1
|
Stearns SA, Xun H, Haddad A, Rinkinen J, Bustos VP, Lee BT. Therapeutic Options for Migraines in the Microsurgical Patient: A Scoping Review. Plast Reconstr Surg 2024; 153:988e-1001e. [PMID: 37337332 DOI: 10.1097/prs.0000000000010861] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
BACKGROUND There exists an increasing array of treatments proposed to prevent, alleviate, and abort symptoms of a migraine; however, for patients who undergo reconstructive microsurgery, caution must be taken to preserve vascular integrity. This study is the first-to-date scoping review of vascular and bleeding risk of current migraine therapies, with the purpose of identifying potential therapeutic agents for postoperative migraine management appropriate for microsurgical patients. METHODS Currently available migraine therapeutics were compiled from the UpToDate software system and the American Academy of Family Physicians. A PubMed literature review was performed for each therapeutic's effect on bleeding or vascular involvement. Data were compiled into tables of abortive, symptom-controlling and prophylactic, and nonpharmacologic treatments. Expert microsurgeons reviewed the data to provide recommendations for optimized patient care. RESULTS Triptans and other ergot derivatives demonstrated strong evidence of vasoconstriction and were greatly advised against for immediate postmicrosurgical use. Novel pharmaceutical therapies such as lasmiditan and calcitonin gene-related peptide antagonists have no literature indicating potential for vasoconstriction or hematoma and remain an investigational option for abortive medical treatment. For symptom control, acetaminophen appears the safest option, with clinical judgment and further research needed for use of nonsteroidal antiinflammatory drugs. Alternative treatment techniques may include migraine prophylaxis with botulinum toxin injection or nutraceutical treatment by means of magnesium supplementation or coenzyme Q10 administration, minimizing the need for additional medication in the postoperative setting. CONCLUSIONS Patients undergoing reconstructive microsurgery have a unique medical profile limiting the therapeutic options available to treat migraines. This review provides preliminary evidence to be considered as a guide for prescribing therapeutics for migraine in the postoperative setting.
Collapse
Affiliation(s)
| | - Helen Xun
- the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Anthony Haddad
- the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Jacob Rinkinen
- the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Valeria P Bustos
- the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Bernard T Lee
- the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| |
Collapse
|
2
|
Kim TH, Lee MS, Birch S, Alræk T, Norheim AJ, Kang JW. Publication status and reporting quality of case reports on acupuncture-related adverse events: A systematic reviews of case studies. Heliyon 2023; 9:e20577. [PMID: 37842566 PMCID: PMC10569964 DOI: 10.1016/j.heliyon.2023.e20577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Case reports on acupuncture-related adverse events (AEs) have been consistently published in the literature. This review aims to assess the current publication status of case reports on acupuncture-related AEs and evaluate their reporting quality in order to identify areas for improvement. Methods This study is a systematic review (SR) of case reports. Studies describing cases for acupuncture-related AEs between 2010 and 2023 (until July) were searched in PubMed, Embase, and local databases (China and Korea), as well as by hand-searching references included in published relevant SRs. A bibliometric analysis was conducted to examine the publication trends of the included literature. The appropriateness of the acupuncture described in the cases, the causality assessment between AEs and acupuncture treatment, and the presence of necessary items from the CAse REport guidelines (CARE) checklist were narratively analyzed. Results A total of 169 case reports were included in this review. Over the past decade, an average of 12 case reports on acupuncture-related AEs were published annually. However, only 38.2% of the articles provided sufficient information to determine the appropriateness of the acupuncture treatment used in the reported cases, and considerable numbers of the included case reports did not suggest enough information for the assessment of a causal relationship. The majority of cases did not report the timeline (n = 164), patient perspectives (n = 157), and informed consent (n = 121) items from the CARE checklist. Discussion Acupuncture-related AEs persist in being frequently reported in the literature. Nonetheless, the information concerning acupuncture and causality assessment within these publications is still found to be insufficient. The development of reporting guidelines for future case reports on acupuncture-related AEs is anticipated to promote an academic environment conducive to more comprehensive reporting.
