OBJECTIVE: To master the clinical manifestations of rhinogenic headache and improve the diagnostic ability of chronic rhinosinusitis accompanied by primary headache. METHOD: The clinical manifestations, the diagnostic process, and the treatment of 1 patient with headache were analyzed, and also the related articles were studied. RESULT: Rhinogenic headache and primary headache had different clinical features and different treatment. In clinical work misdiagnosis were easily made if not being carefully analyzed. CONCLUSION Diagnosis of rhinogenic headache do need strong clinical evidence, but the differential diagnosis of other headache should be made.
Cluster Headache ; complications ; Humans ; Male ; Middle Aged ; Sinusitis ; complications

Adolescent ; Cysts ; complications ; Headache ; etiology ; Humans ; Male ; Nasal Septum ; pathology ; Nose Diseases ; complications

OBJECTIVETo investigate the states of chronic symptoms of other parts of the body concomitant with temporomandibular joint (TMJ) pain.

METHODSFifty-one patients with TMJ pain and thirty-one control subjects without TMJ symptoms were chosen randomly. The TMJ symptoms and chronic symptoms of other regions were investigated at the base line. The TMJ pain patients were investigated again half year after treatment. Between-symptom correlations were analyzed using linear regression and Chi-squared analysis method (alpha = 0.05).

RESULTSThe chronic symptoms related to the TMJ pain at the base line were headache, back pain, numbness of hand, neck and shoulder pain, insomnia, dizziness, reduced hearing ability, eye pain and fatigue (P < 0.05). The incidences of the symptoms of patients were higher than those of the control subjects (P < 0.01). Half year later, the headache, neck and shoulder pain and fatigue were the symptoms improved with the TMJ pain treatment (P < 0.05).

CONCLUSIONThe symptoms of adjacent regions of orofacial area such as neck and shoulder pain and headache are the main concomitant symptoms of the TMJ pain, and these symptoms may be improved by the treatment of TMJ.

Adolescent ; Adult ; Aged ; Facial Pain ; complications ; Female ; Headache ; complications ; Humans ; Male ; Middle Aged ; Neck Pain ; complications ; Shoulder Pain ; complications ; Temporomandibular Joint Disorders ; complications ; Young Adult

The clinical manifestation of acute invasive fungal sinusitis was associated with facial pain,altered sense of smell, blindness and headache. Physical examinations show that dark brown nasal secretions with bone resorption in paranasal sinus. Radiographi parameters showed uneven density in paranasal sinus and intraorbital extension. Fungus smears and pathological examination can make a definitive diagnosis.
Acute Disease ; Facial Pain ; etiology ; Fungi ; isolation & purification ; Headache ; etiology ; Humans ; Mycoses ; complications ; pathology ; Paranasal Sinuses ; Sinusitis ; complications ; microbiology ; pathology

OBJECTIVES: This descriptive study was conducted to examine the degree of stress, coping styles, communication with the mother and depression between headache-suffering children and headache-free children and to explore predicted factors for headache occurrence in children. METHOD: The subjects of this study consisted of 196 headache-free children and 107 headache-suffering children. They were 4th-6th graders of an elementary school in T city. The instruments in this study were David's stressor of children, Lazarus & Folkman's Stress Coping Style, PACI (Parent-Adolescent Communication Inventory) by Barnes & Olsen and Kovac's CDI (Children's depression inventory). Data were collected from May 2 to July 16, 2004. RESULTS: Total stress(t=-3.76, p=.035), school stress(t=-3.02, p=.001), mass media stress(t=-1.39, p=.029) and depression(t=7.62, p=.001) in headache-suffering children were significantly higher than those of headache-free children. Problem-oriented coping skills (t=1.23, p=.023), and the score of communication with the mother (t=2.32, p=.012) in headache-suffering children were lower than those of headache-free children. Logistic regression analysis (stepwise) showed that the most powerful predictor was stressors in school, followed by depression, stressors in mass media and communication with the mother. CONCLUSIONS: This study revealed that important factors such as the degree of school stress, depression, the degree of mass media stress, communication with the mother and problem-oriented coping skills should be controlled for reducing of headaches in children.
Stress, Psychological/complications ; Mother-Child Relations ; Male ; Humans ; Headache/etiology/*psychology ; Female ; Child ; Adaptation, Psychological

