Ýdiyopatik intrakraniyal hipertansiyon (ÝÝH) þiddetli baþaðrýsý, papilödem ve görme bozukluklarýna yol açan, nedeni bilinmeyen intrakraniyal basýnç artýþý ile karakterize bir sendromdur. Eskiden kullanýlan psödotümör serebri tanýmý son yýllarda yeniden gündeme gelmiþtir. Ýdiyopatik intrakraniyal hipertansiyon için en tutarlý ve en güçlü risk faktörleri obezite ve kadýn cinsiyettir. Nadiren ÝÝH’de papilödem görülmeyip, baþaðrýsý migrenöz özellikler taþýyan kronik günlük baþaðrýsý profili gösterebilir. Farklý klinik durumlarla birlikteliði görülen bu durumun etiyolojisini açýklamaya yönelik çeþitli mekanizmalar öne sürülmüþtür. Son yýllarda, enflamatuvar etmenler, natriüretik peptitler ve akuaporinlerin pathogeneze katký olasýlýklarý üzerinde durulmaktadýr. Öte yandan bazý araþtýrýcýlar, ÝÝH hastalarýnýn çoðunda iki yanlý transvers sinüs darlýðý görüldüðünü bildirmiþ, bu nedenle de bazý hastalarda dural sinüslere stent yerleþtirilmiþtir. Görüldüðü gibi tek bir kuram bu sendromla ilgili sorularý açýklamaya yetmemektedir ve ÝÝH’nin kesin nedeni üzerinde görüþ birliði saðlanamamýþtýr. Bu derlemenin amacý, ÝÝH’nin gizemli patogenezi üzerine yeni geliþen görüþleri tartýþmaktýr.

Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure of unknown cause, leading to severe headache, papilledema and visual disturbances. Its former name, pseudotumor cerebri, has gained popularity recently. The strongest and most consistent risk factors of IIH are obesity and female gender. Infrequently, IIH may present in the absence of papilledema showing a headache profile similar to chronic daily headache with migrainous features. There have been several proposed mechanisms to explain the etiology of this disorder associated with various clinical conditions. In recent years, some inflammatory factors, natriuretic peptides and aquaporins have been proposed as possible contributors of the pathogenesis. On the other hand, some investigators have reported that bilateral transverse sinus stenosis is seen in the majority of IIH patients; therefore, dural sinus stent placement is used in some patients. No single theory has been able to provide a comprehensive answer, and there is no consensus about the exact cause of IIH. The aim of this review was to discuss the new insights on the mysterious pathogenesis of IIH.

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Amaç: Huzursuz bacak sendromu (HBS) aðrý, dinlendirici olmayan uyku, gündüz uyku hali ve konsantrasyon bozukluklarý yaratan bir hastalýktýr. Düzenli hemodiyalize giren son dönem böbrek yetersizliði olan hastalarda huzursuz bacak sendromunun sýklýðýnýn artmýþ olabileceði düþünülmektedir. Bu çalýþmada düzenli hemodiyalize giren hastalarda huzursuz bacak sendromu ve yaþam kalitesi arasýndaki iliþkinin araþtýrýlmasý amaçlandý.
Gereç ve Yöntem: Türk Böbrek Vakfý Diyaliz Ünitesi’ne ayaktan baþvuran 118 kronik hemodiyaliz hastasý deðerlendirildi. Uluslararasý Huzursuz Bacak Sendromu Çalýþma Grubu’nun (IRLSSG) belirlediði taný kriterlerne uyan 49 hasta çalýþmaya dahil edildi. Huzursuz bacak sendromu sempromlarýnýn þiddeti Uluslararasý Huzursuz Bacak Sendromu Sýnýflama Skalasý (IRLS) kullanýlarak deðerlendirildi. Yaþam kalitesini deðerlendirmek amacýyla KýsaForm-36 (KF-36) ölçeði kullanýldý. Hastalarýn demografik özellikleri, komorbid hastalýklarý ve laboratuvar verileri kaydedildi. Ýstatistiksel analizde SPSS paket program kullanýldý.
Bulgular: Uluslararasý Huzursuz Bacak Sendromu Çalýþma Grubu taný ölçütlerini karþýlayan 26 kadýn 23 erkek toplam 49 hasta çalýþmaya dahil edildi. Hastalarýn yaþ ortalamasý 61.35±13.17 yýldý. IRLS skoru ile KF-36 Fiziksel, Zihinsel ve Toplam skorlar arasýnda istatistiksel açýsýndan anlamlý negatif korelasyon saptandý (p=0.018 r=-0.351, p=0.01 r=-0.380, p=0.00 r=-0.499). IRLS skoru ile diyaliz süresi, yaþ, serum ferritin, PTH ve komormid hastalýklar ile anlamlý iliþki bulunmadý p>0.05).
Sonuç: Huzursuz bacak sendromu diyalize giren son dönem hastalarda sýk rastlanan bir sorun olduðu düþünülmektedir. Huzursuz bacak sendromuna baðlý aðrý ve diðer semptomlarýn son dönem böbrek yetersizlikli hastalarýn yaþam kalitesini kötü yönde etkileyebileceði düþünülerek bu yakýnmalara yönelik taný ve tedavi yaklaþýmlarý bu hastalarýn yaþam kalitelerinin artýrýlmasýna katkýda bulunacaktýr.

