RESUMO
Identification of brain regions that differentially respond to pain intensity may improve our understanding of trigeminally mediated nociception. This report analyzed cortical responses to painless and painful electrical stimulation of a right human maxillary canine tooth. Functional magnetic resonance images were obtained during the application of five graded stimulus strengths, from below, at, and above the individually determined pain thresholds. Study participants reported each stimulus on a visual rating scale with respect to evoked sensation. Based on hemodynamic responses of all pooled stimuli, a cerebral network was identified that largely corresponds to the known lateral and medial nociceptive system. Further analysis of the five graded stimulus strengths revealed positive linear correlations for the anterior insula bilaterally, the contralateral (left) anterior mid-cingulate, as well as contralateral (left) pregenual cingulate cortices. Cerebral toothache intensity coding on a group level can thus be attributed to specific subregions within the cortical pain network.
Assuntos
Encéfalo/fisiologia , Limiar da Dor/fisiologia , Odontalgia/fisiopatologia , Adulto , Tonsila do Cerebelo/fisiologia , Tronco Encefálico/fisiologia , Cerebelo/fisiologia , Córtex Cerebral/fisiologia , Dente Canino/inervação , Imagem Ecoplanar/métodos , Estimulação Elétrica , Lobo Frontal/fisiologia , Giro do Cíngulo/fisiologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Córtex Motor/fisiologia , Nociceptividade/fisiologia , Dor Nociceptiva/fisiopatologia , Lobo Occipital/fisiologia , Lobo Parietal/fisiologia , Putamen/fisiologia , Limiar Sensorial/fisiologia , Lobo Temporal/fisiologia , Tálamo/fisiologia , Nervo Trigêmeo/fisiologia , Adulto JovemRESUMO
Duodenal diverticula are usually asymptomatic but may induce major hemorrhage on rare occasions. When endoscopy cannot determine the cause of bleeding, angiography must be performed. This paper describes a patient in whom angiography identified the diverticulum as the bleeding source, which was an exceptional occurrence, and thereby allowed prompt, appropriate treatment.
Assuntos
Divertículo/complicações , Duodenopatias/complicações , Hemorragia Gastrointestinal/etiologia , Idoso , Divertículo/diagnóstico por imagem , Divertículo/cirurgia , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Feminino , Humanos , RadiografiaRESUMO
A patient is described who developed an intramural haematoma of the oesophagus shortly after variceal endoscopic sclerotherapy. This unusual complication is best imaged by computed tomography or nuclear magnetic resonance and needs conservative treatment. Resolution usually occurs spontaneously and may result in eradication of the varices.