Background: Insertion of an external ventricular drain (EVD) is an important neurosurgical technique. There is a minor risk of misplacement, and complications including infections or hemorrhages have been reported. Tr...Background: Insertion of an external ventricular drain (EVD) is an important neurosurgical technique. There is a minor risk of misplacement, and complications including infections or hemorrhages have been reported. Transient neurological complications are, however, very rare, especially when EVD is placed under endoscope assistance. We report a case of unilateral transient oculomotor palsy after an EVD procedure. Case presentation: An 11-year-old boy with past medical history of moyamoya disease suffered from intraventricular hemorrhage and acute hydrocephalus. Insertion of EVD and hematoma removal was performed with endoscope assistance. After the surgery, transient oculomotor palsy occurred by the direct compression of the brain stem by the drainage tube. Conclusion: Transient unilateral oculomotor palsy due to the direct compression of the midbrain by an EVD tube is a very rare, but possible complication, even under endoscopic assistance. Attention through the procedure is required until skin closure to avoid tube dislocation.展开更多
The pathophysiology of migraines has been commonly explained by the trigeminovascular theory, although recent studies have suggested that the cause of migraines stems from cortical hyperexcitability. The aim of this s...The pathophysiology of migraines has been commonly explained by the trigeminovascular theory, although recent studies have suggested that the cause of migraines stems from cortical hyperexcitability. The aim of this study was to demonstrate the effectiveness of antiepileptic drugs for treating patients with cephalic hypersensitivity symptoms in Japan. In this study, we assessed the （1） demographics; （2） medical history; （3） treatment status and （4） electroencephalograms of the subjects. This study was performed after approval by the ethics committee at Tokyo Women＇s Medical University. We examined the electroencephalograms of 1,616 patients experiencing daily headaches accompanied by dizziness and cephalic ringing. Of these patients, approximately 80% had migraine without aura, and were asymptomatic before migraine onset. In addition, we measured the effects, dosages, and treatment durations of anti-epileptic drugs commonly prescribed as migraine prophylactics in 172 patients （age ~ standard deviation： 55.8 ~ 14.3 years） with cephalic hypersensitivity symptoms. Our results suggested that the electroencephalogram abnormalities related to cephalic hypersensitivity symptoms were associated with age and photophobia. Anti-epileptic drugs for cephalic hypersensitivity symptoms may be effective for reducing cerebral hypersensitivity. Statistics show that the drugs were markedly effective in about 28% of patients, moderately effective in 52% of patients, and not effective in 20% of patients. Our study suggests that erroneous migraine treatment methods from childhood may exacerbate hypersensitivity of the brain leading to the development of dizziness, tinnitus, or cephalic ringing, and shows that anti-epileptics are effective for treating this condition.展开更多
文摘Background: Insertion of an external ventricular drain (EVD) is an important neurosurgical technique. There is a minor risk of misplacement, and complications including infections or hemorrhages have been reported. Transient neurological complications are, however, very rare, especially when EVD is placed under endoscope assistance. We report a case of unilateral transient oculomotor palsy after an EVD procedure. Case presentation: An 11-year-old boy with past medical history of moyamoya disease suffered from intraventricular hemorrhage and acute hydrocephalus. Insertion of EVD and hematoma removal was performed with endoscope assistance. After the surgery, transient oculomotor palsy occurred by the direct compression of the brain stem by the drainage tube. Conclusion: Transient unilateral oculomotor palsy due to the direct compression of the midbrain by an EVD tube is a very rare, but possible complication, even under endoscopic assistance. Attention through the procedure is required until skin closure to avoid tube dislocation.
文摘The pathophysiology of migraines has been commonly explained by the trigeminovascular theory, although recent studies have suggested that the cause of migraines stems from cortical hyperexcitability. The aim of this study was to demonstrate the effectiveness of antiepileptic drugs for treating patients with cephalic hypersensitivity symptoms in Japan. In this study, we assessed the （1） demographics; （2） medical history; （3） treatment status and （4） electroencephalograms of the subjects. This study was performed after approval by the ethics committee at Tokyo Women＇s Medical University. We examined the electroencephalograms of 1,616 patients experiencing daily headaches accompanied by dizziness and cephalic ringing. Of these patients, approximately 80% had migraine without aura, and were asymptomatic before migraine onset. In addition, we measured the effects, dosages, and treatment durations of anti-epileptic drugs commonly prescribed as migraine prophylactics in 172 patients （age ~ standard deviation： 55.8 ~ 14.3 years） with cephalic hypersensitivity symptoms. Our results suggested that the electroencephalogram abnormalities related to cephalic hypersensitivity symptoms were associated with age and photophobia. Anti-epileptic drugs for cephalic hypersensitivity symptoms may be effective for reducing cerebral hypersensitivity. Statistics show that the drugs were markedly effective in about 28% of patients, moderately effective in 52% of patients, and not effective in 20% of patients. Our study suggests that erroneous migraine treatment methods from childhood may exacerbate hypersensitivity of the brain leading to the development of dizziness, tinnitus, or cephalic ringing, and shows that anti-epileptics are effective for treating this condition.
