by Derdeyn, Colin P and Chimowitz, Marc I and Lynn, Michael J and Fiorella, David and Turan, Tanya N and Janis, L Scott and Montgomery, Jean and Nizam, Azhar and Lane, Bethany F and Lutsep, Helmi L and Barnwell, Stanley L and Waters, Michael F and Hoh, Brian L and Hourihane, J Maurice and Levy, Elad I and Alexandrov, Andrei V and Harrigan, Mark R and Chiu, David and Klucznik, Richard P and Clark, Joni M and McDougall, Cameron G and Johnson, Mark D and Pride, G Lee and Lynch, John R and Zaidat, Osama O and Rumboldt, Zoran and Cloft, Harry J and for the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial Investigators and Stenting Aggressive Med Management and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial Investigators ...
The management of biliary strictures depends on their correct pre-operative evaluation which remains challenging. Biliary strictures have various etiologies (traumatic, inflammatory, tumoral, ischemic etc), which are necessarily needed to be known for the correct therapeutic approach. Despite the emerging multitudes of new diagnostic opportunities and modalities (laboratory, radiological, endoscopic, histopathologic and immunohistological) which exist today, there is still a large number of biliary stenosis misdiagnosed with a profound negative impact on the patients´ outcome. The dilemma that exists is how to balance the risk of missing the chance of curative surgery for some malignancy and preventing some patients from unnecessary surgery for benign etiologies and not to waste time. Therefore, diagnostic methods which can maximize the chance of the preoperative diagnosis of indeterminate biliary strictures are needed.. This study will:. compare two methods helping in the diagnosis of ...
BACKGROUND:. Cardiovascular disease is the leading cause of death in patients with diabetes. The BARI 2D study is designed to determine the potential value of specific treatment regimens for those with diabetes and will test the hypothesis that with a target HbA1C of less than 7.5%, a strategy of hyperglycemic management directed at insulin sensitization results in lower 5 year mortality compared to a strategy of insulin provision. This ancillary study is designed to provide mechanistic insight into potential benefits derived from two different treatment strategies employed by characterizing the thrombotic potential in those patients assigned to the aggressive medical management strategy and long-range goal is to demonstrate that treatment of diabetes with regimens that reduce thrombotic potential decreases cardiovascular risk. The results of this ancillary study should help to define the extent to which specific regimens diminish the pro-thrombotic state.. The study is in response to an ...
Looking for online definition of anastomotic stricture in the Medical Dictionary? anastomotic stricture explanation free. What is anastomotic stricture? Meaning of anastomotic stricture medical term. What does anastomotic stricture mean?
We performed this clinical trial to evaluate the outcome of symptomatic IAS and to evaluate the efficacy of cilostazol in this condition. The major findings of our study are: (1) the symptomatic IAS is a dynamic lesion; and (2) aspirin plus cilostazol regimen is tolerable and superior to aspirin monotherapy in the prevention of the progression of symptomatic IAS.. Because digital subtraction angiography was considered invasive, we used MRA to assess the IAS in this study. To augment the reliability of the results, we additionally used TCD. Because there are no validated criteria for the change of IAS with TCD, we arbitrarily defined the change of ,20 cm/s and 20% of mean flow velocity as a significant finding. The results obtained by MRA and TCD were similar and concordant. On MRA study, the symptomatic IAS progressed in 29% and regressed in 15% in patients receiving aspirin alone, illustrating that symptomatic IAS is subject to change even at 6 months of follow-up. This dynamic change of ...
From the Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, China (X.S., D.M., F.G., N.M., B.W., Z.M.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (X.S., D.M., F.G., N.M., B.W., Z.M.); China National Clinical Research Center for Neurological Diseases Center of Stroke, Beijing (X.S., D.M., F.G., N.M., B.W., Z.M.); Beijing Institute for Brain Disorders, China (X.S., D.M., F.G., N.M., B.W., Z.M.); Department of Neurology, Tangshan Gongren Hospital, Hebei Medical University, China (X.T.); and Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China (W.T.L.). ...
