Headache and Pain Research

Sung-Hee Hwang

1 Article

일반연제-Trigeminal Neuralgia After Linear Pontine Trigeminal Root Lesion: Seok-Beom Kwon, Sung-Hee Yun, Hee-Jung Suh, San-Jung, Sung-Hee Hwang , Byung-Chul Lee; Korean J Headache. 2005;6(1):105-105. Published online June 30, 2005

Abstract PDF: Background
Various lesions affecting the trigeminal nerve entry zone may produce trigeminal neuralgia, and include tortuous vessels, aneurysms, arteriovenous malformations, and tumors. However, pontine in- farction or pontine multiple sclerosis(MS) lesion has not been well recognized as a cause of trigeminal neuralgia. Here we report two patients with a pontine lesion(ischemic or demyelinating) transecting the trigeminal pathways resulting with trigeminal neuralgia. These are very rare cases of unusual causes of trigeminal neuralgia. Case: A 55-year-old man presented with severe lacinating pain in the right V2 and V3 distributions. Magnetic resonance imaging of the brain demonstrated a small linear infarct at the root entry zone of the right trigeminal nerve in the pons. The other 30-year-old woman developed electric shocklike pain in the same distributions as a symptom of MS. Brain MRI showed multiple patchy cerebral lesions including right lateral portion of the pons. Conclusion: The mechanism for the trigeminal neuralgia due to pontine lesion may be increased neuronal activity in the trigeminal fascicles and nucleus. Our patients illustrate that the differential diag- nosis of trigeminal neuralgia should include pontine infarction or pontine MS lesion.

Sung-Hee Hwang

1 Article

자발두개내압저하와 요추천자후두통: Seok-Beom Kwon, Sung-Hee Hwang, Whi-Chul Choi; Korean J Headache. 2010;11(2):81-90. Published online December 31, 2010

Abstract PDF: Spontaneous intracranial hypotension (SIH) is an uncommon but not rare cause of new onset daily persistent headaches in young and middle-aged individuals, but initial misdiagnosis is common. The underlying cause is a spontaneous spinal cerebrospinal fluid (CSF) leak. Typically the headache is orthostatic in nature but other headache patterns occur as well. Associated symptoms are common and include neck pain, a change in hearing, diplopia, facial numbness, cognitive abnormalities and even coma. The spectrum of clinical and radiographic manifestations is varied, with diagnosis largely based on clinical suspicion, cranial magnetic resonance imaging, and myelography. Numerous treatment options are available, but outcomes have been poorly studied and much remains to be learned about this disorder. Lumbar puncture is a frequently performed procedure in neurological emergencies and anaesthesia. The typical nature of headache after lumbar puncture is also orthostatic like that of SIH. This article also deals with some part of headache after lumbar puncture.

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