Yokukansankachimpihange has been applied to practical use for some indications such as irritability, excitability, anxiety and insomnia. We report 6 cases of chronic headache patients (tension-type headache [1], migraine [2] and mixed-type headache [3]) with the significant pulsation at pit of stomach and navel, who were successfully treated with Yoku-kan-san-ka-chimpi-hange for prophylaxis. These findings suggest that Yokukansankachimpihange might be useful for not only tension-type headache but also migraine and mixed-type headache.
Headache ; Prevention ; Application, NOS ; Chronic Headache ; Migraine

Posttraumatic headache (PTH) is one of several complications of traumatic brain injury (TBI). PTH usually resolving within the first 3 months, although a minority develop chronic headaches. PTH remains among the most controversial headache topics to its propensity for chronicity and often associated additional cognitive, behavioral, and somatic problems. Sufficient psychological or neurobiological markers for PTH do no exist, thus treatment can be very challenging and should always be multidisciplinary to make every reasonable effort in preventing the development of chronic pain. Posttraumatic seizure or epilepsy (PTE) is defined as a recurrent seizure disorder due to traumatic brain injury. PTE can be divided into three groups: immediate, early and late seizures. Immediate and early seizures are provoked seizures, whereas late seizure is unprovoked seizure. The effects of antiepileptic drugs (AED) in patients with TBI must be assessed separately in terms of prevention and control of provoked seizures and prevention of subsequent unprovoked seizures. Routine preventive AEDs are not indicated for patients with TBI and the effects are controversy.
Anticonvulsants ; Brain ; Brain Injuries ; Chronic Pain ; Epilepsy ; Headache ; Headache Disorders ; Humans ; Post-Traumatic Headache ; Seizures

Although it may occur in organized hematoma throughout the body, calcification within a chronic subdural hematoma is a rare condition. The total number of cases reported so far was not more than 110. We report a case of chronic subdural hematoma with calcification in 21 year old male who suffered from chronic headache for more than 6 months. The hematoma and calcification were surgically removed, and the patient's symptom disappeared.
Headache Disorders ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Male ; Young Adult

Radiofrequency lesioning is a valuable tool for third occipital headache. Relative to most neural targets, a radiofrequency lesion is very small. Reliable pre-operative diagnosis of the nociceptive source is critical, as inappropriately placed lesions will not modulate pain. Knowledge of the anatomical courses of nerves and extremely precise electrode placement are required for accurate lesioning. This report describes our experience with RF lesioning in the treatment of chronic pain in two patients who suffered from third occipital headaches. In one patient, satisfactory improvement of the pain was observed after 10 months of follow up.
Chronic Pain ; Diagnosis ; Electrodes ; Follow-Up Studies ; Headache ; Humans ; Mouth*

OBJECTIVE: To assess the available literature evaluating the safety and efficacy of sildenafil citrate in improving erectile function in patients with end stage renal disease.
METHODS: From the period of 1990-June 2016, the authors assessed the Cochrane Register of Controlled Trials and Medline for randomized controlled trials evaluating the safety and efficacy of sildenafil citrate for the treatment of erectile dysfunction in patients with chronic renal disease. Review authors selected articles for inclusion, extracted data and assessed trial quality. Risk ratios were determined and reported for dichotomous data and mean differences with 95% confidence intervals for continuous data.
RESULTS: Three randomized control trials involving a total of were identified. All trials investigated the safety and efficacy of sildenafil citrate in patients with chronic renal disease. Pooled analysis of the trials showed statistically significant improvement in the IIEF score with sildenafil citrate on the study as well as on the meta-analysis level. Pooled analysis of all three trials shows no statistical difference with regards to side effects between the treatment arms on the meta-analysis level. Common side effects include nausea, headache and palpitation.
CONCLUSION: Based on the meta-analysis of the available literature, oral sildenafil citrate is an effective and safe treatment for erectile dysfunction in patients with chronic kidney disease.

Acupuncture appears to be a clinically effective treatment for acute and chronic pain. A considerable amount of research has been conducted to evaluate the role that acupuncture plays in pain suppression; however, few studies have been conducted to evaluate the side effects of the acupuncture procedure. This case report describes a suspected postdural puncture headache following acupuncture for lower back pain. Considering the high opening pressure, cerebrospinal fluid leakage, and the patient's history of acupuncture in the lower back area, our diagnosis was iatrogenic postdural puncture headache. Full relief of the headache was achieved after administration of an epidural blood patch.
Acupuncture ; Blood Patch, Epidural ; Cerebrospinal Fluid Pressure ; Chronic Pain ; Headache ; Low Back Pain ; Needles ; Post-Dural Puncture Headache