Collapse
Affiliation(s)
- Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Myeong Soo Lee
- Division of Clinical Medicine, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Stephen Birch
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Terje Alræk
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Community Medicine, Faculty of Medicine, National Research Center in Complementary and Alternative Medicine, UiT the Arctic University of Norway, Tromso, Norway
| | - Arne Johan Norheim
- Department of Community Medicine, Faculty of Medicine, National Research Center in Complementary and Alternative Medicine, UiT the Arctic University of Norway, Tromso, Norway
| | - Jung Won Kang
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| |
Collapse
|
3
|
Hsieh HT, Chou HJ, Wu PY, Lin SK. Bleeding risk after acupuncture in patients taking anticoagulant drugs: a case control study based on real-world data. Complement Ther Med 2023; 74:102951. [PMID: 37141924 DOI: 10.1016/j.ctim.2023.102951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/19/2023] [Accepted: 05/01/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVES Patients on anticoagulant medications may be at a higher risk of bleeding after acupuncture. This study aimed to assess the association between anticoagulant drug use and bleeding after acupuncture. DESIGN Case control study SETTING: We analysed the diagnosis and treatment records (2000-2018) of a random sample of two million patients from the National Health Insurance Research Database in Taiwan. INTERVENTIONS anticoagulant and antiplatelet drugs MAIN OUTCOME MEASURES: The incidence rates of major (visceral bleeding or ruptured blood vessels requiring transfusion) and minor (skin bleeding or contusion) bleeding after acupuncture RESULTS: We included the records of 13,447,563 acupuncture sessions in 821,946 participants and followed up the patients for 14 days after each session. The incidence of minor bleeding was 8.31 per 10,000 needles, whereas that of major bleeding was 4.26 per 100,000 needles. Anticoagulants significantly increased the risk of minor bleeding (adjusted OR = 1.15 (1.03-1.28)), but the risk of major bleeding did not reach statistical significance (adjusted OR = 1.18 (0.8 0-1.75)). Anticoagulants, such as warfarin (adjusted OR = 4.95 (2.55-7.64)), direct oral anticoagulants (adjusted OR = 3.07 (1.23-5.47)), and heparin (adjusted OR = 3.72 (2.18-6.34)) significantly increased the risk of bleeding. However, antiplatelet drug was not significantly associated with post-acupuncture bleeding. Comorbidities including liver cirrhosis, diabetes, and coagulation defects, were the risk factors for bleeding after acupuncture. CONCLUSIONS Anticoagulant drugs may increase the risk of bleeding after acupuncture. We encourage physicians to ask patients in detail about their medical history and drug use prior to acupuncture treatment.
Collapse
Affiliation(s)
- Hsu-Tung Hsieh
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC.
| | - Hui-Jer Chou
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC.
| | - Pei-Yun Wu
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Musculoskeletal and Sports Science Laboratory (Ortho Lab.), Department of Physical Therapy and Assistive Technology National Yang-Ming Chiao-Tung University, Taiwan, ROC.
| | - Shun-Ku Lin
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; General Education Center, University of Taipei, Taipei, Taiwan, ROC.
| |
Collapse
|
4
|
Zhou LL, Zhu SG, Fang Y, Huang SS, Huang JF, Hu ZD, Chen JY, Zhang X, Wang JY. Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke: Two case reports. World J Clin Cases 2022; 10:11835-11844. [PMID: 36405285 PMCID: PMC9669878 DOI: 10.12998/wjcc.v10.i32.11835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cervical myelopathy is a potential stroke imitator, for which intravenous thrombolysis would be catastrophic.
CASE SUMMARY We herein present two cases of cervical myelopathy. The first patient presented with acute onset of right hemiparesis and urinary incontinence, and the second patient presented with sudden-onset right leg monoplegia. The initial diagnoses for both of them were ischemic stroke. However, both of them lacked cranial nerve symptom and suffered neck pain at the beginning of onset. Their cervical spinal cord lesions were finally confirmed by cervical computed tomography. A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy.
CONCLUSION The current report and the review remind us to pay more attention to these two clues in suspected stroke patients, especially those within the thrombolytic time window.
