To estimate the duration of postoperative headache after surgery for acoustic neuroma and the effects of age, sex, tumor size, extent of tumor resection, type of skin incision, surgical duration, hearing preservation, and postoperative facial nerve palsy. This retrospective review analyzed clinical data from 97 patients who had undergone surgery for unilateral acoustic neuroma via the retrosigmoid approach >1 year previously. We investigated whether patients had headache at hospital discharge and during attendance at outpatient clinics. We classified postoperative headache as grade 0 (no headache), 1 (tolerable headache without medication), or 2 (headache requiring medication). The period of headache was defined as the interval in days between surgery and achievement of grade 0. The period of medication for headache was defined as the interval in days between surgery and achievement of grade 0 or 1. Kaplan-Meier analysis revealed median durations of medication and headache of 81 and 641 days, respectively. Headache was cured significantly earlier in patients who underwent surgery using a C-type skin incision (P < 0.001). Headache persisted significantly longer among patients who underwent a shorter surgical procedure (P < 0.02). Multivariate analysis confirmed the type of skin incision as a factor independently associated with duration of postoperative headache. Postoperative headache was cured in the majority of patients within about 2 years after surgery. The C-type skin incision is likely beneficial for reducing the duration of postoperative headache, although headache persisted in a small number of patients.
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http://dx.doi.org/10.2176/nmc.oa.2017-0108 | DOI Listing |
Cureus
December 2024
Neurosurgery, Southmead Hospital, North Bristol NHS, Bristol, GBR.
Cerebral arteriovenous malformations (AVMs) are tangles of abnormal vessels with early arteriovenous (AV) shunting that can lead to intracerebral hemorrhage, seizures, neurologic deficit, or headache. To date, only a few cases of carcinomas metastasizing to pre-existing cerebral AVMs have been reported in the literature. However, renal clear cell carcinoma (RCC) brain metastases that exhibit early AV shunting, where AVM pathology is not present, are extremely rare.
View Article and Find Full Text PDFLancet Gastroenterol Hepatol
January 2025
The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel. Electronic address:
Background: Infliximab and adalimumab are the only biologics thus far approved for paediatric patients with inflammatory bowel disease (IBD), so other biologics, such as vedolizumab, are prescribed off-label. Despite its frequent use, prospective data for vedolizumab treatment in children are available only for short-term induction outcomes. We aimed to evaluate the long-term efficacy and safety of maintenance therapy with vedolizumab in paediatric patients with IBD.
View Article and Find Full Text PDFZhongguo Zhen Jiu
January 2025
Department of Acupuncture and Moxibustion, China-Japan Friendship Hospital, Beijing 100029, China.
Visual minimally invasive acupotomy is applicable for the diseases with the pathological characteristics of soft tissue injury, including disorders of spine, four limbs and joints, peripheral nerve compression and chronic soft tissues. The diseases with superior effect obtained are cervicogenic headache, lumbar disc herniation, carpal tunnel syndrome and flexor tendon stenosing tenosynovitis. Under the guidance with ultrasound, visual minimally invasive acupotomy is advantaged at preoperative diagnosis, intraoperative guidance and postoperative evaluation in clinical practice so that it is precise, safe and reliable in clinical treatment.
View Article and Find Full Text PDFCurr Pain Headache Rep
January 2025
Columbia University Medical Center, New York, NY, USA.
Purpose Of Review: The purpose of this review is to provide the most recent update and summary on the consideration, benefits and application of regional anesthesia in the ICU setting, as it pertains to the management of perioperative pain.
Recent Findings: Regional anesthesia and analgesia have become ubiquitous in the perioperative setting, with numerous indications and benefits. As integral part of the multimodal analgesia approach, various regional blocks have been increasingly utilized in critically ill patients.
Br J Pain
January 2025
Department of Pain Medicine and Neuromodulation, The Walton centre NHS foundation Trust, Liverpool, UK.
Although spinal cord stimulator (SCS) therapy is generally used safely to treat chronic neuropathic pain conditions, this document highlights the less reported complication of unusual neurological problems including headaches. These developed temporally after the initiation of SCS therapy despite initial positive response to pain. The mechanisms might include activation of trigeminal receptors and neuroplasticity after SCS.
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