As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndrome...As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndromes mainly caused by dysfunction of the upper cervical spine and its component muscles,ligaments,bony,vertebral arteries and/or soft tissue elements,usually not accompanied by neck pain.Therefore,the treatment strategy of CH focuses on pain relief and repair cervical lesions.Patients with painful disorders of upper cervical zygapophysial joints showed significant headache relief after directly treated at disordered cervical joints[1].展开更多
Background and Purpose: Headache is one of the most common side effects of electroconvulsive therapy (ECT), with a reported prevalence as high as 45%. Typical pharmacologic measures include aspirin, acetaminophen, or ...Background and Purpose: Headache is one of the most common side effects of electroconvulsive therapy (ECT), with a reported prevalence as high as 45%. Typical pharmacologic measures include aspirin, acetaminophen, or nonsteroidal anti-inflammatory medications. Among the latter, ketorolac may be especially advantageous in that it can be administered intravenously right before a treatment. The primary aim of this study was to measure the efficacy of intravenous ketorolac administration for the prevention of post-ECT headache at the first treatment session. Methods: Sixteen patients were assigned to the control group, while eight patients were assigned to the ketorolac treatment group (8 males, 16 females;mean age ± standard deviation = 46 ± 13.5 years). Statistical analysis consisted of a one-way analysis of variance using the two-sample test. We utilized a post-ECT headache severity scale from zero (no headache) to 3 (severe headache). Results:The mean score for the control group was 1.3 (±1.1), while the mean score for the ketorolac treatment group was 1.2 (±1.1), p = 0.86 (not significant). Conclusions: Ketorolac administration does not decrease the incidence of post ECT headache at the first treatment session. It is possible that ketorolac may be effective at subsequent treatments for patients with particularly bothersome headaches after the first treatment. Implications: Ketorolac should not be routinely used at the first treatment session to prevent headache associated with ECT.展开更多
Objective:To assess the clinical efficacy and safety of three-step acupuncture and cupping therapy for cervicogenic headache(CEH).Methods:A randomized,single-blind,multi-center,parallel controlled clinical trial was p...Objective:To assess the clinical efficacy and safety of three-step acupuncture and cupping therapy for cervicogenic headache(CEH).Methods:A randomized,single-blind,multi-center,parallel controlled clinical trial was performed,including 63 patients with CEH who met the study criteria.They were randomly divided into treatment(n=32)and control groups(n=31).The treatment group was treated with three-step acupuncture and cupping therapy,and the control group was treated with sham acupuncture.The simplified McGill pain scores,comprising three parts:the pain rating index,visual analogue scale score,and present pain intensity,alongside head and neck stiffness and cervical vertebra range of motion,and a safety evaluation were recorded in the two groups before treatment,immediately after the first treatment,after 10 days of treatment,after 20 days of treatment,and 3 months after the end of treatment.Results:Compared with before treatment,the scores at each follow-up time point were significantly improved after treatment;moreover,the treatment group was significantly better than the control group.When the scores at the 3 months follow-up after the end of the treatment were compared with the scores after 20 days of treatment,there were no significant differences in the treatment group while significant differences from the scores of the control group,suggesting that the treatment group had better long-term benefits than the control group.Conclusion:Compared with the sham acupuncture group,the three-step acupuncture and cupping method has a beneficial effect in the treatment of CEH.It provides rapid benefits,has better short-and long-term efficacy than sham acupuncture,and is associated with a low recurrence rate.展开更多
This article introduces the writers’ experience in treating 100 cases of headache bymainly needling Fengchi (GB 20) and Taichong (LR 3). It is considered in TCM that headache ismostly caused by pathogenic wind, and t...This article introduces the writers’ experience in treating 100 cases of headache bymainly needling Fengchi (GB 20) and Taichong (LR 3). It is considered in TCM that headache ismostly caused by pathogenic wind, and there is a saying of "no wind, no headache". The combinationof the two points can expel both endogenous and exogenous wind. So we treat headache mainly withneedling Fengchi and Taichong. The result is good, especially for cluster headache and psychicheadache.’展开更多
Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be fa...Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be familiar with a novel treatment option. Background: Post-dural puncture headache is the most common serious complication resulting from lumbar puncture and epidural or spinal anesthetics. The syndrome is characterized by severe headache that occurs within 48 hours following the puncture, located in the frontal and/or occipital region, worsened in the upright position and refractory to routine analgesia. The syndrome incidence was reported to be approximately 1% with typical obstetric anesthesiology practice which reflects more than 20,000 cases per 2014 in the US. Two possible mechanisms are hypothesized as responsible for this syndrome;cerebrospinal fluid leakage and pneumocephalus. Multiple methods of treatment have been applied with wide-ranging results. Design or Methods: Review article with introduction of a novel treatment option. Results: We postulate that Hyperbaric Oxygen Therapy can be used to treat post-dural puncture headache. The rationale for treatment is dual: enhancement of fibroblast proliferation at the site of dural puncture to facilitate faster closure of the tear and compression of air bubbles in case of pneumocephalus according to Boyle’s law. We also claim that hyperbaric oxygen therapy should be considered a prophylactic treatment, if a dural tear is suspected.展开更多
Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing t...Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine-like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.展开更多
目的观察头穴扬刺为主治疗频发性紧张型头痛的临床疗效。方法将66例频发性紧张型头痛患者随机分为观察组(33例)和对照组(33例),两组均脱落2例,最终纳入每组31例。观察组予头穴扬刺为主联合常规针刺治疗,对照组予常规针刺治疗。观察两组...目的观察头穴扬刺为主治疗频发性紧张型头痛的临床疗效。方法将66例频发性紧张型头痛患者随机分为观察组(33例)和对照组(33例),两组均脱落2例,最终纳入每组31例。观察组予头穴扬刺为主联合常规针刺治疗,对照组予常规针刺治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、头痛频率、持续时间、头痛指数、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分和生存质量测定量表简表(World Health Organization quality of life brief,WHOQOL-BREF)评分以及双侧大脑前动脉(anterior communicating artery,ACA)、大脑中动脉(middle cerebral artery,MCA)和大脑后动脉(posterior cerebral artery,PCA)血流速度的变化,比较两组临床疗效和复发情况。结果治疗后和治疗后3个月随访时,两组疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分均降低(P<0.05),WHOQOL-BREF评分均升高(P<0.05),两侧ACA、MCA和PCA血流速度均下降(P<0.05)。观察组治疗后和治疗后3个月随访时疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分低于对照组(P<0.05),WHOQOL-BREF评分高于对照组(P<0.05),两侧ACA、MCA和PCA血流速度低于对照组(P<0.05)。观察组总有效率为90.3%,优于对照组的77.4%(P<0.05)。观察组复发率低于对照组(P<0.05)。结论在常规针刺治疗基础上,头穴扬刺为主治疗可提高频发性紧张型头痛的临床疗效,可进一步降低脑血流速度,减轻头痛程度,减少疼痛持续时间和发作频率,缓解焦虑和抑郁状态,提高患者生活质量,降低复发率。展开更多
文摘As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndromes mainly caused by dysfunction of the upper cervical spine and its component muscles,ligaments,bony,vertebral arteries and/or soft tissue elements,usually not accompanied by neck pain.Therefore,the treatment strategy of CH focuses on pain relief and repair cervical lesions.Patients with painful disorders of upper cervical zygapophysial joints showed significant headache relief after directly treated at disordered cervical joints[1].
文摘Background and Purpose: Headache is one of the most common side effects of electroconvulsive therapy (ECT), with a reported prevalence as high as 45%. Typical pharmacologic measures include aspirin, acetaminophen, or nonsteroidal anti-inflammatory medications. Among the latter, ketorolac may be especially advantageous in that it can be administered intravenously right before a treatment. The primary aim of this study was to measure the efficacy of intravenous ketorolac administration for the prevention of post-ECT headache at the first treatment session. Methods: Sixteen patients were assigned to the control group, while eight patients were assigned to the ketorolac treatment group (8 males, 16 females;mean age ± standard deviation = 46 ± 13.5 years). Statistical analysis consisted of a one-way analysis of variance using the two-sample test. We utilized a post-ECT headache severity scale from zero (no headache) to 3 (severe headache). Results:The mean score for the control group was 1.3 (±1.1), while the mean score for the ketorolac treatment group was 1.2 (±1.1), p = 0.86 (not significant). Conclusions: Ketorolac administration does not decrease the incidence of post ECT headache at the first treatment session. It is possible that ketorolac may be effective at subsequent treatments for patients with particularly bothersome headaches after the first treatment. Implications: Ketorolac should not be routinely used at the first treatment session to prevent headache associated with ECT.
