Giant Virchow- Robin spaces may play a role at headache attributed to hypoxia and/or hypercapnia.

According to International Classification of Headache Disorders (ICHD-III Beta version) headache attributed to hypoxia and/or hypercapnia is classified under the 4 title: 10.1.1 High altitude headache, 10.1.2 Airplane travel associated headache, 10.1.3 Diving headache and 10.1.4 Sleep apnoea headache. Headache associated with airplane travel is encountered infrequently in our clinical practice and firstly reported in 2004 as a case in the literature. The pathophysiology of headache associated with airplane travel is not yet clear. We presented this case in the aspect of the patient having both airplane travel and high altitude headaches and seen giant Virchow-Robin spaces in cranial MRI and disappearence of pain with a preventive treatment.

Intravascular escape during lumbar transforaminal anterior epidural steroid injection: A retrospective study.

OBJECTIVES: Demonstrate of accidental intravascular injection during lumbar transforaminal anterior epidural steroid injection (TAESI) performed with three-dimensional imaging angiography (3DIA) and fluoroscopy. METHODS: We assessed 20 (9 males and 11 females) patients (with a total of 40 levels) whose images were received with simultaneously 3DIA and fluoroscopy-guided TAESI between January 2016 and September 2016 as retrospective. Injections were carried out in the lumbar fourth intervertebral space bilaterally and performed in the same way all of the cases. RESULTS: The mean age and body mass index of the patients were 47.9±2.72 years and 26.95±1.21, respectively. There were 10 patients with disc herniation, seven patients with spinal stenosis, and three patients with failed back surgery syndrome. In 3D imaging, vascular escape was detected in the 7 levels (17.5%) which were thought to be no escape in the fluoroscopy imaging. CONCLUSION: In chronic lumbar radiculopathy patients, intravascular escapes may occur during the fluoroscopic TAESI procedure. To avoid intravascular injections during TAESI procedure, it may be appropriate to use different imaging methods that can give more detailed results such as 3D angiography.

Effectiveness of Pregabalin for Treatment of Burning Mouth Syndrome.

Treatment of burning mouth syndrome (BMS) is challenging because there is no consensus regarding pharmalogical or nonpharmalogical therapies. The use of anticonvulsants is controversial. We present nine patients BMS who respond to pregabalin. They were diagnosed secondary BMS except two. Etiologic regulations were made firstly in patients with secondary BMS but symptoms did not decrease. We preferred pregabalin in all patients and got good results. Furthermore the addition of pregabalin to the treatment of two patients who did not respond adequately to duloxetine provided good results. We are only aware that pregabalin may reduce symptoms as a result of case reports. We believe that the diagnosis of pathologic etiology with appropriate diagnostic tests will result in better outcomes in treatment.