Collapse
Affiliation(s)
- Li-Li Zhou
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Shi-Guo Zhu
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yuan Fang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Shi-Shi Huang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jie-Fan Huang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ze-Di Hu
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jin-Yu Chen
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xiong Zhang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jian-Yong Wang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| |
Collapse
|
5
|
Vastani A, Mirza AB, Lavrador JP, Boardman TM, Khan MF, Malik I, Barazi S, Grahovac G. Risk Factor Analysis and Surgical Outcomes of Acute Spontaneous Spinal Subdural Hematoma. An Institutional Experience of Four Cases and Literature Review. World Neurosurg 2021; 146:e384-e397. [PMID: 33223130 DOI: 10.1016/j.wneu.2020.10.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Spontaneous spinal subdural hematoma (SSSDH) is exceedingly rare, with significant morbidity in most patients. Acute neurologic deficit in the context of a SSSDH is considered a neurosurgical emergency. We performed a literature review and compared the results with our institutional experience to evaluate the risk factors and neurologic outcomes of SSSDH. METHODS We retrospectively collected the medical, radiologic, and surgical information of 4 patients with SSSDH who were operated on in our neurosurgical unit. A literature review of surgically managed patients with SSSDH and their neurologic outcomes was performed. Ordered logistic regression statistics were used to study the risk factors influencing the postoperative Domenicucci grade. RESULTS A total of 112 patients were evaluated, with a female/male ratio of 1.3:1. Mean patient age was 60.25 years. Our analysis of the data showed that the cohort of patients presenting with bladder dysfunction in addition to paraparesis were found to have worse neurologic outcomes postoperatively. Adjusted analysis identified 3 clinical characteristics that influenced surgical outcome: cervical SSSDH (P = 0.029), neurologic deficit (P < 0.001), and anticoagulation medication (P < 0.001). CONCLUSIONS This review shows that patients aged ≥60 years and on anticoagulation are at an increased risk of sustaining a spontaneous subdural spinal hematoma without history of trauma. To our knowledge, this is also the first study to show a presenting symptom of bladder dysfunction as a significant risk factor for poor surgical outcome in SSSDH. Our study supports surgical evacuation of acute SSSDH in the presence of these risk factors.
Collapse
Affiliation(s)
- Amisha Vastani
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom.
| | - Asfand Baig Mirza
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Jose Pedro Lavrador
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Muhammed Faheem Khan
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Irfan Malik
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Sinan Barazi
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Gordan Grahovac
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
6
|
Feret WB, Kwiatkowska E, Domański L. Paraplegia Caused by Spontaneous Spinal Hemorrhage in a Patient Undergoing Rivaroxaban Therapy. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923607. [PMID: 32636352 PMCID: PMC7369144 DOI: 10.12659/ajcr.923607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Patient: Female, 82-year-old Final Diagnosis: Spinal hemorrhage Symptoms: Back pain • paraplegia • stool retention Medication: — Clinical Procedure: — Specialty: General and Internal Medicine
Collapse
Affiliation(s)
- Wiktoria B Feret
- Department of Nephrology, Transplantology and Internal Medicine, Independent Public Clinical Hospital No. 2, Szczecin, Poland
| | - Ewa Kwiatkowska
- Department of Nephrology, Transplantology and Internal Medicine, Independent Public Clinical Hospital No. 2, Szczecin, Poland
| | - Leszek Domański
- Department of Nephrology, Transplantology and Internal Medicine, Independent Public Clinical Hospital No. 2, Szczecin, Poland
| |
Collapse
|
7
|
Chen CL, Chang MH, Lee WJ. A Case Report: An Acute Spinal Epidural Hematoma after Acupuncture Mimicking Stroke. J Emerg Med 2020; 58:e185-e188. [PMID: 32204999 DOI: 10.1016/j.jemermed.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/27/2019] [Accepted: 01/12/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute or subacute onset and varied symptoms, making it difficult to diagnose. This condition can mimic acute stroke, so it is vital to establish a clear diagnosis before considering thrombolytic therapy, which could be disastrous if applied inappropriately. CASE REPORT We describe a 52-year-old man who presented to our emergency department (ED) with acute onset of unilateral weakness of the limbs for 3.5 h immediately after receiving acupuncture at the bilateral neck and back. The acute stroke team was activated. In the ED, computer tomography angiography from the aortic arch to the head revealed spinal epidural hematoma. The patient was admitted to the ward for conservative treatment and was discharged with subtle residual symptoms of arm soreness 5 days later. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Acute spinal epidural hematoma rarely presents with unilateral weakness of the limbs, mimicking a stroke. Because inappropriate thrombolysis can lead to devastating symptoms, spinal epidural hematoma should be excluded when evaluating an acute stroke patient with a history of acupuncture who is a possible candidate for thrombolytic therapy.
