1/3. The cluster-tic syndrome and its surgical therapy.The term cluster-tic syndrome (CTS) is used to designate a clinical pain pattern in which symptoms of cluster headache (CH) and tic douloureux (TD) coexist. The TD elements of the attack occur in paroxysms of many seconds or minutes, always affect the maxillary or mandibular divisions of the trigeminal nerve, with spread into the ophthalmic division in some cases, and may be triggered by slight superficial stimuli. These features may occur independent of CH elements but more often the two blend together. Four patients with CTS unresponsive to medication underwent surgery. blood vessels were found to cross compress the trigeminal nerve in all four patients and the nerve was decompressed. A similar condition was found affecting the facial nerve in two of the three patients in whom that nerve was explored and the facial nerve was decompressed in these two. The TD component of the CTS disappeared after surgery in all four patients. The CH component of the syndrome returned after surgery but in a modified form. In three patients, the CH changed from what had been chronic cluster to infrequent episodic cluster periods; additionally in two patients, the duration of cluster was shorter and the pain was of lesser severity.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/3. The stroke syndrome of long intraluminal clot with incomplete vessel obstruction.A stroke syndrome is described in 3 patients where long intraluminal clot formation with incomplete vessel obstruction was seen angiographically. The vessel involved in 2 cases were carotid arteries and in the third a vertebral artery. The intervening phase of long clot formation may be a feature of many cases of complete vessel occlusion. The common features of the syndrome were vessel tenderness (carotidynia in 2 cases, and vertebral artery tenderness in the third), vascular headache, the presence of subintimal haemorrhage as an anchor point for the clot, and the recurrence of clinical events. Surgical removal of these clots were successfully undertaken in each case at the acute stage.- - - - - - - - - - ranking = 8keywords = vessel (Clic here for more details about this article) |
3/3. cluster headache, hemicrania, and other head pains: morbidity of carotid endarterectomy.Carotid endarterectomy has become a widely used approach to the treatment of cerebrovascular disease. In spite of increasing experience, a significant and varied morbidity remains attached to the procedure. A poorly recognized complication is postoperative headache. In a series of 57 endarterectomies in 50 patients, 24 patients experienced postoperative headaches encompassing the entire spectrum of vascular headaches: nonspecific diffuse headaches, severe hemicranias, cluster headaches occurring early and delayed, chronic paroxysmal hemicranias, carotidynia, and Eagle's syndrome. Five patients had hemicranias, and all were homolateral to the endarterectomy. Therefore, we hypothesize that the spontaneously occurring hemicranias, the counterparts of postsurgical headache syndromes, also may be due to some overt or occult injury or disease of the carotid vessels or carotid sheaths in the regions from the carotid bifurcation to the base of the skull.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |