Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review
Subdural hematoma (SDH) is one of the most lethal types of traumatic brain injury. SDH caused by Intracranial Pressure Reduction (ICPR) is rare, and the mechanism remains unclear. Here, we report three cases of SDH that occurred after substandard cupping therapy and are conjected to be associated wi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.900145/full |
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| author | Tangtang Xiang Tangtang Xiang Xinjie Zhang Xinjie Zhang Yingsheng Wei Yingsheng Wei Dongyi Feng Dongyi Feng Zhitao Gong Zhitao Gong Xuanhui Liu Xuanhui Liu Jiangyuan Yuan Jiangyuan Yuan Weiwei Jiang Weiwei Jiang Meng Nie Meng Nie Yibing Fan Yibing Fan Yupeng Chen Yupeng Chen Jiancheng Feng Jiancheng Feng Shiying Dong Shiying Dong Chuang Gao Chuang Gao Jinhao Huang Jinhao Huang Rongcai Jiang Rongcai Jiang |
| author_facet | Tangtang Xiang Tangtang Xiang Xinjie Zhang Xinjie Zhang Yingsheng Wei Yingsheng Wei Dongyi Feng Dongyi Feng Zhitao Gong Zhitao Gong Xuanhui Liu Xuanhui Liu Jiangyuan Yuan Jiangyuan Yuan Weiwei Jiang Weiwei Jiang Meng Nie Meng Nie Yibing Fan Yibing Fan Yupeng Chen Yupeng Chen Jiancheng Feng Jiancheng Feng Shiying Dong Shiying Dong Chuang Gao Chuang Gao Jinhao Huang Jinhao Huang Rongcai Jiang Rongcai Jiang |
| author_sort | Tangtang Xiang |
| collection | DOAJ |
| description | Subdural hematoma (SDH) is one of the most lethal types of traumatic brain injury. SDH caused by Intracranial Pressure Reduction (ICPR) is rare, and the mechanism remains unclear. Here, we report three cases of SDH that occurred after substandard cupping therapy and are conjected to be associated with ICPR. All of them had undergone cupping treatments. On the last cupping procedure, they experienced a severe headache after the cup placed on the occipital-neck junction (ONJ) was suddenly removed and were diagnosed with SDH the next day. In standard cupping therapy, the cups are not usually placed on the ONJ. We speculate that removing these cups on the soft tissue over the cisterna magna repeatedly created localized negative pressure, caused temporary but repeated ICPR, and eventually led to SDH development. The Monro-Kellie Doctrine can explain the mechanism behind this - it states that the intracranial pressure is regulated by a fixed system, with any change in one component causing a compensatory change in the other. The repeated ICPR promoted brain displacement, tearing of the bridging veins, and development of SDH. The literature was reviewed to illustrate the common etiologies and therapies of secondary ICPR-associated SDH. Despite the popularity of cupping therapy, its side effects are rarely mentioned. This case is reported to remind professional technicians to fully assess a patient's condition before cupping therapy and ensure that the cups are not placed at the ONJ. |
| first_indexed | 2024-04-13T03:47:17Z |
| format | Article |
| id | doaj.art-c67e4f5299f140639786c735af220f74 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T03:47:17Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-c67e4f5299f140639786c735af220f742022-12-22T03:03:59ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-07-011310.3389/fneur.2022.900145900145Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature reviewTangtang Xiang0Tangtang Xiang1Xinjie Zhang2Xinjie Zhang3Yingsheng Wei4Yingsheng Wei5Dongyi Feng6Dongyi Feng7Zhitao Gong8Zhitao Gong9Xuanhui Liu10Xuanhui Liu11Jiangyuan Yuan12Jiangyuan Yuan13Weiwei Jiang14Weiwei Jiang15Meng Nie16Meng Nie17Yibing Fan18Yibing Fan19Yupeng Chen20Yupeng Chen21Jiancheng Feng22Jiancheng Feng23Shiying Dong24Shiying Dong25Chuang Gao26Chuang Gao27Jinhao Huang28Jinhao Huang29Rongcai Jiang30Rongcai Jiang31Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaKey Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin, Tianjin, ChinaSubdural hematoma (SDH) is one of the most lethal types of traumatic brain injury. SDH caused by Intracranial Pressure Reduction (ICPR) is rare, and the mechanism remains unclear. Here, we report three cases of SDH that occurred after substandard cupping therapy and are conjected to be associated with ICPR. All of them had undergone cupping treatments. On the last cupping procedure, they experienced a severe headache after the cup placed on the occipital-neck junction (ONJ) was suddenly removed and were diagnosed with SDH the next day. In standard cupping therapy, the cups are not usually placed on the ONJ. We speculate that removing these cups on the soft tissue over the cisterna magna repeatedly created localized negative pressure, caused temporary but repeated ICPR, and eventually led to SDH development. The Monro-Kellie Doctrine can explain the mechanism behind this - it states that the intracranial pressure is regulated by a fixed system, with any change in one component causing a compensatory change in the other. The repeated ICPR promoted brain displacement, tearing of the bridging veins, and development of SDH. The literature was reviewed to illustrate the common etiologies and therapies of secondary ICPR-associated SDH. Despite the popularity of cupping therapy, its side effects are rarely mentioned. This case is reported to remind professional technicians to fully assess a patient's condition before cupping therapy and ensure that the cups are not placed at the ONJ.https://www.frontiersin.org/articles/10.3389/fneur.2022.900145/fullcupping therapyAtorvastatindexamethasonesubdural hematoma (SDH)Intracranial Pressure Reduction |
| spellingShingle | Tangtang Xiang Tangtang Xiang Xinjie Zhang Xinjie Zhang Yingsheng Wei Yingsheng Wei Dongyi Feng Dongyi Feng Zhitao Gong Zhitao Gong Xuanhui Liu Xuanhui Liu Jiangyuan Yuan Jiangyuan Yuan Weiwei Jiang Weiwei Jiang Meng Nie Meng Nie Yibing Fan Yibing Fan Yupeng Chen Yupeng Chen Jiancheng Feng Jiancheng Feng Shiying Dong Shiying Dong Chuang Gao Chuang Gao Jinhao Huang Jinhao Huang Rongcai Jiang Rongcai Jiang Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review Frontiers in Neurology cupping therapy Atorvastatin dexamethasone subdural hematoma (SDH) Intracranial Pressure Reduction |
| title | Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review |
| title_full | Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review |
| title_fullStr | Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review |
| title_full_unstemmed | Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review |
| title_short | Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review |
| title_sort | possible mechanism and atorvastatin based treatment in cupping therapy related subdural hematoma a case report and literature review |
| topic | cupping therapy Atorvastatin dexamethasone subdural hematoma (SDH) Intracranial Pressure Reduction |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.900145/full |
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