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Publié par

neurochirurgiechufortdefrance

Publié le

30 janvier 2013

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English

About Headaches and Stimulation Chef de Service de Neurochirurgie CHU FORT DE FRANCE Occipital neuralgia • A . Paroxysmal stabbing pain ,with or without persistent aching between paroxysms , in the distribution(s) of the greater , lesser and/or 3rd occipital nerves . • B . Tenderness over the affected nerve . • C .

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Publié par

neurochirurgiechufortdefrance

Publié le

30 janvier 2013

Nombre de lectures

Langue

English

About Headaches and Stimulation Chef de Service de Neurochirurgie CHU FORT DE FRANCE

Occipital neuralgia

• A . Paroxysmal stabbing pain ,with or without persistent aching between paroxysms , in the distribution(s) of the greater , lesser and/or 3rd occipital nerves . • B . Tenderness over the affected nerve . • C . Pain is eased temporarily by anaesthetic block of the nerve

Cervicogenic headaches

A- pain referred from a source in the neck and perceived in one or more regions of the head or face fulfilling criteria C and D

B-evidence of lesion or disorder of the neck known to be a valid cause of headache C-evidence that the pain can be attributed to the neck disorder

D-pain resolve after successful treatment of the causative lesion

Primary headaches

•Migraine • Tension-type headache • Cluster-headache and other trigeminal autonomic cephalalgias • Other primary headaches

Trigemino –cervical complex

Is defined by its afferents : Trigeminal nerve (face) Upper three cervical nerves (neck ; cerebral posterior fossa )

Is not defined by any distinctive cytoarchitecture or by any intrinsic boundaries

The pars caudalis of the spinal nucleus of the trigeminal nerve is continuous longitudinally with the outer laminae of the dorsal horns of the upper 3 to 4 segments of the cervical spinal cord

Trigemino-vascular system

Around meningeal vessels and veinous sinuses the nervous plexus comes from 1-st branch of trigeminal nucleus with unilateral distribution

Orthodromic conduction ,via the thalamus , to the cortex , is the way ot the conscious sensation of pain

Antidromic activation af amyelinic trigeminal fibers leads to liberation of neuropeptides …..

NEUROGENIC INFLAMMATION

Migraine without aura

A .At least 5 attacks fulfilling criteria B . Headache lasting 4 –72 h(untreated) C . Headache has 2 of the following characteristics 1 ; unilateral location 2 .pulsating quality 3 .moderate or severe pain intensity 4 .aggravation by or causing avoidance of routine physical activity D . During headache 1 of the following : 1 .nausea and:or vomiting 2 .phono and photophobia E . Not attributable to another disorder

Chronic migraine

• A-Headache fulfilling criteria C and D for Migraine without aura on >15d/mofor>3mo • B-Not attributable to another disorder

Cluster headache and other trigeminal autonomic cephalalgias • Cluster headache • Paroxysmal hemicrania • Short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) • Probable trigeminal autonomic cephalalgia

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