Determining successful pain clinic treatment through validation of cost effectiveness.

Initially, the Center for Pain Control designed and implemented multiple measures to indicate treatment efficacy in an outpatient setting. Decreased use of medical care at 1 year after treatment was one of five measures used. Economic concerns, both in the health and the insurance industries, mandated greater emphasis on cost effectiveness at a primary success determinate.

Coincidental multiple asymptomatic intracranial aneurysms and symptomatic carotid stenosis.

A patient experiencing transient cerebral ischemic attacks (TIAs) was studied angiographically and found to have a symptomatic stenosis of the appropriate internal carotid artery (ICA) and three asymptomatic intracranial aneurysms. A therapeutic approach to this type of problem is discussed in this article.