“
“Lumbar puncture (LP) is associated with complications that include post-LP orthostatic headache, local bleeding, and subdural hematoma. We report a unique

case of a spontaneous frontal epidural hematoma following a therapeutic lumbar puncture in a patient with a history of idiopathic intracranial hypertension. This case highlights the importance of symptomatology in patients following LPs by revealing a rare intracranial presentation that would be devastating if not discovered promptly and appropriately managed. “
“Nasal sprays can provide relief to migraine patients in as soon as 15 minutes, and are GSK126 purchase especially useful with nausea and vomiting, or in those who seek to avoid an injection. They are sprayed into the nostril with the head upright. Vigorous sniffing or tipping the head backward puts the medicine down the throat, turning a spray into an oral medication and losing advantages of rapid nasal delivery. There are several categories of nasal spray treatment. Nasal triptans (sumatriptan and zolmitriptan) and dihydroergotamine (DHE), contain migraine-specific treatment. Triptans and DHE are highly effective but do cause blood vessel narrowing and should not be used in people www.selleckchem.com/products/chir-99021-ct99021-hcl.html with known or suspected vascular disease. A third nasal option is a non-steroidal anti-inflammatory

(NSAID) spray, nasal ketorolac, containing medicine targeting migraine inflammation. Many patients have an oral acute treatment for slower onset mild-moderate migraines without vomiting, and a nasal formulation for faster wake-up, throw-up, or more severe migraines. With this plan, one must be careful to choose oral treatment compatible with the nasal spray. Different triptan types cannot be safely mixed, and triptans and DHE also cannot be combined. An anti-inflammatory nasal spray, tablet, or liquid can be mixed 上海皓元医药股份有限公司 with either oral or injectable triptans, or with DHE. This combination of triptan or DHE plus NSAID may improve the benefits of both drugs, reversing inflammation and blood vessel dilation.

This may prevent recurrence. Nasal DHE or NSAID migraine treatment sometimes works even late in a migraine. Triptans may be less effective when a patient wakes up with a migraine progressed to “central sensitization,” where everything hurts, including light, noise, touch, and smells. As many as 40% of patients do not respond to triptans, and nasal DHE or nasal ketorolac may be quite helpful. Both nasal DHE and nasal ketorolac can be used for “rescue,” when a migraine has progressed out of control after several days of usual treatment and may spare you infusion therapy, steroids, or repeated injections. The non-narcotic sprays discussed are not habit forming, don’t cause drowsiness, and don’t cause the jitteriness and increased risk of bone loss associated with steroids.