Objectives: Patients with RLS suffer nonrestorative sleep, daytime sleepiness, fatigue, and concentration problems. In addition, dialysis itself effects the psychological and social life of the patient negatively. The aim of this study was to determine the prevalence of RLS in patients on regular hemodialysis, and its relationship with patients’ quality of life, socio-demographic and laboratory data.
Methods: One hundred and eighteen stable chronic hemodialysis (HD) patients referring to the hemodialysis unit of Turkish Kidney Foundation and 49 patients that met IRLSSG diagnostic criteria were included into the study. IRLSSG Diagnostic Criteria and International Restless Leg Syndrome rating scale were used as a guideline to diagnose and evaluate the severity of RLS. Short form-36 health survey was used to evaluate the quality of life. For statistical analysis, the “SPSS for Windows” package program was used.
Results: A total of forty-nine patients, of whom 26 were female and 23 were male, that met IRLSSG diagnostic criteria were included into the study. Mean age of the patients was 61.35±13.17 years. There was a negative correlation between the IRLSS score and SF36 Physical Score, Mental Score and Total Score, respectively (p=0.018 r=-0.351, p=0.01 r=-0.380, p=0.00 r=-0.499). There was no significant correlation between the IRLSS score and dialysis duration, blood ferritin and parathyroid hormone and other comorbid diseases.
Conclusion: RLS is a common distressing problem in patients with ESRD, which negatively impacts functional health status. Clinicians should be aware of the symptoms of RLS to decrease morbidities related with quality of life.

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Amaç: Bu çalýþmanýn amacý EMG incelemesi sýrasýnda kaslardaki aðrý düzeylerinini deðerlendirmek ve ayrýca cinsiyet ile aðrý düzeyleri arasýndaki iliþkiyi araþtýrmaktýr.
Gereç ve Yöntem: Ýki yüz yirmi yedi olgu (166 kadýn, 111 erkek) çalýþmaya katýldý. Numerik analog skala (NAS)’sý her kas için iðne EMG’si sonrasýnda öðrenildi.
Bulgular: Toplamda 1242 kas incelendi. Ýncelenen kaslar arasýnda en yüksek NAS düzeyleri Abduktor Pollisis Brevis (APB) (5.8±2.6), 1. Dorsal Interosseöz (4.2±2.6) ve Vastus Lateralis (4.0±2.6) kaslarýnda bulundu. Kadýn hastalarýn NAS düzeyleri (4.3±2.7) erkek hastalarýn NAS düzeylerinden (2.8±2.3) belirgin olarak yüksekti (p<0.01).
Sonuç: Hastalar için 1. Dorsal Interosseöz kasý APB kasýndan daha az aðrýlý bulundu. Çalýþmamýz kadýnlarýn iðne EMG’de erkekelere kýyasla daha yüksek aðrý düzeyleri bildirdiðini, ancak her iki cinsde de incelenen kaslarda aðrý düzeylerinin ortadan daha yüksek olmadýðýný ortaya koymuþtur.