文摘Objective:To assess the clinical efficacy and safety of three-step acupuncture and cupping therapy for cervicogenic headache(CEH).Methods:A randomized,single-blind,multi-center,parallel controlled clinical trial was performed,including 63 patients with CEH who met the study criteria.They were randomly divided into treatment(n=32)and control groups(n=31).The treatment group was treated with three-step acupuncture and cupping therapy,and the control group was treated with sham acupuncture.The simplified McGill pain scores,comprising three parts:the pain rating index,visual analogue scale score,and present pain intensity,alongside head and neck stiffness and cervical vertebra range of motion,and a safety evaluation were recorded in the two groups before treatment,immediately after the first treatment,after 10 days of treatment,after 20 days of treatment,and 3 months after the end of treatment.Results:Compared with before treatment,the scores at each follow-up time point were significantly improved after treatment;moreover,the treatment group was significantly better than the control group.When the scores at the 3 months follow-up after the end of the treatment were compared with the scores after 20 days of treatment,there were no significant differences in the treatment group while significant differences from the scores of the control group,suggesting that the treatment group had better long-term benefits than the control group.Conclusion:Compared with the sham acupuncture group,the three-step acupuncture and cupping method has a beneficial effect in the treatment of CEH.It provides rapid benefits,has better short-and long-term efficacy than sham acupuncture,and is associated with a low recurrence rate.
文摘This article introduces the writers’ experience in treating 100 cases of headache bymainly needling Fengchi (GB 20) and Taichong (LR 3). It is considered in TCM that headache ismostly caused by pathogenic wind, and there is a saying of "no wind, no headache". The combinationof the two points can expel both endogenous and exogenous wind. So we treat headache mainly withneedling Fengchi and Taichong. The result is good, especially for cluster headache and psychicheadache.’
文摘Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be familiar with a novel treatment option. Background: Post-dural puncture headache is the most common serious complication resulting from lumbar puncture and epidural or spinal anesthetics. The syndrome is characterized by severe headache that occurs within 48 hours following the puncture, located in the frontal and/or occipital region, worsened in the upright position and refractory to routine analgesia. The syndrome incidence was reported to be approximately 1% with typical obstetric anesthesiology practice which reflects more than 20,000 cases per 2014 in the US. Two possible mechanisms are hypothesized as responsible for this syndrome;cerebrospinal fluid leakage and pneumocephalus. Multiple methods of treatment have been applied with wide-ranging results. Design or Methods: Review article with introduction of a novel treatment option. Results: We postulate that Hyperbaric Oxygen Therapy can be used to treat post-dural puncture headache. The rationale for treatment is dual: enhancement of fibroblast proliferation at the site of dural puncture to facilitate faster closure of the tear and compression of air bubbles in case of pneumocephalus according to Boyle’s law. We also claim that hyperbaric oxygen therapy should be considered a prophylactic treatment, if a dural tear is suspected.
文摘Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine-like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.
文摘目的观察头穴扬刺为主治疗频发性紧张型头痛的临床疗效。方法将66例频发性紧张型头痛患者随机分为观察组(33例)和对照组(33例),两组均脱落2例,最终纳入每组31例。观察组予头穴扬刺为主联合常规针刺治疗,对照组予常规针刺治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、头痛频率、持续时间、头痛指数、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分和生存质量测定量表简表(World Health Organization quality of life brief,WHOQOL-BREF)评分以及双侧大脑前动脉(anterior communicating artery,ACA)、大脑中动脉(middle cerebral artery,MCA)和大脑后动脉(posterior cerebral artery,PCA)血流速度的变化,比较两组临床疗效和复发情况。结果治疗后和治疗后3个月随访时,两组疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分均降低(P<0.05),WHOQOL-BREF评分均升高(P<0.05),两侧ACA、MCA和PCA血流速度均下降(P<0.05)。观察组治疗后和治疗后3个月随访时疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分低于对照组(P<0.05),WHOQOL-BREF评分高于对照组(P<0.05),两侧ACA、MCA和PCA血流速度低于对照组(P<0.05)。观察组总有效率为90.3%,优于对照组的77.4%(P<0.05)。观察组复发率低于对照组(P<0.05)。结论在常规针刺治疗基础上,头穴扬刺为主治疗可提高频发性紧张型头痛的临床疗效,可进一步降低脑血流速度,减轻头痛程度,减少疼痛持续时间和发作频率,缓解焦虑和抑郁状态,提高患者生活质量,降低复发率。
