Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report
The introduction of ventricular shunts dramatically changed the outcome and quality of life of hydrocephalic patients. However, shunt surgery continues to be associated with numerous adverse events. Headache is one of the most common complications after shunt operation. It is often of prolonged dura...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.mdpi.com/2039-7283/13/1/27 |
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| author | Athanasia Alexoudi Efstathios Vlachakis Stamatios Banos Konstantinos Oikonomou Panayiotis Patrikelis Anastasia Verentzioti Maria Stefanatou Stylianos Gatzonis Stefanos Korfias Damianos Sakas |
| author_facet | Athanasia Alexoudi Efstathios Vlachakis Stamatios Banos Konstantinos Oikonomou Panayiotis Patrikelis Anastasia Verentzioti Maria Stefanatou Stylianos Gatzonis Stefanos Korfias Damianos Sakas |
| author_sort | Athanasia Alexoudi |
| collection | DOAJ |
| description | The introduction of ventricular shunts dramatically changed the outcome and quality of life of hydrocephalic patients. However, shunt surgery continues to be associated with numerous adverse events. Headache is one of the most common complications after shunt operation. It is often of prolonged duration, the symptoms resemble those of migraine, and pain does not respond to medication. We propose invasive peripheral nerve stimulation as a potential solution in the treatment of patients suffering from chronic headache associated with shunted hydrocephalus. A young woman presented with daily holocephalic headache with diffuse pain exacerbated by lying down. Imaging revealed panventricular enlargement and possible aqueduct stenosis. When a ventriculoperitoneal shunt was placed, clinical symptoms resolved. Nevertheless, she gradually exacerbated after a second valve replacement due to wound infection. Imaging revealed decompressed ventricles and appropriate shunt placement. The diagnosis of chronic post-intracranial disorder headache was set. Therefore, occipital nerve stimulation was applied and, considering that the patient did not have a total response, bilateral parietal stimulation was added. Three months after the combined PNS, she experienced total remission of headache. Combined PNS eases refractory headaches much more than occipital nerve stimulation alone and could be considered as a solution for shunted hydrocephalus-associated headache. |
| first_indexed | 2024-03-11T08:59:27Z |
| format | Article |
| id | doaj.art-f56c97bc4afd499595098016663841bf |
| institution | Directory Open Access Journal |
| issn | 2039-7283 |
| language | English |
| last_indexed | 2024-03-11T08:59:27Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-f56c97bc4afd499595098016663841bf2023-11-16T19:51:59ZengMDPI AGClinics and Practice2039-72832023-02-0113129730410.3390/clinpract13010027Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case ReportAthanasia Alexoudi0Efstathios Vlachakis1Stamatios Banos2Konstantinos Oikonomou3Panayiotis Patrikelis4Anastasia Verentzioti5Maria Stefanatou6Stylianos Gatzonis7Stefanos Korfias8Damianos Sakas9Department of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceRoyal Victoria Infirmary, Newcastle Upon Tyne Hospitals, NHS Trust, Newcastle NE14LP, UKDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceDepartment of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, 10646 Athens, GreeceThe introduction of ventricular shunts dramatically changed the outcome and quality of life of hydrocephalic patients. However, shunt surgery continues to be associated with numerous adverse events. Headache is one of the most common complications after shunt operation. It is often of prolonged duration, the symptoms resemble those of migraine, and pain does not respond to medication. We propose invasive peripheral nerve stimulation as a potential solution in the treatment of patients suffering from chronic headache associated with shunted hydrocephalus. A young woman presented with daily holocephalic headache with diffuse pain exacerbated by lying down. Imaging revealed panventricular enlargement and possible aqueduct stenosis. When a ventriculoperitoneal shunt was placed, clinical symptoms resolved. Nevertheless, she gradually exacerbated after a second valve replacement due to wound infection. Imaging revealed decompressed ventricles and appropriate shunt placement. The diagnosis of chronic post-intracranial disorder headache was set. Therefore, occipital nerve stimulation was applied and, considering that the patient did not have a total response, bilateral parietal stimulation was added. Three months after the combined PNS, she experienced total remission of headache. Combined PNS eases refractory headaches much more than occipital nerve stimulation alone and could be considered as a solution for shunted hydrocephalus-associated headache.https://www.mdpi.com/2039-7283/13/1/27combined peripheral nerve stimulationoccipital nerve stimulationsecondary headache disorderschronic post-intracranial disorder headache and case report |
| spellingShingle | Athanasia Alexoudi Efstathios Vlachakis Stamatios Banos Konstantinos Oikonomou Panayiotis Patrikelis Anastasia Verentzioti Maria Stefanatou Stylianos Gatzonis Stefanos Korfias Damianos Sakas Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report Clinics and Practice combined peripheral nerve stimulation occipital nerve stimulation secondary headache disorders chronic post-intracranial disorder headache and case report |
| title | Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report |
| title_full | Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report |
| title_fullStr | Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report |
| title_full_unstemmed | Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report |
| title_short | Combined Invasive Peripheral Nerve Stimulation in the Management of Chronic Post-Intracranial Disorder Headache: A Case Report |
| title_sort | combined invasive peripheral nerve stimulation in the management of chronic post intracranial disorder headache a case report |
| topic | combined peripheral nerve stimulation occipital nerve stimulation secondary headache disorders chronic post-intracranial disorder headache and case report |
| url | https://www.mdpi.com/2039-7283/13/1/27 |
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