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Copyright of Filozofski Vestnik is the property of Scientific Research Centre of Slovenian Academy of Sciences & Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Occipital neuralgia (ON) is unilateral or bilateral neuralgia in the dermatomal nerve distribution of the greater, lesser or third occipital nerves and is a very common presentation of neuropathic pain. ON, although common and well defined, is still a poorly understood pain syndrome. It often requires invasive treatment for long term and significant pain alleviation; however, the evidence supporting different options is still limited. Several minimally invasive techniques have proven to be efficacious and safe, and the selection depends mostly on response to nerve blocks, patient choice and provider preference. This is a comprehensive review of the latest and seminal literature available about occipital neuralgia and currently available minimally invasive treatment options. It covers the anatomical and physiologic biology at the base of neuralgia, the presentation and diagnostic process. It then reviews the available literature to provide description and comparison of the available methods for alleviation.

Objectives: The study aims to retrospectively compare steroid and radiofrequency treatments for the greater occipital nerve(GON) under ultrasound guidance in chronic migraine., Methods: Monthly average headache attack frequency, attack duration, visual analog scale(VAS) and the number of days analgesics were taken were recorded. Under ultrasound guidance, GON block was administered once a week for a total of four sessions. In the final session, 4 mg of dexamethasone was added to the local anesthetic for the steroid group (n:26). Pulsed radiofrequency (RF) treatment was applied to the RF group (n:25) just before the last session of the GON block. The pain course in the week following the procedure monthly average headache attack frequency, attack duration, VAS and the number of days analgesics were taken in a month were compared for both groups at 1-3-6 months., Results: In the first month, a statistically significant decrease in attack frequency was observed in the RF group. However, no statistically significant differences were found between the groups in other findings at different time intervals. A significant decrease headache attack duration,VAS, and the number of days analgesics were taken in a month was observed in both treatment groups. Both treatments were found to be effective, but the effect size of the treatment was higher in the RF group compared to the steroid group., Conclusion: Although the results were better in the group receiving pulsed RF treatment, except for the attack frequency in the first month, no statistically significant superiority of one treatment method over the other was determined., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background/Aim: Migraine is a common, disabling neurological disorder and cranial nerve blocks (CNB) are used in the treatment of headaches. This study aimed to compare the effectiveness of a CNB with conventional medical treatment in patients with chronic migraine resistant to first-line treatment. Methods: This retrospective cohort study included 102 patients with chronic migraine resistant to first-line treatment who were treated in our outpatient clinic. The patients were divided into two groups as those who underwent CNB (n=67) and the control group, who were only treated with conventional drugs (n=35). Bilateral CNB was performed on the patients at baseline and in the second week. The patients' Visual Analogue Scale (VAS) scores, number of days in pain, and the number of analgesics taken were recorded at baseline and the second month. Results: The second-month VAS scores and the number of days in pain were significantly lower than baseline in both the CNB and control groups (P<0.01, and P<0.05, respectively). However, while the number of analgesics taken in the 2nd month was lower in the CNB group, it was similar in the control group. (P<0.01, P=0.33). No significant difference was found between the groups in terms of the number of days in pain in the second month (P=0.09). The second month's VAS scores and the number of analgesics taken were significantly lower in the CNB group compared to the control group (P=0.01, P<0.01). Conclusion: Our findings indicated that the CNB was more effective than conventional treatment in patients with chronic migraine resistant to first-line treatment. [ABSTRACT FROM AUTHOR]

Occipital neuralgia (ON) is unilateral or bilateral neuralgia in the dermatomal nerve distribution of the greater, lesser or third occipital nerves and is a very common presentation of neuropathic pain. ON, although common and well defined, is still a poorly understood pain syndrome. It often requires invasive treatment for long term and significant pain alleviation; however, the evidence supporting different options is still limited. Several minimally invasive techniques have proven to be efficacious and safe, and the selection depends mostly on response to nerve blocks, patient choice and provider preference. This is a comprehensive review of the latest and seminal literature available about occipital neuralgia and currently available minimally invasive treatment options. It covers the anatomical and physiologic biology at the base of neuralgia, the presentation and diagnostic process. It then reviews the available literature to provide description and comparison of the available methods for alleviation. [ABSTRACT FROM AUTHOR]