Objectives: The aim of this study was to evaluate the pain level of each muscle during an EMG study and also search for any association between the pain levels and gender.
Methods: Two hundred and twenty-seven subjects (166 females and 111 males) participated in the present study. Numeric analogue scale (NAS) was obtained from the patients after needle EMG for each muscle.
Results: In total, 1242 muscles were examined. The highest pain levels among examined muscles were found on Abductor Pollicis Brevis (APB) (5.8±2.6), First Dorsal Interosseous (4.2±2.6) and Vastus Lateralis (4.0±2.6). NAS levels of the female patients (4.3±2.7) were apparently higher than those of the male patients (2.8±2.3) (p<0.01).
Conclusion: First Dorsal Interosseous muscle was found less painful than APB muscle for the patients. Our study displayed greater pain sensitivity among females compared with males during the needle EMG; however, the pain levels of examined muscles were not higher than moderate for both genders.

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Amaç: Bu çalýþmada bel aðrýsý dolayýsý ile transforaminal anterior epidural steroid injeksiyonu (TAESÝ) uygulanan hastalarda yapýlan giriþimin, yaþam, uyku kalitesi ve nöropatik aðrý üzerine üzerine etkilerinin araþtýrýlmasý amaçlanmýþtýr.
Gereç ve Yöntem: Çalýþmamýza Adnan Menderes Üniversitesi Týp Fakültesi Etik Kurul izni ve hasta onamý alýndýktan sonra Ekim 2011- Ekim 2012 tarihleri arasýnda Algoloji Bilim Dalý Polikliniði’ne bel aðrýsý þikayeti ile baþvuran ve transforaminal anterior epidural steroid enjeksiyonu yapýlmýþ hastalar dahil edildi. Ýþlem öncesi ve sonrasý hastalara Pittsburgh Uyku Kalitesi Ölçeði (PSQI), Kýsa form 12 (SF 12) ve DN4 testi uygulandý ve Visual Analog Skala (VAS) Skoru bakýldý.
Bulgular: Çalýþmaya 102 (Kadýn/Erkek: 52/50) hasta dâhil edildi. Hastalarýn yaþ ortalamasý 53.29±1.39 idi. Seksen yedi hasta lomber disk hernisi, yedi hasta spinalstenoz, sekiz hastanýn baþarýsýz bel cerrahisi tanýsý mevcuttu. Hastalarýn VAS, DN4 ve PSQI toplam deðerlerinde istatistiksel olarak anlamlý düzelme görüldü (p=0.0001). Uyku kalitesi ölçeðinin uyku süresi (p=0.0001) ve alýþýlmýþ uyku etkinliði (p=0.0001) alt komponentlerinde çok anlamlý olmak üzere, subjektif uyku kalitesi (p=0.003), uykuya dalma süresi (p=0.014), uyku bozukluklarý (p<0.001), uyku ilacý kullanýmý (p=0.003) ve gündüz iþlevsellik kaybý (p=0.015) alt komponentlerinde anlamlý düzelme görüldü. Yaþam kalitesinde anlamlý farklýlýk tespit edilmedi.
Sonuç: Çalýþmamýzda bel aðrýsý dolayýsý ile yapýlan transforaminal anterior epidural steroid uygulamasýnýn, hastalarýn aðrý, nöropatik aðrý ve uyku kalitesinde anlamlý ölçüde iyileþme saðladýðýný fakat yaþam kalitesi üzerine etkili olmadýðýný tespit ettik.

