• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.144-146
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• 2015

Postdural punctural headache (PDPH) following spinal anesthesia is due to intracranial hypotension caused by cerebrospinal fluid (CSF) leakage, and it is occasionally accompanied by an intracranial hematoma. To the best of our knowledge, an intracranial chronic subdural hematoma (CSDH) presenting with an intractable headache after a cervical epidural steroid injection (ESI) has not been reported. A 39-year-old woman without any history of trauma underwent a cervical ESI for a herniated nucleus pulposus at the C5-6 level. One month later, she presented with a severe headache that was not relieved by analgesic medication, which changed in character from being positional to non-positional during the preceding month. Brain magnetic resonance imaging revealed a CSDH along the left convexity. Emergency burr-hole drainage was performed and the headache abated. This report indicates that an intracranial CSDH should be considered a possible complication after ESI. In addition, the event of an intractable and changing PDPH after ESI suggests further evaluation for diagnosis of an intracranial hematoma.

• 대한통합의학회지
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• 제2권1호
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• pp.51-62
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• 2014

Purpose : The purpose of this work was to ascertain the effects of cervical traction on the pain, the range of motion and the quality of sleep of the older women with the tension headache. Method : 25 subjects between ages 66 and 82 who agreed on this experiment and diagnosed with tension headache participated in this study. All subjects were treated with air-pressure cervical traction while 20 minutes a day, 3 times per week, for 4 weeks. The effects of air-pressure cervical traction were evaluated by PSQI(Pittsburgh sleep quality index), a pain last a day, VAS, and four ROMs. In order to investigate the effect of age on the treatment, subjects were divided into two groups, of less and of over than age 75. The measured data were analyzed by using one-way repeated ANOVA and two-way repeated ANOVA. Result : 1) The group of less than age 75 showed the significant improvements in all measurement variables, PSQI, a pain last a day, VAS and four ROMs. 2) The group of over than age 75 showed the significant improvements in all measurement variables excluding the flexion ROM of cervical. 3) No significant differences between two groups were showed in all measurement variables, but the interaction effect between group and period was significant in only VAS. Conclusion : From the results of this study, a cervical traction intervention using an air-pressure cervical traction proved to be effective on the reduction of tension headache and the improvement of the quality of sleep.

• 국제물리치료학회지
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• 제9권3호
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• pp.1564-1570
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• 2018

The International Headache Society (IHS) has validated cervicogenic headache (CGH) as a secondary headache type that is hypothesized to originate due to nociception in the cervical area. CGH is a common form of headache and accounts for 15% to 20% of all chronic and recurrent headaches. CGH is commonly treated with manual and exercise therapy. To date, no studies have isolated only one manual intervention in an attempt to determine its effectiveness. In this case study we present a 28-year-old patient with right upper cervical (UC) and occipital pain who responded well to a single manual intervention technique. This technique was applied in isolation for the first three visits and two therapeutic exercises prescribed on the fourth and fifth visit. In total, manual and exercise intervention occurred over 8 visits at which point in time the patient was discharged with no UC motion impairments, an NPRS rating of 0, a NDI and HDI demonstrating a 100% improvement and a 37% improvement in FOTO score. The traction based manual intervention and two therapeutic exercises prescribed for this patient were successful in relieving UC pain and CGH. At six months follow up, the patient was still symptom free.

• The Korean Journal of Pain
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• 제18권1호
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• pp.64-68
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• 2005

Migraine is a disabling headache that can occur with or without aura. We present here a case of migraine that was effectively managed by a series of cervical epidural blocks. A 41-year-old woman who had suffered from severe headache on her left temporal area for 12 years visited our pain clinic. Her 11-point numeric pain rating scale was 10 out of 10 at the first visit and the symptoms were associated with homonymous visual disturbances, paresthesia on the left face, shoulder and arm, and general weakness. For the first 5 years after the headaches began, her headache was relatively well controlled by acetaminophen; after then, the acetaminophen wasn't effective. After wandering from this hospital to the next one in search of relief, she managed to visit our pain clinic. We tried several blocks including cervical epidural block, and she was continuously medicated with sumatriptan. Her headache was gradually relieved. Now, her 11-point numeric rating scale is 1-2 out of 10 at the most during her headache attacks.

• 대한물리치료과학회지
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• 제10권1호
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• pp.212-221
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• 2003

To observe the anatomical structures which cause a cervicogenic headache it reports, from viewpoint of physical therapist in treatment multiple to observe method which approaches, the reporter it does. With the manipulation the vertebral manipulation effected an affirmative effect to cervicogenic headache(Niels Nilsson et al,1997). The manipulation, soft the tissue massage, postural education/advice, muscular elongation, the traction, and postural exercises initially came to be used with that technique which the upper cervical vertebra(0-C3) passive accessory intervertebral movement comes to be used with a cervicogenic headache treatment technique(Grant T & Niere K., 2000). Also, it relates with the diagnosis standard about a cervicogenic headache when the body function over of the cervical vertebra is discovered, the Muscle energy technique was proposed in the treatment which is safety and effect(Bogduk N,2001). The TENS and the Mange gave a reduction effect of pain often.

