A Case of Postherpetic Itch Effectively Treated With Pulsed Radiofrequency Therapy.

We report a case of a 65-year-old female with postherpetic itch (PHI) over the left chest, who experienced significant relief after pulsed radiofrequency (PRF) therapy. While her initial pain and rash had improved with nerve blocks and medications, she had developed severe itching. PRF therapy significantly reduced the itching, which nearly disappeared.

A Prospective Comparison of CT-Epidurogram Between Th1-Transforaminal Epidural Injection and Th1/2-Parasagittal Interlaminar Epidural Injection for Cervical Upper Limb Pain.

Background: Cervical epidural injections for treating neck and upper limb pain are performed by 2 methods: transforaminal and interlaminar. Many serious complications caused by inadvertent intravascular injection have been reported with the use of cervical transforaminal epidural steroid injection through the anterior-lateral approach. Despite international practical guidelines that have been proposed, cervical transforaminal epidural injection is still less recommended than cervical interlaminar epidural injection.

Transforaminal vs Interlaminar Epidural Steroid Injection for Acute-Phase Shingles: A Randomized, Prospective Trial.

Background: The acute phase of shingles is characterized by severe pain, and one of the complications of shingles known as postherpetic neuralgia (PHN) is associated with prolonged pain. Although factors predicting the development of PHN, as well as its preventative measures, have been investigated, there is no single treatment effective for PHN. Some studies showed effectiveness of epidural injection to alleviate pain associated with acute-phase shingles.

Transforaminal epidural blood patch for intractable spontaneous cerebrospinal fluid leak: a case report.

Background: Epidural blood patch (EBP) is a recognized treatment for spontaneous cerebrospinal fluid leak (SCFL) and is typically administered by the interlaminar approach. Here, we report a case of a patient in whom SCFL failed to resolve after three applications of interlaminar EBPs before finally being successfully treated with transforaminal EBP.

Case Presentation: We report a case of a 41-year-old female with a definitive diagnosis of SCFL according to computed tomography (CT) myelography.

Evaluation on a clinical course of subdural hematoma in patients undergoing epidural blood patch for spontaneous cerebrospinal fluid leak.

Objective: Subdural hematoma (SDH) is a frequent complication of spontaneous intracranial hypotension (SIH), in which epidural blood patch (EBP) may be applied as a treatment to stop cerebrospinal fluid (CSF) leak. However, a clinical course of SDH in SIH patients has not been sufficiently evaluated. We retrospectively evaluated the temporal relationships between EBP and SDH in the patients with SIH.

[Diagnosis and treatment of chronic pain by pain clinicians].

Pain is classified into physical and psychological pain. Physical pain is nociceptive, inflammatory, or neuropathic. Pain can be categorized into acute or chronic pain depending on the duration of pain and mechanism of onset.

Comparison between computed tomography-myelography and radioisotope-cisternography findings in whiplash-associated disorders suspected to be caused by traumatic cerebrospinal fluid leak.

Study Design: A retrospective observational study.

Objective: To investigate the traumatic cerebrospinal fluid (CSF) leak in whiplash-associated disorders (WADs) by comparing radioisotope-cisternography (RIC) and computed tomography (CT)-myelography (CTM) findings.

Summary Of Background Data: WAD has been considered to be caused by traumatic CSF leak and termed as traumatic CSF hypovolemia.

Comparison of computed tomography myelography and radioisotope cisternography to detect cerebrospinal fluid leakage in spontaneous intracranial hypotension.

Study Design: A retrospective observational study.

Objective: To compare the usefulness of radioisotope cisternography (RIC) and computed tomography myelography (CTM) for the detection of cerebrospinal fluid (CSF) leakage in spontaneous intracranial hypotension (SIH).

Summary Of Background Data: CSF leakage sites have been generally identified by RIC in patients with SIH.

Fluoroscopically guided epidural blood patch in patients with postdural puncture headache after spinal and epidural anesthesia.

Postdural puncture headache (PDPH) is one of the major complications after spinal and epidural anesthesia. An epidural blood patch (EBP) may be applied when PDPH persists regardless of conservative treatment. We describe the results of management including fluoroscopically guided EBP in a series of patients with moderate to severe PDPH.

Fluoroscopically guided epidural blood patch with subsequent spinal CT scans in the treatment of spontaneous cerebrospinal fluid hypovolemia.

Object: Recent evidence has indicated that the efficacy of the epidural blood patch (EBP) in the treatment of spontaneous CSF hypovolemia (SCH) is still limited. Therefore, further improvement of the EBP technique is an important clinical challenge. The authors describe a series of cases of SCH treated with fluoroscopically guided placement of an EBP and followed up with subsequent spinal CT scans.

[Case of cerebrospinal fluid hypovolemia possibly due to acceleration of cerebrospinal fluid absorption].

The authors present a case of a 31-year-old man suffering from intractable cerebrospinal fluid hypovolemia (CSFH), in whom autologous epidural blood patch at the cervical, thoracolumbal, and sacral sites was not effective. Repeated radionuclide cisternography reproducibly demonstrated "early accumulation of radioactivity in the bladder", "cystic accumulation of radioactivity at the sacral site" and "less activity than expected over the cerebral convexities"; but computerized tomography myelography did not demonstrate CSF leakage but detected a sacral cyst. These repeated radionuclide cisternography findings suggested unusually rapid uptake of tracer by the circulation but did not always CSF leakage.

Inexpensive phantom for fluoroscopy guided nerve block training*.

Objective: Regional anesthesia simulation manikins with phantom skeletal structures are commercially available. Unfortunately, they are quite expensive. This article introduces our handmade, low cost, phantom for training of nerve block with fluoroscopic guidance.