OBJECTIVE: This study is designed to demonstrate a relationship between reconstruction methods of the craniectomy site and the development of postoperative complications including headache, tinnitus, and operation site pain after microvascular decompression(MVD) in patients with hemifacial spasm. METHODS: This study included 44 consecutive patients who underwent MVD due to hemifacial spasm from 1995 to 2001. Craniectomy site was reconstructed with only Gelfoam(group 1) in 20, the bone dust and Gelfoam(group 2) in 11, the bone chips and Gelfoam(group 3) in 13. Group 1, 2 were studied retrospectively and group 3 was studied prospectively on the postoperative complications. RESULTS: Postoperatively, wound infection occurred in 3(6.8%), headache in 14(31.8%), operation site pain in 17(38.6%), tinnitus in 15(34.1%), hearing loss in 1(2.2%). Wound infection was noticed in 5% of group 1, 18.2% of group 2, and none of group 3. Headache developed in 45% of group 1, 27.3% of group 2, and 15.4% of group 3. Operation site pain was noticed in 50% of group 1, 27.3% of group 2, 15.4% of group 3. Tinnitus revealed in 45% of group 1, 18.2% of group 2, 30% of group 3. CONCLUSION: Reconstruction of the craniectomy site with the bone chips in patients with hemifacial spasm might have effects on diminution of the postoperative headache, operation site pain and wound infection.
Dust ; Headache ; Hearing Loss ; Hemifacial Spasm* ; Humans ; Postoperative Complications ; Prospective Studies ; Retrospective Studies ; Tinnitus ; Wound Infection

The management of petroclival tumors has been improved by the techniques of cranial base surgery. However, these tumors are still among the most difficult cranial base lesions to treat. The t ranspetrosal approach is a routine procedure for petroclival tumors, but there are some disadvantages such as the time-consuming craniotomy during surgery. CSF leakage due to incomplete dural closure, postoperative infection, epidural hematoma and depressed deformity of the mastoid area after surgery. To solve these disadvantages, we modified the transpetrosal approach to mini-pet rosal technique involving total petrosectomy without temporal or suboccipital craniotomy. 11 petroclival tumors were operated on using this technique between August 1994 and August 1997. Gross total removal was achieved in tumors of up to 4cm diameter by this technique. The advantages of this approach are smaller skin incision, shorter operation time, and less postoperative complications such as epidural hematoma, CSF leakage infection, and headache. This technique can be indicated for medium to large petroclival tumors which do not extend to cavernous sinus and Jugular foramen.
Cavernous Sinus ; Congenital Abnormalities ; Craniotomy ; Headache ; Hematoma ; Mastoid ; Postoperative Complications ; Skin ; Skull Base

The common etiologies of pneumocephalus, presence of air in the intracranial cavity, are trauma and cranial surgery. Pneumocephalus after spinal surgery is an unusual postoperative complication. We report the case of a male 59-year-old man who developed a pneumacephalus after posterior lumbar surgery for spinal stenosis. Intraoperatively, a cerebrospinal fluid leak following a dural tear was noted and immediately repaired. The next day, the patient complained of headache and dizziness. Head and lumbar computed tomography scans revealed significant air in the frontal region, several cisterns, intraventricle, and extra-dural area in the spine canal. Symptoms were spontaneously resolved within 2 weeks with conservative management.
Cerebrospinal Fluid Rhinorrhea ; Dizziness ; Head ; Headache ; Humans ; Male ; Middle Aged ; Pneumocephalus ; Postoperative Complications ; Spinal Stenosis ; Spine

Adult ; Arachnoid Cysts ; complications ; diagnosis ; diagnostic imaging ; Headache ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography

BACKGROUND: Several reports have indicated that there are fewer postoperative complications after using a smaller spinal needle in young patients. However, no comparative report has been issued on the incidences of postoperative complications after using differently sized spinal needles for spinal anesthesia in elderly patients. Here, we compared a 22 G Quincke needle with a 25 G Quincke needle in elderly patients and investigated postoperative complications. METHODS: Fifty patients, aged over 60 years presented for an elective urological operation. Patients were randomized into two groups to receive spinal anesthetics using a 22 G Quincke needle (group L) or a 25 G Quincke needle (group S). The incidences of postdural puncture headache (PDPH), backaches, and the outcomes of spinal anesthesia were compared between the two groups. RESULTS: Two patients in group L and one in group S developed PDPH postoperatively with no significant statistical difference between the two groups. Four patients suffered backache in group L and two in group S again without significance. But the number of puncture attempts was significantly higher in group S. CONCLUSION: In conclusion, postoperative complications were similar for both groups. However, spinal anesthesia was performed more easily when using a larger spinal needle. Therefore, we recommend that a larger spinal needle be used when difficult spinal anesthesia is anticipated in elderly patients.
Aged* ; Anesthesia, Spinal* ; Anesthetics ; Back Pain ; Humans ; Incidence ; Needles* ; Post-Dural Puncture Headache ; Postoperative Complications* ; Punctures