Copyright of Filozofski Vestnik is the property of Scientific Research Centre of Slovenian Academy of Sciences & Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study design: Description of a new technique. Objectives: To describe a safe ultrasound (US)‐guided cryoneuroablation technique of the proximal greater occipital nerve (GON). Background: Cryoneuroablation is a treatment option for occipital neuralgia, providing more sustained relief when steroid injections fail. US can identify the proximal GON between the C2 spinous and C1 transverse process over the inferior oblique capitis muscle (IOCM), where the GON is clearly visualized. US‐guided GON injections are often performed with an out‐of‐plane approach; however, that approach is difficult with cryoneuroablation, because the probe has no opening (prohibiting hydrodissection), and the size and dullness of the probe hinders easy manipulation. Setting: University‐based outpatient pain clinic. Methods: We provide a description of the procedure based on experience in the authors' clinic. With the patient in the prone position, the US probe is placed parallel to the IOCM. The GON is seen on top of the IOCM; a midline 2‐mm incision allows access to the bilateral GONs with a single skin entry. Using an in‐plane approach, the cryo probe is advanced to the nerve in a medial‐to‐lateral direction, with constant US visualization, staying far away from the spinal cord and vertebral artery, which increases safety. Conclusions: Based on anecdotal evidence from the authors' clinic, cryoneuroablation of the proximal GON can be performed safely at the level of the IOCM. Limitations: The procedure described is based on anecdotal evidence from a small number of patients; however, the procedure is promising and formal study is warranted. Lay Summary: Chronic headaches can develop after accidents or wear and tear from poor posture. They are challenging to treat, and steroid injections often fail to provide sustained relief. Once the occipital nerve is identified as a source of pain, it may be treated with cryoablation, which is freezing the nerve with a needle at the back of the head. [ABSTRACT FROM AUTHOR]

Background: Peripheral nerve blockade has been using in primer headache treatment for a long time. Our aim in this study was to examine the efficiency of greater occipital nerve (GON) blockade in patients with primary headache especially medical overuse headache. Materials and Methods: Sixty-nine headache patients who were treated with greater occipital nerve blockade have been examined retrospectively. Thirty-seven of the patients had migraine, 17 of them had medication overuse headache, 7 of them had autonomic cephalagia, 4 of them had trigeminal neuralgia and 3 of them had cervicogenic headache. Results: It has been observed that the intensity, period and frequency of the pain were significantly reduced after the first blockade and ranged stable in repetitive blockades. For the migraine patients; attack frequency was decreased at 50% rate in the first blockade. Attack period was decreased at 91.6% rate at first, then at repetitive blockades effect proceeded as 95.83% and 72.22% respectively. Similar results were reached in other headache groups as well. Discussion: Patients can have significant symptomatic reliefs with first GON blockade. Repetitive blockades can be used in order to provide continuance in the effect or to provide pain relief until the effect of other preventive treatments will start. [ABSTRACT FROM AUTHOR]