Collapse
Affiliation(s)
- Chieh-Ling Chen
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Hong Chang
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Dementia and Parkinson's Disease Integrated Center, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| |
Collapse
|
8
|
Wang Y, Zheng H, Ji Y, Lu Q, Li X, Jiang X. Idiopathic Spinal Subdural Hematoma: Case Report and Review of the Literature. World Neurosurg 2018; 116:378-382. [DOI: 10.1016/j.wneu.2018.05.155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/20/2018] [Accepted: 05/22/2018] [Indexed: 12/29/2022]
|
9
|
Iatrogenic Spinal Subdural Hematoma due to Apixaban: A Case Report and Review of the Literature. Case Rep Hematol 2018; 2018:4507638. [PMID: 29670777 PMCID: PMC5836423 DOI: 10.1155/2018/4507638] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/03/2017] [Accepted: 12/24/2017] [Indexed: 11/17/2022] Open
Abstract
In the last decade, the clinical relevance for developing safer oral anticoagulants prompted the development of new classes of drugs that have shown a lower risk of life-threatening bleeding events as compared to standard warfarin. Nontraumatic spinal subdural hematoma is an uncommon urgent complication that can be associated with the use of these agents. An unusual case of spinal subdural hematoma related to apixaban treatment for nonrheumatic atrial fibrillation is reported here.
Collapse
|
10
|
Lee HJ, Kim YJ, Kim WY. Safety Concerns with Thoracoabdominal Acupuncture: Experience at a Tertiary-Care Emergency Department. PAIN MEDICINE 2017; 18:2504-2508. [DOI: 10.1093/pm/pnx068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
11
|
The rising root sign: the magnetic resonance appearances of post-operative spinal subdural extra-arachnoid collections. Skeletal Radiol 2017; 46:1225-1231. [PMID: 28578526 DOI: 10.1007/s00256-017-2682-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 02/02/2023]
Abstract
We present a case series of symptomatic post-operative spinal subdural extra-arachnoid collections that displace the cauda equina roots anteriorly. This is described as the "rising root sign".
Collapse
|
12
|
Furuse N, Shinbara H, Uehara A, Sugawara M, Yamazaki T, Hosaka M, Yamashita H. A Multicenter Prospective Survey of Adverse Events Associated with Acupuncture and Moxibustion in Japan. Med Acupunct 2017; 29:155-162. [PMID: 28736592 PMCID: PMC5512321 DOI: 10.1089/acu.2017.1230] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: There have been only a few prospective surveys on adverse events (AEs) in Japanese-style acupuncture practice, and these surveys were conducted only in a single college acupuncture clinic. Objective: The goal of this research was to assess the safety of acupuncture and moxibustion performed in educational facilities in Japan. Materials and Methods: This was a multicenter prospective survey, using paper reporting forms. It was conducted in eight acupuncture clinics affiliated with educational institutions. The subjects were outpatients attending the clinics. The main outcome measure was the number of reported adverse events. The study was conducted for 5-7 months at each facility between October 2014 and June 2015. Participating acupuncture practitioners were instructed to self-report AEs observed during and after treatment; patients were interviewed upon treatment completion. For returning patients, treatment was preceded by an interview survey regarding the AEs identified after the previous treatment session. A specialized 4-sheet questionnaire was used. Results: Two hundred and thirty-two acupuncture practitioners participated, 2180 patients received treatment, and there were 14,039 sessions, overall. In total, 847 (6.03%) AEs were reported. The most common AEs included subcutaneous bleeding and hematomas (370, 2.64%), followed by discomfort (109, 0.78%) and residual pain at insertion points (94, 0.67%). No infections or serious AEs were reported. Conclusions: Acupuncture and moxibustion performed in educational facilities in Japan were safe because most of the AEs reported were mild and transient. However, the risk cannot be defined definitely because the survey sample size was too small.
Collapse
Affiliation(s)
- Nobutatsu Furuse
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Osaka Minami Prefectural Special Needs Education School for the Visually Impaired, Osaka, Japan
- Morinomiya University of Medical Sciences Acupuncture Information Center, Osaka, Japan
| | - Hisashi Shinbara
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Department of Acupuncture and Moxibustion Therapy, Faculty of Health Promotional Sciences, Tokoha University, Shizuoka, Japan
| | - Akihito Uehara
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Oriental Medicine Clinical Laboratory, Kuretake College of Medical Arts & Sciences, Tokyo, Japan
| | - Masaaki Sugawara
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Toshiya Yamazaki
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Masayoshi Hosaka
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Morinomiya University of Medical Sciences Acupuncture Information Center, Osaka, Japan
| | - Hitoshi Yamashita
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Morinomiya University of Medical Sciences Acupuncture Information Center, Osaka, Japan
| |
Collapse
|
13
|
In Reply to the Letter to the Editor regarding “An Acute Cervical Subdural Hematoma as the Complication of Acupuncture: Case Report and Literature Review”. World Neurosurg 2017; 98:858. [DOI: 10.1016/j.wneu.2016.10.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 01/11/2023]
|
14
|
Eghbal K, Ghaffarpasand F. An Acute Cervical Subdural Hematoma as the Complication of Acupuncture: Case Report and Literature Review. World Neurosurg 2016; 95:616.e11-616.e13. [PMID: 27591101 DOI: 10.1016/j.wneu.2016.08.090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 08/18/2016] [Accepted: 08/20/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several injuries in the cervical region as complications of acupuncture have been previously reported in the literature, including cord and medulla oblongata injuries, subdural empyema, and cervical hematoma. Spinal cord subdural hematoma is a rare condition mainly associated with coagulopathy, trauma, and iatrogenic procedures. We herein report an acute cervical subdural hematoma after cervical acupuncture for neck and shoulder pain. CASE DESCRIPTION A 74-year-old woman presented with progressive quadriparesis and sensory deficit after receiving acupuncture in the neck and shoulder. Magnetic resonance imaging of the cervical spine showed a subdural lesion that was a hyperintense mass in the T1-weighted and hypointense in T2-weighted images at the C4-C6 level, which proved to be an early subacute subdural hematoma. After surgical evacuation of the hematoma, the patient had significant neurologic improvement. CONCLUSIONS Although rare, cervical spinal cord hematomas are disastrous complications of cervical acupuncture. These procedures should be performed under direct observation of trained physicians with appropriate knowledge of cervical anatomy to avoid these complications.
Collapse
MESH Headings
- Acupuncture Therapy/adverse effects
- Aged
- Cervical Vertebrae/diagnostic imaging
- Cervical Vertebrae/surgery
- Female
- Hematoma, Subdural, Acute/diagnostic imaging
- Hematoma, Subdural, Acute/etiology
- Hematoma, Subdural, Acute/surgery
- Hematoma, Subdural, Spinal/diagnostic imaging
- Hematoma, Subdural, Spinal/etiology
- Hematoma, Subdural, Spinal/surgery
- Humans
- Magnetic Resonance Imaging
- Quadriplegia/etiology
Collapse
Affiliation(s)
- Keyvan Eghbal
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Ghaffarpasand
- Student Research Committee, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
15
|
Protzman NM, Kapun J, Wagener C. Thoracic spinal subdural hematoma complicating anterior cervical discectomy and fusion: case report. J Neurosurg Spine 2016; 24:295-299. [DOI: 10.3171/2015.5.spine141191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A spinal subdural hematoma is a rare clinical entity with considerable consequences without prompt diagnosis and treatment. Throughout the literature, there are limited accounts of spinal subdural hematoma formation following spinal surgery. This report is the first to describe the formation of a spinal subdural hematoma in the thoracic spine following surgery at the cervical level. A 53-year-old woman developed significant paraparesis several hours after anterior cervical discectomy and fusion of C5–6. Expeditious return to operating room for anterior cervical revision decompression was performed, and the epidural hematoma was evacuated without difficulty. Postoperative imaging demonstrated a subdural hematoma confined to the thoracic level, and the patient was returned to the operating room for a third surgical procedure. Decompression of T1–3, with evacuation of the subdural hematoma was performed. Postprocedure, the patient’s sensory and motor deficits were restored, and, with rehabilitation, the patient gained functional mobility. Spinal subdural hematomas should be considered as a rare but potential complication of cervical discectomy and fusion. With early diagnosis and treatment, favorable outcomes may be achieved.