BACKGROUND: In Korea, the proportion and absolute number of old people are increasing very rapidly. And the concern about the quality-of-life of elderly is to increase more and more among health care workers. The quality-of-life of elderly is affected by chronic medical conditions in some part. The purpose of this study is to evaluate the association between eight chronic medical conditions and health-related quality of life among the community-based elderly. METHODS: Target areas were 22 dongs in Dong-gu,Kwangju and 2 dongs in Buk-gu. Six hundreds subjects were randomly sampled from target ares. Interview survey was performed for chronic medical conditions by check list and health-related quality of life by COOP chart. Actual subjects were 568 elderlies. RESULTS: The results are followed ; 1) Compared with other domains of health-related quality of life, overall health was the most associated with chronic medical conditions, and social activity the least associated. 2) Stroke were significantly associated with every domain. And also back problems/joint problems were except the domain of social activity. Compared with other disease, stroke was the most associated with health-related quality of life except the domain of pain. 3) Migraine/chronic headache, gastroduodenal problems, and heart conditions were significantly associated with overall health, bodily pain, and one or two domains. 4) Hypertension and diabetes mellitus were signi ficantly associated with only one domain; overall health 5) Asthma and chronic bronchitis was not associated with any domains. CONCLUSION: Generally, health-related quality of life was highly associated with mobility limiting diseases such as back problems/joint problems stroke. And also moderately associated with pain relation disease such ans migraine/chronic headache, gastroduodenal problems, and heart condition.
Aged ; Asthma ; Bronchitis, Chronic ; Chronic Disease* ; Delivery of Health Care ; Diabetes Mellitus ; Headache ; Heart ; Humans ; Hypertension ; Korea ; Quality of Life* ; Stroke

Botulinum toxin has been used for the treatment of many clinical disorders by producing temporary skeletal muscle relaxation. In pain management, botulinum toxin has demonstrated an analgesic effect by reducing muscular hyperactivity, but recent studies suggest this neurotoxin could have direct analgesic mechanisms different from its neuromuscular actions. At the moment, botulinum toxin is widely investigated and used in many painful diseases such as myofascial syndrome, headaches, arthritis, and neuropathic pain. Further studies are needed to understand the exact analgesic mechanisms, efficacy and complications of botulinum toxin in chronic pain disorders.
Arthritis ; Botulinum Toxins ; Chronic Pain ; Headache ; Muscle, Skeletal ; Neuralgia ; Pain Management ; Relaxation

OBJECTIVE: Spontaneous intracranial hypotension(SIH) is a rare condition presented with cardinal postural headache and low CSF pressure. The authors describe the characteristic clinical features, imaging findings, and treatment methods in the patients with spontaneous intracranial hypotension. METHODS: Between May 1994 and Aug. 2001, eight patients were diagnosed with spontaneous intracranial hypotension based on characteristic radiologic and clinical findings in our department. All cases were shown diffuse meningeal enhancement(DME) on magnetic resonance(MR) image. Two cases had subdural hematoma. RESULTS: The most characteristic feature on Brain MR image is DME with/without subdural fluid collection. Radionuclide image reveals direct leaking point and rapid appearance of urinary bladder activity. Direct leaking points were detected in all four cases who performed radioisotope study. Autologous epidural blood patches were applied to four cases, and all of them were improved without complication. Among four patients treated with conservative method, three were improved, but one patient was died of spontaneous chronic subdural hematoma. CONCLUSION: We suggest that 1) meticulous studies need to be performed aggressively if SIH is diagnosed clinically and radiologically, 2) the most effective study may be radioisotope study, and 3) if leaking point is found, aggressive management such as autologous epidural blood patches is recommended.
Blood Patch, Epidural ; Brain ; Headache ; Hematoma, Subdural ; Hematoma, Subdural, Chronic ; Humans ; Intracranial Hypotension* ; Urinary Bladder

Secure fixation is essential for continous epidural catheterization on a long-term-basis. Adhesive tape or surgical knots were commonly used for those patients, but the surgical knot method has a tendency to cause strangulation of catheter. Another invasive technique, subcutaneous tissue tunnelling is more safe than other methods but requires sophisticated technique and time. We employed a simple device using a blood transfusion set for patients who have epidural catheters placed safely on their backs. In 120 patients treated for postoperative and chronic pain by means of this technique, the results were as follows: 1) Five of 120 patients (4.2%) developed backache and pruritus, but there were no instances of respiratory depression, local infection and headache. 2) Nine of 120 patients (7.5%) failed booster-injections, but two cases were due to be non-technical errors. 3) The duration of fixation was 1-3 days in most cases (85%), the longest being for 21 days.
Adhesives ; Back Pain ; Blood Transfusion ; Catheterization ; Catheters* ; Chronic Pain ; Headache ; Humans ; Pruritus ; Respiratory Insufficiency ; Subcutaneous Tissue