Copyright of Filozofski Vestnik is the property of Scientific Research Centre of Slovenian Academy of Sciences & Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tám mẫu cây được thu tại một số tỉnh thuộc đồng bằng sông Cửu Long là cây Gòn (C. pentandra), Chó đẻ thân hồng (P. urinaria), Chó đẻ thân xanh (P. amarus), Bá bịnh (E. longifolia), Càng cua (P.pellucida), dây Cóc (T. crispa), cây Lốt (P. sarmentosum) và Thần thông (T. cordifolia). Cao methanol trích từ tám cây này được đánh giá khả năng kháng sốt rét thông qua sự ức chế sự tổng hợp ?-hematin (BH) in vitro. Kết quả cho thấy, cao methanol từ cây Gòn, Chó đẻ thân hồng, Chó đẻ thân xanh có khả năng ức chế sự tổng hợp BH ở nồng độ cao methanol là 2 mg/ml. Cao methanol từ dây Cóc có ức chế sự biến đổi heme thành BH ở nồng độ cao là 1, 0,5 và 0,25 mg/ml. Cao methanol từ cây Lốt ức chế sự biến đổi heme thành BH nồng độ cao 0,25 mg/ml. Mẫu cao từ cây Càng cua có hoạt tính ức chế sự hình thành BH ở các nồng độ cao 2, 1, 0,5 và 0,25 mg/ml. IC50 của cao methanol ở cây Càng cua là 0,8 mg/ml. Cao methanol của cây Càng cua được tách phân đoạn thành cao nước, cao diethyl ether và cao nước được tách phân đoạn bằng phương pháp sắc ký lỏng cao áp (HPLC). Tất cả các phân đoạn và các phân đoạn HPLC của cây Càng cua được khảo sát khả năng kháng sốt rét ở mức độ in vitro và mức độ tế bào. Sáu phân đoạn của cao nước sau khi tách bằng HPLC được chứng minh có khả năng ức chế sự biến đổi heme thành BH có ý nghĩa thống kê.

The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases. Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain stimulation, occipital nerve stimulation, stimulation of sphenopalatine ganglion, cervical spinal cord stimulation, vagus nerve stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and transcutaneous electrical nerve stimulation are extensively published although proper RCT-based evidence is limited. The European Headache Federation herewith provides a consensus statement on the clinical use of neuromodulation in headache, based on theoretical background, clinical data, and side effect of each method. This international consensus further gives recommendations for future studies on these new approaches. In spite of a growing field of stimulation devices in headaches treatment, further controlled studies to validate, strengthen and disseminate the use of neurostimulation are clearly warranted. Consequently, until these data are available any neurostimulation device should only be used in patients with medically intractable syndromes from tertiary headache centers either as part of a valid study or have shown to be effective in such controlled studies with an acceptable side effect profile. [ABSTRACT FROM AUTHOR]

We propose a novel method to reconstruct the hypothetical geometry of the healthy vasculature prior to intracranial aneurysm (IA) formation: a Frenet frame is calculated along the skeletonization of the arterial geometry; upstream and downstream boundaries of the aneurysmal segment are expressed in terms of the local Frenet frame basis vectors; the hypothetical healthy geometry is then reconstructed by propagating a closed curve along the skeleton using the local Frenet frames so that the upstream boundary is smoothly morphed into the downstream boundary. This methodology takes into account the tortuosity of the arterial vasculature and requires minimal user subjectivity. The method is applied to 22 clinical cases depicting IAs. Computational fluid dynamic simulations of the vasculature without IA are performed and the haemodynamic stimuli in the location of IA formation are examined. We observe that locally elevated wall shear stress (WSS) and gradient oscillatory number (GON) are highly correlated (20/22 for WSS and 19/22 for GON) with regions susceptible to sidewall IA formation whilst haemodynamic indices associated with the oscillation of the WSS vectors have much lower correlations. [ABSTRACT FROM AUTHOR]