• 척추신경추나의학회지
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• 제8권2호
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• pp.105-111
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• 2013

Objectives : The purpose of this study is to evaluate the Korean medical treatment for chronic tension-type headache, especially chuna manual therapy on cervical vertebrae. Methods : One patient was treated with acupuncture, herbal medication and chuna manual therapy on cervical vertebrae. To evaluate the pain of head and neck, visual analog scale(VAS) was measured. Results : After treatment for 1 week, the pain of head and neck was declined from VAS 10 to VAS 3. Conclusions : Korean medical treatment including acupuncture, herbal medication and cervical chuna manual therapy is effective for chronic tension-type headache. But further studies are required to prove the effectiveness of chuna manual therapy on cevical vertebrae.

• 대한통합의학회지
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• 제5권1호
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• pp.11-18
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• 2017

Purpose : The purpose of this case study was to clinical effects of cervical exercise with sling program using on torture of survivor with sleep disturbance and Headache, neck disfunction. Methods : This study selects 1 subjects for 55 years old who were diagnosed with torture of survivor with sleep disturbance and headache. The Design is ABA of single-subject study design. Baseline(A) and TypeII Baseline(A : 6weeks) phases were received with musculoskeletal disease of prevention education, Intervention(B : 6weeks) phase provided with 65 minute exercise with sling program using in a session twice a week. In order to analyze the measure results of PSQI-K(korean version of the pittsburgh sleep quality index), VAS(visual analog scale), NDI(neck disability index), FABQ(fear-avoidance beliefs questionnaire) in torture of survivor during baseline, intervention and typeII baseline phase. Result : A significant differences in PSQI-K during baseline, intervention, typeII baseline. A significant differences in VAS during baseline, intervention, typeII baseline. A significant differences in NDI during baseline, intervention, typeII baseline. A significant differences in FABQ during baseline, intervention, typeII baseline. Conclusion : In conclusion, The intervention method to applied cervical exercise with sling program on torture of survivor effectively improve on sleep disturbance and neck function, headache.

• 국제물리치료학회지
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• 제1권2호
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• pp.99-106
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• 2010

The purpose of this study was to identify the effects of manipulation on the velocity of cerebral blood flow and level of pain in cervicogeinc headache patients. The velocity of cerebral blood flow of 30 cervicogeinc headache patients(male=15, female=15, age=$24.00{\pm}3.60$) and 33 normal subjects(male=15, female=18, age=$23.27{\pm}3.00$) was compared. The 30 cervicogeinc headache patients were divided into suboccipitalis relaxation group, cervical manipulation group, and placebo group, and each were given different interventions. The velocity of cerebral blood flow and pain level was measured before intervention, and 1, 2, 3 weeks after intervention. The velocity of cerebral blood flow was measured with the Transcranial Doppler(TCD), and pain level was measured with visual analog scale(VAS). Blood flow velocity of middle cerebral artery in cervicogeinc headache patients was slower than those in healthy subjects. Physical therapy intervention did not have significant effect on velocity of cerebral blood flow, but slowly decreased at intervention for pain level increased. The suboccipitalis relaxation group and cervical manipulation group showed significant effect in decreasing pain level compared to the placebo group(p<.05). Directly applied manipulation therapy in the neck area not only has effect on joint of cervical and soft tissue but also on blood vessels and nerves which pass the neck area, and because of those results of manual therapy seems to help recovery.

• The Korean Journal of Pain
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• 제33권3호
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• pp.275-283
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• 2020

Background: Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. Methods: The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson's coefficient. Results: The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the P < 0.001), while the ADC values were significantly higher (P = 0.003, P < 0.001, and P = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 (P < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = -0.420, P = 0.037 and r = 0.531, P = 0.006, respectively) was found. Conclusions: DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.

• 척추신경추나의학회지
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• 제6권2호
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• pp.33-44
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• 2011

양혈풍탕(養血風湯)을 처방하여 경추 추간판 탈출증으로 인한 극심한 통증 및 두통이 호전된 2례를 통하여 신경학적 결손이 없는 요추 방출성 골절에 대해 양혈풍탕(養血風湯)이 환자의 자각적인 증세 및 NRS, NDI 상으로 유효한 효과가 있었음을 확인하였다. 이에 저자는 두통이 동반된 경추 추간판 탈출증으로 입원하여 양혈풍탕(養血風湯)을 복용한 후 호전된 2케이스를 보고하는 바이다.