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Biomedical subjects

P Rothbart

Publications and source records attributed to P Rothbart.

9 recordsLinked to original sources
PubMed1998

Microsurgical C-2 ganglionectomy for chronic intractable occipital pain.

OBJECT: The authors evaluated the effectiveness of microsurgical C-2 ganglionectomy in 39 patients with medically refractory chronic occipital pain. In this procedure the neurons transmitting sensory inputs from the occiput are removed and, unlike peripheral nerve ablation, axonal regeneration is not possible. METHODS: The patients in this series had symptoms for 1 to 43 years. In 22 patients the occipital pain was caused by trauma; in 17 patients the pain was spontaneous. Pain relief failed in 17 patients who had undergone a previous occipital neurectomy or C-2 rhizolysis. Twenty-three patients experienced pain that was described as shocklike, electric, shooting, jabbing, stabbing, sharp, or exploding (Group I). Eight patients described their pain as dull, pounding, aching, throbbing, or pressurelike (Group II). The patients underwent unilateral or bilateral C-2 open microsurgical ganglionectomies. The postoperative follow-up period ranged from 19 to 48 months. Nineteen patients experienced an excellent result (> 90% reduction in pain). Pain caused by trauma or that described using Group I terms responded best to ganglionectomy (80% good or excellent response). In contrast, the majority of the patients with nontraumatic pain or those described using Group II descriptors did not achieve favorable results. CONCLUSIONS: The authors conclude that: 1) patients who suffer from chronic occipital pain after having sustained injury obtain worthwhile benefit from microsurgical C-2 ganglionectomy; 2) patients suffering from migraine, tension, and vascular headaches involving the occipital area are most often not helped by this operation; and 3) terms such as "shock," "electric," "shooting," "jabbing," and "sharp" used to describe occipital pain predict a favorable pain outcome following a C-2 ganglionectomy.

Adult↗
PubMed1993

Subcutaneous sumatriptan in the treatment of acute episodes of posttraumatic headache.

Seven patients with posttraumatic headaches refractory to other medical treatment were treated with sumatriptan, 6 mg subcutaneously, at the peak of a headache. In all, the throbbing temporal part of the headache disappeared leaving a persistent occipital pain. It is postulated that involvement of the trigeminovascular system is involved in part of the pain of posttraumatic headache, making it amenable to treatment with sumatriptan.

Adult↗