Objectives: Transforaminal anterior steroid injections are frequently used for low back pain. In the current study, It was aimed to investigate the effects of transforaminal anterior epidural steroid injection (TAESI) in patients with low back pain in regards to quality of life and sleep, and neuropathic pain.
Methods: Ethics committee approval and patient consent were obtained. Patients with low back pain scheduled to receive transforaminal epidural steroid injections between October 2011 and October 2012 were included into the study. Pittsburgh Sleep Quality Index (PSQI), Short form 12 (SF 12), DN4 tests and Visual Analog Scale Score (VAS) were measured prior to procedure and three months later. All the tests were compared with baseline evaluations prior to injections.
Results: One hundred and two (female/male: 52/50) patients with a mean age of 53.3±1.4 were included. Primary diagnoses were lumbar disc herniation in eighty-seven patients, spinal stenosis in seven and failed back surgery syndrome in eight patients. Statistically significant improvement was seen in the total VAS, DN4 and PSQI scores (p=0.0001) of the patients at the third month follow-up. Sleep duration (p=0.0001), habitual sleep efficiency (p=0.0001), subjective sleep quality (p=0.003), sleep latency (p=0.014), sleep disturbances (p<0.001), sleep medication use (p=0.003), and day time dysfunction (p=0.015) showed a significant decrease in sub-components. There was no significant difference in SF 12 quality of life.
Conclusion: It was determined in the study that transforaminal epidural steroid injection provided a substantial improvement in patients’ pain and neuropathic pain and quality of sleep, but had no effect on the quality of life.

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Amaç: Aðrý kliniðinde yatan hastalarýn algýladýðý aðrýnýn uyku ve yaþam kalitesi üzerine etkisini belirlemek.
Gereç ve Yöntem: Sivas’ta bir üniversite hastanesinin aðrý kliniðinde yatarak tedavi gören, çalýþmaya katýlmayý kabul eden 122 hasta örneklemi oluþturmuþtur. Veriler Kiþisel Bilgi Formu, Visüel Analog Skala (VAS), Pittsburg Uyku Kalitesi Ölçeði (PUKÖ) ve Kýsa Form 36 (SF-36) ile toplanmýþtýr. Verilerin deðerlendirilmesinde baðýmsýz gruplarda t-testi, Mann-Whitney U testi, Kruskal-Wallis testi ve pearson korelasyon analizi kullanýlmýþtýr. Anlamlýlýk düzeyi p<0.05 olarak alýnmýþtýr.
Bulgular: VAS ile yaþam kalitesi alanlarý olan fiziksel iþlevsellik, fiziksel rol güçlüðü ve emosyonel rol güçlüðü arasýnda orta derecede ters yönde bir iliþki belirlendi. VAS ile vitalite ve ruhsal saðlýk arasýnda zayýf derecede ters yönde bir iliþki belirlendi. VAS ve toplam uyku skoru arasýnda orta derecede doðrusal bir korelasyon var iken VAS ve yaþam kalitesi aðrý alan puaný arasýnda iyi bir korelasyon saptandý. Uyku kalitesi ile yaþam kalitesi alt alanlarý olan genel saðlýk ve sosyal fonksiyon alanlarýnda ise istatistiksel olarak anlamlý bir iliþki belirlenemedi.
Sonuç: Aðrý, uyku kalitesi ve yaþam kalitesi arasýnda iliþki vardýr. Aðrý düzeyi arttýkça uyku ve yaþam kalitesinin olumsuz olarak etkilendiði, uyku kalitesi azaldýðýnda da yaþam kalitesinin olumsuz yönde etkilendiði saptanmýþtýr. Araþtýrma bulgularýna göre hastalarýn uyku kalitesinin kötü olduðu belirlenmiþtir. Bunun için de aðrýyý gidermeye yönelik uygulamalar, uyku ve yaþam kalitesi üzerinde olumlu bir etkiye sahip olacaktýr.

Objectives: The aim of the present study was to determine the effects of perceived pain on quality of sleep and life in patients hospitalized in a pain clinic.
Methods: Population of the present descriptive study composed of patients (>18 years old) treated as inpatients in the algology clinic of a university located at the city center of Sivas, who consented to participate in the study (122 patients). Data were collected through Personal Information Form, Visual Analog Scale (VAS), Pittsburg Sleep Quality Index (PSQI) and Short Form 36. Data were analyzed using independent t-test, Mann Whitney U test, Kruskal Wallis test and Pearson correlation test. Statistical significance level was set at p<0.05.
Results: A moderate negative correlation was found between VAS and three dimensions of SF-36, namely Physical Functioning, Role-Physical and Role-Emotional. VAS was weakly and negatively correlated to Vitality and Mental Health. There was a good linear correlation between VAS and quality of life (QoL), pain score while there was a moderate linear correlation between VAS and the total sleep score. It was found that quality of life was not statistically significantly correlated to General Health and Social Functioning.
Conclusion: There is a relationship between pain, sleep quality and quality of life. Quality of sleep and life was found to decrease as the level of pain increased, and quality of life was affected negatively when the quality of sleep was poor. Applications towards resolving pain would have a positive effect on the quality of sleep and life.

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Amaç: Ýnguinal herni onarýmý sonrasý eriþkinlerde %5-35 oranýnda kronik aðrý geliþmektedir. Bu aðrýnýn; uygulanan cerrahi tekniðe, ameliyat öncesi ve sonrasý aðrýya, hastanýn psikososyal ve fizyolojik yapýsýna veya diðer nedenlere baðlý oluþabileceði belirtilmekle birlikte kesin bir fikir birliði bulunmamaktadýr. Bu çalýþmada; inguinal herni onarýmý sonrasý geliþen kronik aðrýnýn görülme sýklýðý ve risk faktörlerinin belirlenmesi amaçlanmýþtýr.
Gereç ve Yöntem: 2011 yýlý Ocak ayý ile 2012 yýlý Aralýk ayý arasýnda inguinal herni onarýmý yapýlan 204 hasta çalýþmaya dahil edildi. Ýlk 24 saat içindeki akut aðrýlarý VAS ile ölçülen hastalarýn operasyon sonrasý üçüncü ve altýncý ay içerisindeki bulgularý telefon görüþmesi ile kaydedildi. Aðrý veya baþka bir rahatsýzlýðýn varlýðý, aðrý kesici ilaç kullanýmý, VAS deðerleri ve aðrýnýn karakterine iliþkin bulgular araþtýrýldý. Operasyondan üç ay sonrasýnda VAS ≥3 olan hastalardaki aðrý, kronik aðrý olarak deðerlendirildi.
Bulgular: Operasyondan üç ay sonrasýnda devam eden ameliyat sonrasý aðrý insidansý %18, altý ay sonra sonrasýnda ise %11.2 olarak bulundu. Hastalarýn %78.3’ünde ameliyat öncesi aðrý olduðu ve %21.8’inde kronik aðrý geliþtiði saptandý. Ameliyat sonrasý ilk 24 saatteki VAS deðerlerinin ortalamasý kronik aðrý geliþenlerde 3.13±1.12 ve kronik aðrý geliþmeyenlerde ise 1.71±1.27 olarak bulundu. Herni onarýmý reoperasyonu olan hastalarýn (%5.2) hepsinde kronik aðrý geliþtiði görüldü. Hastalarýn %48’inde kronik aðrý nöropatik özellikler taþýyordu ve þiddeti orta düzeyde idi.
Sonuç: Ýnguinal herni onarýmý sonrasý %18 olarak bulduðumuz ameliyat sonrasý kronik aðrý oraný yapýlan benzer çalýþmalar ile uyumludur. Diðer risk faktörleri ile karþýlaþtýrýldýðýnda; ameliyat öncesi dönemde aðrýnýn varlýðý, ameliyat sonrasý akut aðrýnýn þiddeti ve reoperasyonlar ameliyat sonrasý kronik aðrýnýn geliþiminde en önemli risk faktörleri olarak deðerlendirildi.

