Primary headaches include common forms such as migraine, tension-type headache, and the less frequent cluster headache. Besides, several uncommon primary headaches were included in the section on ‘Cluster headache and other trigeminal autonomic neuralgias’ (section 3) and ‘Other primary headaches’ (section 4) in the second edition of the International Classification of Headache Disorders (ICHD-II, 2004). Since the prevalences of these uncommon headaches are quite low, datas related to clinical features, physiopathology and management are still controversial. While paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) are listed in the third section, hemicrania continua (HC) with not prominent autonomical signs are classified in the fourth section in the ICHD-II classification. The fourth section also includes other rare primary headache syndromes. In this review, some of the uncommon primary types of headache will be discussed. Even though these headaches are reported seldomly, the prevalences are possibly higher than known. It is of importance to recognize these uncommon disorders, since their management differs from common primary headaches.

Childhood migraine is a common problem among the primary complaints of the pediatric population but for the general practitioners there are little known about clinical characteristics and management strategies. Headache practitioners commonly noticed that the age related differences of headache clinic characteristics and management shedules. This paper primarily aimed to answered the question of “is pediatric migraine an unmaturated form of adult migraine?” using discussion of pathophysiological basis, clinical forms and management strategies for childhood- adolescent practitioners keep in mind headache is as an important symptom for their practice.

Osteoarthritis (OA) is one of the most common health problems in the aging world. Pain and stiffness are the most prominent symptoms. Despite there are numerous risk factors that to be considered as responsible, the exact pathophysiology remains uncertain. According to this enigma, there isn’t any single mechanism that explains emerge of pain in OA. Pain experienced in osteoarthritic joint may not always be caused by local pathology; there are also neurologic, neuromuscular and psychosocial influences. Understanding more about the pain mechanism might help us to develop better treatment options.

In this study, we aimed to assess the effect of administration of ondansetron in patient undergoing morphine and tramadol using patient controlled analgesia procedure for postoperative analgesia on analgesic consumption.
After approval by the ethic committee, 120 patient planned to receive lower extremity surgery with ASA status I or II were included in the study. Patients were randomly divided into 4 groups following the induction. Group I received tramadol as PCA with an infusion of 0.3 mg/kg following a loading dose of 1.5 mg/kg administered 1 hour before the end of surgery. Group II received ondansetron 0.1 mg/kg following induction of anesthesia, additionally. Group III received morphine as PCA with an infusion following a loading dose of 0.15 mg/kg administered 30 minutes before the end of surgery. Group IV received ondansetron 0.1 mg/kg following induction of anesthesia, additionally.
Pain scores(VAS), nausea, vomitting and sedation scores, analgesic consumptions and adverse effects were recorded at 5th, 15th, 30th, 45th minutes and 4th, 8th, 12th and 24th hours postoperatively.
Postoperative VAS, nausea, vomitting and sedation scores were similar among the groups. The analgesic consumption was found significantly higher at 4th, 8th, 12th and 24th hours in group II. No statistical significant difference was found in analgesic consumption between group III and IV at all times.
We concluded that, ondansetron, when administered as antiemetic prophylaxia in patients receiving tramadol and morphine as PCA, did not effect morphine consumption whereas did increased tramadol consumption.

The purpose of this study was to determine the effectiveness of intraarticular (ia) bupivacaine and tramadol injection and preemptive intraarticular tramadol in providing pain control after arthroscopic knee surgery. Following local research ethics committee approval, 60 patients were assigned in a randomized manner into three groups: Group I received ia 20 ml of 0.25% bupivacaine at the end of the operation, Group II received ia 20 ml of 0.25% bupivacaine and 100 mg of tramadol at the end of the operation and Group III received ia 100 mg of tramadol diluted in 20 ml of saline solution 30 minutes before skin inscision and 20 ml of 0.25% bupivacaine at the end of the operation as well. Analgesic duration, total analgesic consumption and postoperative VAS pain scores recorded at rest and with movement were significantly lower and patient satisfaction was significantly higher in Group II and III, compared to Group I. Total analgesic consumption and the number of patients requiring supplementary analgesics were significantly lower in the preemptive tramadol group compared to the postoperative tramadol group. In conclusion, preemptive ia tramadol provided effective and reliable pain control after artroscopic knee surgeries and may be preferred to postoperative administration.

INTRODUCTION: The aim of this retrospective study is to evaluate the upper and the lower extremity amputations with regard to phantom pain, phantom sensation and stump pain.
Material-METHOD: A questionnaire consisting of 23 questions was send to the patients who underwent upper or lower extremity amputation surgery between 1996- 2005. The patients were questioned for the presence of phantom pain and sensations and if theyexisted for the frequency, intensity, cause of amputation, pre-amputation pain, stump pain, usage of artificial limb.
RESULTS: Totally 147 patients were included and the response rate was 70%. The incidence of phantom pain in Upper Extremity Group was 60% and 65.8% in Lower Extremity Group. The incidence of phantom sensations was 70.7% in Upper Extremity Group and 75.6% in Lower Extremity Group. There was no significant difference between two groups considering in phantom pain and phantom sensations. The phantom pain was significantly higher in patients who lost dominant hand, experienced pre amputation pain and suffered stump pain.
CONCLUSION: There were no significant differences in regard to phantom pain and sensation between upper and lower extremity amputations. However the presence of preamputation pain, stump pain and amputation of dominant hand were found as risk factors for the development of phantom pain.