dr manzo
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dr manzo

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About Headaches and Stimulation Chef de Service de Neurochirurgie CHU FORT DE FRANCE Occipital neuralgia • A . Paroxysmal stabbing pain ,with or without persistent aching between paroxysms , in the distribution(s) of the greater , lesser and/or 3rd occipital nerves . • B . Tenderness over the affected nerve . • C .

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Published 18 January 2013
Reads 34
Language English

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About Headaches and Stimulation Chef de Service de Neurochirurgie CHU FORT DE FRANCE
Occipital neuralgia
• A . Paroxysmal stabbing pain ,with or without persistent aching between paroxysms , in the distribution(s) of the greater , lesser and/or 3rd occipital nerves . • B . Tenderness over the affected nerve . • C . Pain is eased temporarily by anaesthetic block of the nerve
Cervicogenic headaches
A- pain referred from a source in the neck and perceived in one or more regions of the head or face fulfilling criteria C and D
B-evidence of lesion or disorder of the neck known to be a valid cause of headache C-evidence that the pain can be attributed to the neck disorder
D-pain resolve after successful treatment of the causative lesion
Primary headaches
Migraine • Tension-type headache • Cluster-headache and other trigeminal autonomic cephalalgias • Other primary headaches
Trigemino –cervical complex
Is defined by its afferents :  Trigeminal nerve (face)  Upper three cervical nerves  (neck ; cerebral posterior fossa )
Is not defined by any distinctive cytoarchitecture or by any intrinsic boundaries
The pars caudalis of the spinal nucleus of the trigeminal nerve is continuous longitudinally with the outer laminae of the dorsal horns of the upper 3 to 4 segments of the cervical spinal cord
Trigemino-vascular system
Around meningeal vessels and veinous sinuses the nervous plexus comes from 1-st branch of trigeminal nucleus with unilateral distribution
Orthodromic conduction ,via the thalamus , to the cortex , is the way ot the conscious sensation of pain
Antidromic activation af amyelinic trigeminal fibers leads to liberation of neuropeptides …..
NEUROGENIC INFLAMMATION
Migraine without aura
A .At least 5 attacks fulfilling criteria B . Headache lasting 4 –72 h(untreated) C . Headache has 2 of the following characteristics  1 ; unilateral location  2 .pulsating quality  3 .moderate or severe pain intensity  4 .aggravation by or causing avoidance of routine physical  activity D . During headache 1 of the following :  1 .nausea and:or vomiting  2 .phono and photophobia E . Not attributable to another disorder
Chronic migraine
• A-Headache fulfilling criteria C and D for Migraine without aura on >15d/mofor>3mo • B-Not attributable to another disorder
Cluster headache and other trigeminal autonomic cephalalgias • Cluster headache • Paroxysmal hemicrania • Short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) • Probable trigeminal autonomic cephalalgia