Objectives: The percentage of chronic pain in adults having inguinal hernia repair is 5-35%. Although this pain is thought to be related to some reasons, there is not an exact conclusion about this. In this study, the aim was to point out the incidence of chronic pain after inguinal hernia repair and determination of the risk factors.
Methods: Two hundred and four patients having inguinal hernia surgery between January 2011 and December 2012 were included into this study. The patients’ pain was measured with VAS within 24 hours and at the third and the sixth month after surgery. The patients whose VAS was>3 three months after surgery were evaluated to have chronic pain.
Results: The incidence of pain continuing 3 months after surgery was 18.6% and 11.2% six months after surgery. 78.3% of the patients had already had pain before surgery, and in 28% of them, chronic pain had evolved. The measure of VAS within 24 hours postoperatively was found higher in patients who developed chronic pain (3.13±1.12/1.71±1.27). 5.2% of the patients had re-operation for reparation and chronic pain developed in all. Chronic pain was neuropathic in 48% of the patients, and its severity was moderate.
Conclusion: The incidence of chronic pain after inguinal hernia repair was found %18, compatible with similar studies. Compared with other risk factors, preoperative pain, postoperative severe acute pain and reoperations were thought to be the most important risk factors for the development of chronic pain.

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Amaç: Bu araþtýrmanýn amacý, palyatif destek verilecek kanser hastalarýnda palyatif bakýma kabul sýrasýnda görülen semptomlarý belirlemek, þiddetini ölçmek, hastaneye yatýþtan sonra ilk bir haftadaki deðiþiklikleri kaydederek palyatif bakýmýn hasta semptomlarý üzerindeki etkisini deðerlendirmektir.
Gereç ve Yöntem: Araþtýrmanýn örneklemi, ön uygulama verileri kullanýlarak yapýlan kitle ortalamasý önemlilik testi sonuçlarýna göre 108 olarak belirlendi. Hastaneye kabulde, yatýþýn üçüncü ve yedinci günlerinde Edmonton Semptom Tanýlama Ölçeði’ni tamamlayabilen hastalar deðerlendirmeye alýndý. Verilerin toplanmasýnda Tanýtýcý Özellikler Anket Formu, Edmonton Semptom Tanýlama Ölçeði ve Palyatif Performans Skalasý kullanýldý.
Bulgular: Hastalarýn %50’si yatýþ sýrasýnda aðrý þiddetini 5 ve üzeri olarak tanýmlarken yedinci günde bu oranýn %6.5 olduðu saptandý. Hastalarýn aðrý, uykusuzluk, iþtahsýzlýk, kendini iyi hissetme durumu semptomlarý ortalama deðerlerinin hastaneye kabule göre, üçüncü günde ve yedinci günde anlamlý derecede azaldýðý belirlendi. Bununla beraber bulantý, endiþe, nefes darlýðý ve konstipasyon semptomlarý arasýnda istatistiksel olarak anlamlý fark bulunmadý.
Sonuç: Bu araþtýrmada kanser hastalarýnýn yaþam kalitesini bozan aðrý, yorgunluk, uykusuzluk, iþtahsýzlýk ve kendini iyi hissetme durumu gibi semptomlarýn þiddetinde palyatif bakým desteði ile hýzlý bir düzelme saðlandýðý saptandý.

Objectives: The purpose of this study was to determine the symptoms observed during admission to palliative care in patients that would be provided palliative support, to measure their intensity, and to evaluate the effect of palliative care on patient symptoms by recording changes during the first week after admission to hospital.
Methods: The sample of the study was determined as 108 according to the population mean significance test conducted by using preliminary application data. Patients who were able to complete the Edmonton Symptom Assessment Scale during admission to hospital, on the 3rd and 7th days of hospitalization were included into the evaluation. The Introductory Characteristics Questionnaire, Edmonton Symptom Assessment Scale and Palliative Performance Scale were used for the collection of the data.
Results: While 50% of the patients defined pain intensity as 5 and over during admission, this rate was determined to be 6.5% on the 7th day. Mean values of the symptoms of pain, insomnia, loss of appetite, and status of well-being decreased significantly on the 3rd and 7th days after admission compared to the time of admission to the hospital. Besides, no statistically significant difference was found among the symptoms of nausea, anxiety, shortness of breath, and constipation.
Conclusion: In this study, it was determined that the intensity of symptoms deteriorating the life quality of cancer patients such as pain, fatigue, insomnia, loss of appetite, and status of well-being improved rapidly with palliative care support.

