背景:三叉神经自主性头痛(TAC)是一种单侧脑痛性头痛,攻击经常伴随着自主神经反应,比如撕裂,流鼻涕,恐慌,受影响的一侧恶心和呕吐。目前,最常见的治疗策略是药物,神经移植和手术.对TACs的临床理解有限。这里,我们报告了在局部麻醉下,在罕见的TAC中对翼腭神经节进行热凝治疗的情况。
方法:一例罕见的TAC病例采用计算机断层扫描(CT)引导下翼腭神经节内热凝固术治疗。术后疼痛和自主神经体征立即缓解,与专利只保留轻微麻木的左侧的脸。这种麻木在随访6个月时完全消退,没有复发。
结论:三叉神经性头痛严重影响患者的生活质量,但临床认识有限.在这里报道的案件中,我们在CT引导下在90°C下对翼腭神经节进行热凝固180s,以治疗三叉神经自主性头痛。据我们所知,这是在90°C下使用热凝术治疗翼腭神经节的第一份报告。我们发现,与其他选择相比,这种策略的副作用更少,并且对此类患者的治疗更具成本效益。
结论:计算机断层扫描引导下翼腭神经节在90°C下热凝固180s治疗三叉神经自主性头痛是一种安全经济的治疗选择。
BACKGROUND: Trigeminal autonomic cephalalgia (TAC) is a type of one-sided cerebral painful headache, with attacks regularly accompanied by autonomic responses, such as tearing, runny nose, panic, nausea and vomiting on the affected side. Currently, the most common treatment strategies are drugs, nerve grafts and surgery. Clinical understanding of TACs is limited. Here, we report the case of thermocoagulation treatment of the pterygopalatine ganglion in an uncommon TAC under local anesthesia.
METHODS: A rare case of TAC was treated with computed tomography (CT)-guided thermocoagulation within the pterygopalatine ganglion. Pain and autonomic signs were relieved immediately after surgery, with the patent retaining only slight numbness on the left side of the face. This numbness completely resolved at 6 months of follow-up and there was no recurrence.
CONCLUSIONS: Trigeminal autonomic cephalalgia seriously affects the patient\'s quality of life, but clinical understanding is limited. In the case reported here, we performed CT-guided thermocoagulation of the pterygopalatine ganglion at 90 °C for 180 s for treatment of a trigeminal autonomic headache. To our knowledge, this is the first report of using thermocoagulation at 90 °C to treat the pterygopalatine ganglion. We found that this strategy results in fewer side effects and is a more cost-effective treatment for such patients than other options.
CONCLUSIONS: Computed tomography-guided thermocoagulation of the pterygopalatine ganglion at 90 °C for 180 s for treatment of trigeminal autonomic headache is a safe and economical treatment option.