Alopecia After Occipital Nerve Blockade

Occipital nerve blockade is a widely used procedure in the treatment of primary and secondary headache disorders. The procedure is generally well tolerated, although local side effects such as cutaneous atrophy, hyperpigmentation, and alopecia can occur. The present study describes a case of alopecia following occipital nerve blockade with triamcinolone. This complication can be avoided by precautions such as local injection and the use of alternative steroid preparations.

Alopecia After Occipital Nerve Blockade

Occipital nerve blockade is a widely used procedure in the treatment of primary and secondary headache disorders. The procedure is generally well tolerated, although local side effects such as cutaneous atrophy, hyperpigmentation, and alopecia can occur. The present study describes a case of alopecia following occipital nerve blockade with triamcinolone. This complication can be avoided by precautions such as local injection and the use of alternative steroid preparations.

Behavioral and Psychological Symptoms Following Acute Middle Cerebral Artery Infarcts

BACKGROUND: Behavioral and psychological symptoms (BPS) following acute middle cerebral artery (MCA) infarcts are not uncommon, but these have been considered to be less important than physical disability. The purpose of this study is to evaluate the characteristics of BPS following acute MCA infarcts by using the Korean version of neuropsychiatric inventory (K-NPI). METHODS: Fifty-one patients with acute MCA infarcts were studied using the K-NPI scale. We investigated newly developed BPS after the onset of MCA infarcts by interviewing the primary caregiver of each patient. We then evaluated factors related to the BPS such as lesion laterality and various characteristics of the subjects. RESULTS: The most common BPS following acute MCA infarcts was depression. It was present in 69% of the patients, followed by anxiety (61%), agitation (39%), apathy (29%) and irritability (25%). Depression and anxiety were associated with left MCA lesion, whereas apathy was associated with right lesion. Patients with recurrent MCA infarcts more often had depression and anxiety than those without (p=0.03, p=0.04, respectively). Patients with MCA infarcts caused by cardioembolism more often had irritability and disinhibition than those with other subtypes (p=0.01, p=0.02, respectively). CONCLUSIONS: BPS is frequently observed following acute MCA infarcts. Therefore, early and adequate assessment of post stroke BPS and appropriate therapy may be important in patients with MCA infarcts.

Brainstem Infarction in Patients with Basilar Artery Dolichosis

BACKGROUND: Basilar arterial dolichosis (BD) has chracteristics of tortuosity and elongation. BD can cause obstructive hydrocephalus, direct compression of brainstem and cranial nerves, and cerebral ischemia or infarction. It has been reported that brainstem infarction is usually located contralateral to the side of lateral displacement. This study was aimed to reveal the relation between the location of the infarction and the some characteristics of BD. METHODS: Among the 143 patients who had brainstem infarction from January, 2003 to July, 2004, 40 patients with BD were analyzed retrospectively. Characteristics of BD and infarct site were analysed with special respect via MRI and MRA. We surveyed the relation between the location of the infarction and the lateral displacement of BD. Subjects were divided into two groups by the degree of the lateral displacement of basilar artery (BA). We made a comparison between the two in clinical characteristics and risk factors. Height of the infarct site and the maximal point of lateral displacement from arbitrarily defined standard level (lower pons) were measured. We surveyed the lesional laterality associated with relative height of the infarct site. RESULTS: Infarct lesions located to the contralateral side of the laterally displaced BA were more prevalent (25 cases, 62.5%). There was significant correlation between the lesional laterality and the lateral displacement of the BA in group B (p=0.039) and between the lesion-height and the maximal dolichosis-height (r=0.639, p<0.001). CONCLUSIONS: Patients with BD are more likely to have brainstem infarction at the contralateral side of the laterally displaced BA.