Subject(s)
Hypoxia/etiology , Pulmonary Veins/abnormalities , Aged , Female , Humans , Hypotension/etiology , Thoracic Injuries/complicationsABSTRACT
A patient presented with a painful, pulsating nodosity with marked tenderness on the right side of her neck. Cervical magnetic resonance imaging (MRI) exhibited pathological signal changes in the perivascular tissue of the carotid bifurcation area and around the external carotid artery. Similarly, Doppler sonography revealed an echo-poor wall change with outward bulging and slight narrowing of the affected vessel lumen. The clinical symptoms and our findings led to the diagnosis of carotidynia. We proposed that cervical MRI and Doppler sonography could be used for diagnosing carotidynia.
Subject(s)
Carotid Artery Diseases/diagnosis , Hyperalgesia/diagnosis , Magnetic Resonance Imaging , Neck Pain/diagnosis , Neuralgia/diagnosis , Ultrasonography , Female , Humans , Middle Aged , Palpation , Syndrome , TouchABSTRACT
Headache is usually the first and the most frequent symptom of cervicocephalic arterial dissection. Besides headache ipsilateral Horner's syndrome, cranial nerve palsies, or pulsatile tinnitus are observed. Serious complications of arterial dissection are ischemic strokes, which mostly occur later in the course of time. We report on a patient with spontaneous bilateral carotid artery dissection, who suffered from atypically prolonged, severe, and refractory headache. High-dose administration of nonsteroidal anti-inflammatory drugs as well as opioids were ineffective. Pain relief was only achieved after a 3-day course of corticosteroids (100 mg methylprednisolone/day).
Subject(s)
Carotid Artery, Internal, Dissection/physiopathology , Headache/etiology , Adrenal Cortex Hormones/therapeutic use , Adult , Angiography , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Carotid Artery, Internal, Dissection/diagnosis , Carotid Artery, Internal, Dissection/diagnostic imaging , Functional Laterality , Humans , Magnetic Resonance Imaging , MaleABSTRACT
Hypertrophic cranial pachymeningitis is an uncommon, fibrosing, inflammatory process that involves the dura mater. The condition is being reported more frequently owing to the use of cranial MRI. The main clinical feature is headache, whereas cranial nerve lesions, cerebellar symptoms, and epileptic seizures occur more rarely. A variety of autoimmune and infectious diseases can result in this condition, which is labeled as idiopathic in the absence of any definite inciting factor. The diagnosis of hypertrophic cranial pachymeningitis is based on neuroimaging of thickened and enhancing dura mater. It can be defined pathologically on biopsy. A specific treatment is indicated in some cases of secondary hypertrophic cranial pachymeningitis. Mostly, treatment relies on corticosteroids and immunosuppressive agents. This review summarizes the current knowledge on causes, clinical presentation, diagnosis, and treatment of this disorder.
