurosurgery.
- A study from 2012 to 2019 analyzed 18 patients who underwent various surgical procedures, finding that percutaneous methods yielded better outcomes and lower complication rates compared to microvascular decompression.
- The results suggest percutaneous procedures are generally more suitable for most patients with trigeminal neuralgia due to multiple sclerosis, whereas microvascular decompression should be reserved for specific cases with certain anatomical features.
Article Synopsis
- Trigeminal neuralgia (TN) is a painful facial disorder, and microvascular decompression (MVD) is the preferred surgical treatment, yet there are limited studies assessing its efficacy and complications.
- In a study involving 115 TN patients, 86% experienced significant improvement, with better outcomes for men and those showing neurovascular contact on MRI; however, women had a higher rate of failed outcomes.
- Common major complications included hearing impairment, severe numbness, ataxia, and stroke, but the majority of patients (94%) still recommended the surgery due to its effectiveness.
Spontaneous intracranial hypotension is a rare condition, but due to increased awareness and better diagnostics it is more frequently reported. This is a case report of a 52-year-old male with sudden onset of vertigo and orthostatic headache. Initial workup was negative, but over the following six months symptoms progressed and bilateral hygromas were identified.
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- Fosphenytoin is commonly used to treat acute trigeminal neuralgia exacerbations but lacks extensive research; this study evaluates its effectiveness and side effects.
- In a 90-day observational study with 15 patients, 60% showed a significant pain reduction within 24 hours of treatment, with a notable decrease on the pain scale.
- While effective, the treatment can cause side effects like hypotension and dizziness, and should be administered carefully, considering other health conditions and treatment options with expert input.
A 63-year-old woman presented with headache, progressive somnolence, neurocognitive decline and urinary incontinence through a year. Medical history was unremarkable except for hypertension and hypercholesterolaemia. Neurological examination was normal.
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- The study investigates the causes of trigeminal neuralgia in patients with multiple sclerosis, focusing on the role of neurovascular contact and changes in morphology.
- Researchers examined 63 patients at a Danish Headache Center using MRI technology, finding low rates of neurovascular contact on both sides of the face.
- The results indicate that demyelination along the trigeminal pathways is the main contributor to symptoms, suggesting that conventional treatments like microvascular decompression may not be effective for these patients.