Copyright of Filozofski Vestnik is the property of Scientific Research Centre of Slovenian Academy of Sciences & Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Filozofski Vestnik is the property of Scientific Research Centre of Slovenian Academy of Sciences & Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Headache syndromes often suggest occipital and neck involvement, although it is still unknown to what extent branches of segment C1-C3 contribute actively to primary headache. Pain within the occipital area may be referred to the trigeminal territory. However, a modulation of trigeminal transmission by affecting cervical input in humans has not been elucidated so far. A convergence of cervical and trigeminal input at the level of the caudal part of the trigeminal nucleus in the brainstem has been suggested due to anatomical and neurophysiological studies in animals. We examined the R2 components of the nociceptive blink reflex responses in 15 healthy subjects before and after unilateral nerve blockade of the greater occipital nerve with 5 ml prilocain (1%). R2 response areas (AUC) decreased and the R2 latencies increased significantly after the nerve blockade only on the side of injection. AUC and latencies on the non-injection side remained stable. Thresholds for sensory or pain perception did not differ significantly between the repeated measurements on both sides. Our findings extend previous results related to anatomical and functional convergence of trigeminal and cervical afferent pathways in animals and suggest that the modulation of this pathway is of potential benefit in primary headache disorders. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: This study was performed to examine the effect of hypercholesterolemia on inducible nitric oxide synthase (NOS-2) expression and oxidative tissue injury in an experimental rat model of elevated IOP. Methods: Wistar rats were maintained on either regular chow or a high-cholesterol diet for 24 weeks. Intraocular pressure (IOP) was elevated in hypercholesterolemic rats by unilaterally cauterizing three episcleral vessels. Rats were divided into four experimental groups as follows; hypercholesterolemia, hypercholesterolemia+elevated IOP, elevated IOP and control. NOS-2 distribution, lipid peroxidation and retinal nerve fiber layer (RNFL) thickness was evaluated in all experimental groups at the end of 24 weeks. Results: Light microscopic evaluation of retinas in hypercholesterolemic rats revealed breaks and discontinuation in focal areas in the outer nuclear layer (ONL). NOS-2 positive staining was observed throughout the outer plexiform layer (OPL), inner plexiform layer (IPL) and ganglion cell layer (GCL) in rats with elevated IOP and/or hypercholesterolemia. Calculated values of RNFL thickness in hypercholesterolemic rats were significantly higher than those in the control and elevated IOP group. Vitreous malondialdehyde (MDA) levels detected in elevated IOP (3.51±0.31nmol/mg protein) and hypercholesterolemia+elevated IOP (5.14±1.28nmol/mg protein) groups were significantly higher than those detected in hypercholesterolemic (1.92±1.43nmol/mg protein) and control (1.89±0.24nmol/mg protein) groups. Conclusion: The presented data confirms hypercholesterolemia as a risk factor in the development of glaucomatous optic neuropathy (GON) and suggests that increased circulating cholesterol may exacerbate disease progression by inducing NOS-2 expression and elevating oxidant tissue injury. [Copyright &y& Elsevier]

The present study set out to investigate whether nitric oxide, a potent vasodilator, is involved in the regulatory processes in optic nerve head blood flow during an experimental increase in intraocular pressure (IOP). The study was conducted in a randomized, double-masked, placebo-controlled, three way cross-over design. 12 healthy subjects were scheduled to receive either L-NMMA (an unspecific nitric oxide synthase inhibitor), phenylephrine (an α-adrenoceptor agonist) or placebo on three different study days. Optic nerve head blood flow was measured using laser Doppler flowmetry and IOP was increased stepwise with a suction cup. Mean arterial pressure (MAP) and IOP were measured non-invasively and ocular perfusion pressure (OPP) was calculated as OPP = 2/3 MAP-IOP. Administration of L-NMMA and phenylephrine significantly increased MAP and therefore OPP at rest (p < 0.01). L-NMMA significantly reduced baseline blood flow in the optic nerve head (p < 0.01). Application of the suction cup induced a significant increase in IOP and a decrease in OPP (p < 0.01). During the stepwise increase in IOP, some autoregulatory potential was observed until OPP decreased approximately -30% below baseline. None of the administered substances had an effect on this autoregulatory behavior (p = 0.49). The results of the present study confirm that the human optic nerve head shows some regulatory capacity during a decrease in OPP. Nitric oxide is involved in the regulation of basal vascular tone in the optic nerve head but does not seem to be involved in the regulatory mechanisms during an acute increase in IOP in young healthy subjects., (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)