Collapse
Affiliation(s)
| | - Jennifer Kapun
- 2Orthopedics, Coordinated Health, Bethlehem, Pennsylvania
| | | |
Collapse
|
16
|
Nas OF, Sanal B, Buyukkaya R, Hacikurt K, Hakyemez B. Spontaneous cervicothoracic epidural hematoma. Spine J 2015; 15:e63-4. [PMID: 26096487 DOI: 10.1016/j.spinee.2015.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 06/12/2015] [Indexed: 02/03/2023]
Affiliation(s)
- Omer Fatih Nas
- Department of Radiology, Uludag University Faculty of Medicine, Gorukle, Bursa, Turkey
| | - Bekir Sanal
- Department of Radiology, Dumlupinar University Faculty of Medicine, FSM, Kutahya, Turkey
| | - Ramazan Buyukkaya
- Department of Radiology, Duzce University Faculty of Medicine, Konuralp, Duzce, Turkey
| | - Kadir Hacikurt
- Department of Radiology, Uludag University Faculty of Medicine, Gorukle, Bursa, Turkey
| | - Bahattin Hakyemez
- Department of Radiology, Uludag University Faculty of Medicine, Gorukle, Bursa, Turkey
| |
Collapse
|
17
|
Ji GY, Oh CH, Choi WS, Lee JB. Three cases of hemiplegia after cervical paraspinal muscle needling. Spine J 2015; 15:e9-13. [PMID: 25459742 DOI: 10.1016/j.spinee.2014.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 09/22/2014] [Accepted: 11/08/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Muscle needling therapy is common for chronic pain management, but the development of unusual complications such as hemiplegia is not well understood. PURPOSE We report on three cases with hemiplegia after cervical paraspinal muscle needling and propose possible explanations for these unusual complications. STUDY DESIGN Case report. METHODS The authors retrospectively reviewed the medical charts from a decade (2002-2013) at Korea University Hospital. The records were systematically searched, and the cases with hemiplegia (grade<3) after needing therapy were collected. No conflict of interest reported. No funding received. RESULTS A 54-year-old woman, a 38-year-old woman, and a 60-year-old man with hemiplegia by cervical subdural or epidural hematoma after cervical posterior paraspinal muscle needling without direct invasion (intramuscular stimulation, acupuncture, or intramuscular lidocaine) were observed. All patients were taken for emergent decompressive laminectomy, and their postoperative motor function improved substantially. CONCLUSION Spinal hematoma after muscle needling is unusual but was thought to result after a rupture of the epidural or subarachnoid veins by a sharp increase in blood pressure delivered in the intraabdominal or intrathoracic areas after needling therapy.
Collapse
Affiliation(s)
- Gyu Yeul Ji
- Depatment of Neurosurgery, Spine and Spinal Cord Research Institute, Yonsei University, College of Medicne, 50 Yonsei-ro, Seodamun-gu, 120-752 Seoul, Korea; Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
| | - Chang Hyun Oh
- Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
| | - Won-Seok Choi
- Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
| | - Jang-Bo Lee
- Department of Neurosurgery, Korea University Anam Hospital, College of Medicine, 73, Inchon-ro, Seongbuk-gu, 136-705 Seoul, Korea.
| |
Collapse
|
18
|
Chung J, Park IS, Hwang SH, Han JW. Acute spontaneous spinal subdural hematoma with vague symptoms. J Korean Neurosurg Soc 2014; 56:269-71. [PMID: 25368774 PMCID: PMC4217068 DOI: 10.3340/jkns.2014.56.3.269] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/04/2014] [Accepted: 09/18/2014] [Indexed: 11/30/2022] Open
Abstract
Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis.
Collapse
Affiliation(s)
- Jaehwan Chung
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - In Sung Park
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soo-Hyun Hwang
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jong-Woo Han
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|