Soria Emilio D, Fine Edward J
Department of Neurology, State University of New York, Buffalo, NYU.S.A. Veterans Administration Medical Center, Buffalo, NYU.S.A.
Pain. 1991 Mar;44(3):285-288. doi: 10.1016/0304-3959(91)90098-I.
A hypertensive man had a long standing history of contumacious hyperpathia in the right upper extremity, resistant to medical therapy, secondary to a lacunar infarct in the left thalamus. A second cerebrovascular accident caused a small lesion in the left corona radiata, interrupting the thalamoparietal interconnections, and terminated the pain instantly. Interruption of the subcortical parietal white matter may more effectively control pain than cortical lesions. A few surgeons have successfully treated rebellious chronic pain with stereotaxic operations in the corona radiata, resulting in lesions very similar to our patient's. This overlooked and nearly forgotten technique may still have value in treating selected cases.
一名高血压患者长期存在右上肢顽固性痛觉过敏，药物治疗无效，病因是左侧丘脑腔隙性梗死。第二次脑血管意外在左侧放射冠造成一个小病灶，中断了丘脑与顶叶的联系，疼痛随即消失。中断皮质下顶叶白质可能比皮质病变更有效地控制疼痛。一些外科医生通过立体定向手术成功治疗了放射冠部位难治性慢性疼痛，造成的病灶与我们患者的非常相似。这种被忽视且几乎被遗忘的技术在治疗某些特定病例时可能仍有价值。