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Hemiplejik migren hemiparezinin eþlik ettiði auralý migrenin özel bir þeklidir ve etiyolojisi net olmayan nadir bir durumdur. Bu olguda nadir görülen sporadik hemiplejik migrenli (SHM) 39 yaþýnda kadýn hastayý sunduk. Tekrarlayan baþ aðrýlarý, hemiparezi ve fokal nörolojik defisit öyküsü olan hastaya anamnez, muayene bulgularý ve ileri görüntüleme yöntemleri ile SHM tanýsý konularak ayýrýcý tanýlarý gözden geçirildi.

Hemiplegic migraine, whose etiology is unclear, is a specific form of migraine with aura including hemiparesis. In this study, it was aimed to present the case of a 39-year-old women, suffering from sporadic hemiplegic migraine. The patient suffered recurrent severe headaches, and existing focal neurological symptoms, including alternant hemiparesis. On the basis of the history, thorough clinical observation and numerous accessory investigations, a diagnosis of sporadic hemiplegic migraine was established. Differential diagnoses of SHM were highlighted.

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Yetmiþ yedi yaþýnda, erkek hasta. Ýki yýl önce inme geçirmiþ. Ýnme sonrasýnda, sol diz ile kalça arasýnda, sürekli, oyucu tarzda, çok þiddetli, dizden kalçaya doðru yayýlan, ayakta durma ve yürüyüþle artan aðrýsý var. Aðrýnýn nedenine yönelik yaptýðýmýz taný ve uygulanan tedavi yöntemleriyle, bu esnada hastanýn aðrýsýnýn niteliðindeki deðiþimleri inceledik. Ýnme sonrasý, sol bacakta santral nöropatik aðrýsý ve dejeneratif disk hastalýðýna baðlý periferik nöropatik aðrýsý, dejeneratif disk hastalýðýna baðlý radiküler nosiseptif aðrýsý ve gonartroza baðlý nosiseptif aðrýsý olan hastadaki tedavi yaklaþýmlarýmýzý sunmayý amaçladýk.

A seventy-seven year-old male patient had a stroke two years ago. Following the stroke, the patient had continuous, excruciating, severe pain between the left knee, which increased when standing and walking. We looked into the change in the character of the patient’s pain after treatment. This study aimed to present our treatment approaches to the patients who develop central neuropathic pain, degenerative disk disease-related peripheral neuropathic pain and radicular nociceptive pain, and gonarthrosis-related nociceptive pain in the left leg following stroke.

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Küme baþ aðrýsý, tekrarlayýcý, oldukça þiddetli, 15-180 dakika süren, yüz, burun ve gözlerde otonomik semptomlarýn eþlik ettiði, tek taraflý temporal ve periorbital baþ aðrýlarý ile þekillenen bir sendromdur.[1,2] Aðrý, haftalar ya da aylar sürebilen küme dönemleri boyunca, genellikle günün ayný zamanlarýnda ortaya çýkar. Ortalama 20-40 yaþlarý arasýnda baþlar, erkeklerde daha sýktýr. Bu baþ aðrýsý çoðunlukla primer olarak görülür,[2] ancak nadir de olsa tümör, diseksiyon veya enfeksiyonlar gibi sekonder nedenlerle de ortaya çýkabilir.[3,4] Burada, uluslar arasý taný kriterlerini karþýlayan tipik küme tipi baþ aðrýsý þikayetleri ile baþvuran ancak kavernöz sinüs menenjiomu saptanan bir hasta sunulmaktadýr.

Cluster headache is a neurological disorder characterized by recurrent, sudden, short-lasting, very severe, unilateral temporal-periorbital pain. It is a rare subtype of primary headache; and very rarely secondary forms have been reported in the literature. Here is reported a patient with secondary cluster headache due to cavernous sinus meningioma, who have presented with typical features of primary cluster headache fulfilling the criteria defined by the international headache committee.

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Sayýn yetkili editore mektup olarak gönderilmiþtir.

Sayýn yetkili editore mektup olarak gönderilmiþtir.

Abstract | Full Text PDF