Headache
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Occipital neuralgia is a form of neuropathic type of pain in the distribution of the greater, lesser, or third occipital nerves. Patients with intractable occipital neuralgia do not respond well to conservative treatment modalities. This group of patients represents a significant therapeutic challenge and may require interventional or invasive therapeutic approaches. ⋯ Bedside sonography is an excellent imaging modality for soft tissue structures. Ultrasound not only allows distinguishing normal from abnormal entrapped occipital nerves, it can identify the level and the cause of entrapment as well. Ultrasound guidance allows precise occipital nerve blocks and interventions at the level of the "specific" entrapment location rather than into the site of "presumed" entrapment.
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This retrospective chart review examined a mediation model of parent and family functioning, childhood depression, and functional disability in youth with chronic headaches. Specifically, we evaluated whether depression mediates the relations between protective parenting and functional disability and between family functioning and functional disability. ⋯ Family context is an important variable to consider in youth with chronic headaches and disability. While many studies have identified family functioning and depressive symptoms as separately linked to functional impairment, to our knowledge, we are the first to demonstrate depression as an intermediary variable between family dysfunction and disability within the pediatric headache population.
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Over the past 20 years, headache syndromes, especially migraine, have benefited significantly from the knowledge gained through neuroimaging studies. This article is focused on the neuroimaging studies of the functional organization and connectivity of the migraine brain. ⋯ Then, the article reviews the findings to date and discusses how functional connectivity studies have contributed to a better understanding of the mechanisms of the migraine disease by extending the focus from a single region or structure to a network of regions and structures and the interactions among them. Finally, the potential scenarios for the translation of connectivity knowledge to the benefit for patients are discussed.
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A link between patent foramen ovale (PFO) and migraine as well as the utility of closure of PFO and its effect on migraine have been subjects of debate. The present review is an effort to gather the available evidence on this topic and formulate recommendations. ⋯ There is no good quality evidence to support a link between migraine and PFO. Closure of PFO for migraine prevention does not significantly reduce the intensity and severity of migraine. We do not recommend the routine use of this procedure in current practice.
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Meta Analysis
Lower incidence of postdural puncture headache using whitacre spinal needles after spinal anesthesia: A meta-analysis.
The aim of this meta-analysis was to evaluate the postdural puncture headache after spinal anesthesia with Whitacre spinal needles compared with Quincke spine needles. ⋯ We suggest the Whitacre spinal needles as a superior choice for spinal anesthesia compared with Quincke spine needles.