Erosion of the inferior epigastric artery: a rare complication of intrathecal drug delivery systems.

Intrathecal baclofen is an invaluable therapeutic modality in the management of severe spasticity, especially in patients with cerebral palsy, multiple sclerosis, and spinal cord and brain injuries. This case report presents a rare complication of long-term intrathecal infusion with the development of a huge anterior abdominal wall hematoma with extension to the retroperitoneal space as a result of a repeated blunt trauma to the site of the intrathecal pump with erosion of the inferior epigastric artery. This inferior epigastric artery erosion could be avoided by implanting the intrathecal pump laterally away from the rectus abdominus muscle sheath.

Epidural infusion of opiates and local anesthetics for Complex Regional Pain Syndrome.

Complex Regional Pain Syndrome Type-I (CRPS-I) is a neuropathic pain syndrome resulting from complex pain mechanisms that involve several levels and components of the nervous system. CRPS-I consists of multiple signs, including autonomic dysfunction, in the form of edema, vasomotor changes, motor dysfunctions, muscle spasms, tremors and dystonia, as well as burning pain, hypersensitivity and allodynia that could present in any combination. The treatment is progressive physical therapy rehabilitation program.

Intradiscal thermal annuloplasty versus intradiscal radiofrequency ablation for the treatment of discogenic pain: a prospective matched control trial.

Objective: Two minimally invasive techniques have been used more recently as a possible treatment for painful internal disk disruption (IDD). Intradiscal thermal annuloplasty (IDTA), known as IDET, has already shown promising results in pain reduction and functional restoration. The second technique, radiofrequency posterior annuloplasty (RFA), is used in many interventional pain practices, although studies on the technique's efficacy are lacking.

Occipital nerve electrical stimulation via the midline approach and subcutaneous surgical leads for treatment of severe occipital neuralgia: a pilot study.

Persistent occipital neuralgia can produce severe headaches that may not be controllable by conservative or surgical approaches. We describe a case series of 6 patients who had chronic headaches over an average of 4.9 yr who underwent occipital nerve electrical stimulation lead implantation using a modified midline approach.

Successful treatment of spontaneous cerebrospinal fluid leak headache with fluoroscopically guided epidural blood patch: a report of four cases.

Spontaneous cerebrospinal fluid (CSF) leak is a rare clinical entity that may result in disabling headaches. It occurs as a result of dural defects, and the initial symptoms resemble those of postdural puncture headache. However, the positional headache can later evolve into a persistent chronic daily headache.

Atrial fibrillation after ondansetron for the prevention and treatment of postoperative nausea and vomiting: a case report.

Purpose: Even though clinical safety has been established in large studies, ondansetron has been reported to cause adverse cardiovascular events. We present a case of atrial fibrillation in association with ondansetron in the postoperative period.

Clinical Features: A 47-yr-old, 81 kg female presented with a benign lump in her left breast for lumpectomy.