Tête

URL:

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11237083&log$=activity

Keywords:

headaches; evaluation

Abstract:

Classifying headaches as primary (migraine, tension-type or cluster) or secondary can facilitate evaluation and management A detailed headache history helps to distinguish among the primary headache disorders. "Red flags" for secondary disorders include sudden onset of headache, onset of headache after 50 years of age, increased frequency or severity of headache, new onset of headache with an underlying medical condition, headache with concomitant systemic illness, focal neurologic signs or symptoms, papilledema and headache subsequent to head trauma. A thorough neurologic examination should be performed, with abnormal findings warranting neuroimaging to rule out intracranial pathology. The preferred imaging modality to rule out hemorrhage is noncontrast computed tomographic (CT) scanning followed by lumbar puncture if the CT scan is normal. Magnetic resonance imaging (MRI) is more expensive than CT scanning and less widely available; however, MRI reveals more detail and is necessary for imaging the posterior fossa. Cerebrospinal fluid (CSF) analysis can help to confirm or rule out hemorrhage, infection, tumor and disorders related to CSF hypertension or hypotension. Referral is appropriate for patients with headaches that are difficult to diagnose, or that worsen or fail to respond to management.

URL:

http://www.jaoa.org/cgi/content/abstract/108/5/260

Keywords:

muncie technique; osteopathic manipulation; eustachian tube; otitis; vertigo; dizziness

Abstract:

In eustachian tube dysfunction, the eustachian tube fails to open sufficiently, resulting in a difference between the air pressure inside and outside the middle ear. This condition can cause pain and hearing loss and may lead to barotitis media, otitis media, tinnitus, and vertigo. Although several treatment options are available, from antibiotics to surgery, little documentation of osteopathic manipulative techniques exists. The current report discusses various treatment options, including the modified Muncie technique—a type of myofascial release administered inside the patient's mouth—for patients with eustachian tube dysfunction and its symptoms. An illustrative case of a 37-year-old woman who complained of intermittent vertigo and who was treated with this technique is included.

Notes:

La technique semble plutôt simple. Presque trop en fait pour croire que cela pourrait fonctionner.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/12825844?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Keywords:

fontanels; skull; newborn

Abstract:

The diagnosis of an abnormal fontanel requires an understanding of the wide variation of normal. At birth, an infant has six fontanels. The anterior fontanel is the largest and most important for clinical evaluation. The average size of the anterior fontanel is 2.1 cm, and the median time of closure is 13.8 months. The most common causes of a large anterior fontanel or delayed fontanel closure are achondroplasia, hypothyroidism, Down syndrome, increased intracranial pressure, and rickets. A bulging anterior fontanel can be a result of increased intracranial pressure or intracranial and extracranial tumors, and a sunken fontanel usually is a sign of dehydration. A physical examination helps the physician determine which imaging modality, such as plain films, ultrasonography, computed tomographic scan, or magnetic resonance imaging, to use for diagnosis.

Notes:

Bon à savoir... On trouvait que notre plus jeune avait la fontanelle antérieure petite mais il semble que ça rentre dans la fourchette des normales.

Accession Number:

1363

URL:

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16899387&ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Keywords:

cephalees; migraines; neurodynamique; enfants

Abstract:

Headache in children with unknown aetiology is an increasing phenomenon in industrial countries, especially during growth spurts. During this growth phase, the Long Sitting Slump (LSS) can be a useful tool for measurement of neurodynamics and management. This study investigated the difference in cervical flexion and sensory responses (intensity and location) during the LSS tests in children (n=123) aged 6-12 years, between a migraine (primary headache group=PG), cervicogenic headache (secondary headache group=SG) and control group (CG). The results indicated that the intensities of the sensory response rate were highest in the PG and SG when compared to CG. The responses in the legs were predominantly found in the PG (81.9%) and responses in the spine in the SG (80%). The sacrum position varied significantly between both headache groups (PG and SG) and the CG (p<0.0001), but there was no significant difference between the CG and the PG (p>0.05). No significant difference in the neck flexion range was measured in LSS, nor in standardized knee flexion between the PG and CG (p>0.05). The cervical flexion ranges differed significantly (p<0.0001) between the SG on the one hand and the PG and CG on the other. The biggest difference in neck flexion during knee extension was between the SG and CG.

Notes:

En gros, le groupe de céphalées cervicogéniques et le groupe des migraines a une neurodynamique altérée en comparaison au groupe contrôle. Il est intéressant de noter que le groupe des migraines ressent la sensation d'étirement dans les jambes alors que le groupe des céphalées cervicogéniques ressent surtout l'étirement dans la région cervicale. ceci suggère des mécanismes pathophysiologiques différents.

 

Accession Number:

1281

URL:

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1533-2500.2007.00111.x

Keywords:

whiplash; cephalees; douleur cervicale

Abstract:

Motor vehicle accidents result in many patients with chronic head and neck pain, some of which meet the criteria for a "whiplash syndrome." The cervical zygapophysial joint synovium, muscular, and ligamentous strains and other anatomical sites are often implicated in the pathophysiology of these cases. Some patients have a characteristic constellation of vague neurological symptoms, often including headache, posterior neck discomfort, dizziness, nausea, and sometimes visual changes. Recently presented research has noted that some patients who have a whiplash-associated disorder have imaging findings consistent with a low-pressure cerebrospinal fluid leak. Some of these patients respond favorably to high-volume epidural blood patch. The following case presentation focuses on the differential diagnosis of a post-traumatic headache syndrome, specific imaging findings, and treatment strategies.

Notes: