지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.12
- 수록면
- 97 - 109 (13page)
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초록· 키워드
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Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these highpressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH.
Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions.
Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively.
Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.
Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions.
Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively.
Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.
목차
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Stovner Lj / 2007 / The global burden of headache : a documentation of headache prevalence and disability worldwide / Cephalalgia 27:193~210
Steiner TJ / 2015 / Headache disorders are third cause of disability worldwide / J Headache Pain 16:58
Sjaastad O / 2008 / Prevalence of cervicogenic headache : Vågå study of headache epidemiology / Acta Neurol Scand 117:170~183
Sjaastad O / 1998 / Cervicogenic headache:diagnostic criteria. The Cervicogenic Headache International Study Group / Headache 38:442~445
Bogduk N / 2001 / Cervicogenic headache : anatomic basis and pathophysiologic mechanisms / Curr Pain Headache Rep 5:382~386
Steiner TJ / 2015 / Headache disorders are third cause of disability worldwide / J Headache Pain 16:58
Sjaastad O / 2008 / Prevalence of cervicogenic headache : Vågå study of headache epidemiology / Acta Neurol Scand 117:170~183
Sjaastad O / 1998 / Cervicogenic headache:diagnostic criteria. The Cervicogenic Headache International Study Group / Headache 38:442~445
Bogduk N / 2001 / Cervicogenic headache : anatomic basis and pathophysiologic mechanisms / Curr Pain Headache Rep 5:382~386
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UCI(KEPA) : I410-ECN-0101-2021-515-001451734