Büyük oksipital sinir blokajı: Trigeminoservikal sistem ve primer başağrılarındaki klinik uygulamalar
Primer başağrılarında büyük oksipital sinir injeksiyonu hakkındaki çalışmalar Michael Anthony ile başlamıştır ve bugün yapılan çalışmaların hemen hepsi Anthony’nin çalışmalarını referans çalışma olarak kabul ederler. Üzerinden yirmi yılı aşkın süre geçmesine karşın konu hakkında, yeterli sayıda çalışma bulunmamaktadır. Mevcut verilere göre, steroidlerin özellikle küme başağrısında hem koruyucu tedavide hem de akut atak tedavisinde etkili olduğu anlaşılmaktadır. Migren’de ise bu etki küme başağrısındaki kadar belirgin değildir. Lokal anestetiklerin ise, akut ağrının hafifletilmesinde rolü olmakla beraber, tek injeksiyon profilaktik tedavi için uygun görünmemektedir. Klinikte uygulamada özellikle, küme başağrısında ana koruyucu tedavinin etkisi başlayıncaya kadar; analjezik kötüye kullanımı nedeniyle kronikleşen migren’in detoksifikasyon sürecinde bu prosedürün kullanılabileceği konusunda umut vadeden veriler bulunmaktadır. Acil şartlarında akut küme ve migren ataklarında kullanımı hakkında bazı vaka bildirileri bulunsa da sistematik klinik çalışmalara ihtiyaç vardır.
Anahtar Kelimeler:
Küme baş ağrısı, Baş ağrısı, Oksipital lob, Gerilim-tipi başağrısı, Migren bozuklukları
Greater occipital nerve blockade: Trigeminicervical system and clinical applications in primary headaches
Studies about greater occipital nerve injection in primary headaches had begun with Michael Anthony and almost all the studies today accept Anthony’s studies as reference work. Although more than twenty years passed, there is not enough study about the subject. According to the present data, steroids are apparently effective in both preventive and acute attack therapy in cluster headache. Efficacy in migraine is not dramatic as in cluster headache. Despite the fact that local anesthetics has a role in releiving acute headache, single injection is not suitable in prophylactic treatment. In clinical practice, there is promising data about the usage of the procedure, until the beginning of the effect of principal preventive therapy in cluster headache and during the detoxification process in analgesic induced chronic migraine. Although there are case reports about the relieving acute pain in cluster headache and migraine, there is need for systematized clinical studies.
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- ISSN: 1300-0012
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2018
- Yayıncı: Ali Cangül
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