Ma Ying, Xu Shuangshuang, Liu Xiaolan, Xia Zhangtian, Zhao Wei, Huang Bing
Department of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882 Zhong Huan South Road, Jiaxing, 314000, Zhejiang, China.
Pain Ther. 2022 Sep;11(3):1071-1077. doi: 10.1007/s40122-022-00406-9. Epub 2022 Jun 24.
Trigeminal autonomic cephalalgia (TAC) is a type of one-sided cerebral painful headache, with attacks regularly accompanied by autonomic responses, such as tearing, runny nose, panic, nausea and vomiting on the affected side. Currently, the most common treatment strategies are drugs, nerve grafts and surgery. Clinical understanding of TACs is limited. Here, we report the case of thermocoagulation treatment of the pterygopalatine ganglion in an uncommon TAC under local anesthesia.
A rare case of TAC was treated with computed tomography (CT)-guided thermocoagulation within the pterygopalatine ganglion. Pain and autonomic signs were relieved immediately after surgery, with the patent retaining only slight numbness on the left side of the face. This numbness completely resolved at 6 months of follow-up and there was no recurrence.
Trigeminal autonomic cephalalgia seriously affects the patient's quality of life, but clinical understanding is limited. In the case reported here, we performed CT-guided thermocoagulation of the pterygopalatine ganglion at 90 °C for 180 s for treatment of a trigeminal autonomic headache. To our knowledge, this is the first report of using thermocoagulation at 90 °C to treat the pterygopalatine ganglion. We found that this strategy results in fewer side effects and is a more cost-effective treatment for such patients than other options.
Computed tomography-guided thermocoagulation of the pterygopalatine ganglion at 90 °C for 180 s for treatment of trigeminal autonomic headache is a safe and economical treatment option.
三叉自主神经性头痛（TAC）是一种单侧脑部疼痛性头痛，发作时经常伴有自主神经反应，如患侧流泪、流涕、面部潮红、恶心和呕吐。目前，最常见的治疗策略是药物、神经移植和手术。临床上对TAC的了解有限。在此，我们报告了一例在局部麻醉下对罕见TAC进行翼腭神经节热凝治疗的病例。
一例罕见的TAC患者在计算机断层扫描（CT）引导下对翼腭神经节进行了热凝治疗。术后疼痛和自主神经症状立即缓解，患者仅左侧面部留有轻微麻木感。这种麻木感在随访6个月时完全消失，且无复发。
三叉自主神经性头痛严重影响患者的生活质量，但临床了解有限。在本报告的病例中，我们在CT引导下对翼腭神经节进行90°C、持续180秒的热凝治疗三叉自主神经性头痛。据我们所知，这是首次报告使用90°C热凝治疗翼腭神经节。我们发现，与其他治疗方法相比，该策略副作用更少，对这类患者来说是一种更具成本效益的治疗方法。
在CT引导下对翼腭神经节进行90°C、持续180秒的热凝治疗三叉自主神经性头痛是一种安全且经济的治疗选择。