Allograft vasculopathy is an accelerated intimal hyperplastic lesion leading to progressive vascular stenosis; it represents the major long-term limitation to successful solid organ transplant. Although allograft vasculopathy is not formally an autoimmune disease, nor does it constitute a major cause of cardiovascular disease on a purely numerical basis, its pathogenesis provides an important window on the mechanisms by which immune injury can drive more common vascular pathologic entities. Thus, insights gleaned from vascularized solid organ transplants can shed new mechanistic (and therapeutic) light on: 1) the intimal vascular responses accompanying typical atherosclerosis and other inflammatory vessel diseases (e.g., scleroderma); 2) the pathogenesis of vascular stenosis versus aneurysm formation; 3) the sources of intimal smooth muscle cells in the healing of any vascular injury; and 4) the mechanisms by which smooth muscle cells are recruited into intimal lesions. Indeed, research on allograft
Background: Most doctors are used to locate the vascular stenosis position first then clinically estimate vascular stenosis by the CAG images instead of using m
Bile duct strictures are problematic in terms of management and distinction between benign and malignant. Pathology Aetiology There are numerous causes of biliary duct strictures, including 1,2 : malignant cholangiocarcinoma involvement by...
by Derdeyn, Colin P, Prof and Chimowitz, Marc I, Prof and Lynn, Michael J, MS and Fiorella, David, Prof and Turan, Tanya N, MD and Janis, L Scott, PhD and Montgomery, Jean, RN and Nizam, Azhar, MS and Lane, Bethany F, RN and Lutsep, Helmi L, Prof and Barnwell, Stanley L, MD and Waters, Michael F, MD and Hoh, Brian L, MD and Hourihane, J Maurice, MD and Levy, Elad I, Prof and Alexandrov, Andrei V, Prof and Harrigan, Mark R, MD and Chiu, David, Prof and Klucznik, Richard P, MD and Clark, Joni M, MD and McDougall, Cameron G, Prof and Johnson, Mark D, MD and Pride, G Lee, MD and Lynch, John R, MD and Zaidat, Osama O, Prof and Rumboldt, Zoran, Prof and Cloft, Harry J, Prof and Stenting Aggressive Med Management and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial Investigators ...
Arterial stenoses and luminal-surface irregularities at anastomoses cause blood-flow disturbances with slow recirculation. The authors created a computer simulation to study the rates of the release into blood of atherogenic substances such as low-density lipoproteins and their breakdown products from within the arterial walls at stenoses. Finite-difference methods were used to solve the Navier-Stokes equations (in the form of stream function and vorticity function) and the steady-state mass transfer equation for bell-shaped stenoses with two different degrees of constriction. This simulation indicated that the efflux rates of lipids and their breakdown products from the vessel walls were suppressed in the region of disturbed flow, with slow circulation distal to stenoses. The lowest efflux rate was found at the point of flow separation, and this rate was much lower than rates in regions of undisturbed flow. Therefore, this mathematical model predicts that locally disturbed blood flow at arterial
ABSTRACTObjective:To determine how frequent inflow stenosis is a contributing factor in the etiology of arteriovenous access-induced steal (AVAIS).Methods:A retrospective review of hemodialysis patients who underwent interventions from October 1998 to December 2011 for AVAIS was conducted at Mount S
Frontal anatomical illustration of the location of the stenosis or occlusion at the aortic bifurcation, lower limb arterial axis. - Stock Image C029/7635
Looking for online definition of Aspirin Versus Anticoagulants in Symptomatic Intracranial Stenosis in the Medical Dictionary? Aspirin Versus Anticoagulants in Symptomatic Intracranial Stenosis explanation free. What is Aspirin Versus Anticoagulants in Symptomatic Intracranial Stenosis? Meaning of Aspirin Versus Anticoagulants in Symptomatic Intracranial Stenosis medical term. What does Aspirin Versus Anticoagulants in Symptomatic Intracranial Stenosis mean?
Results Overall, the technical success rate was 100% (44/44). Post-stenting residual stenosis ranged from 0% to 40% (mean 15.00±12.94%). The overall 30-day rate of procedure-related complications was 9.09% (4/44). The incidence of recurrent ischemic events related to the territory artery was 4.55% during a mean clinical follow-up period of 25.5 months. Five patients (11.36%) developed in-stent restenosis during a mean angiographic follow-up period of 9.3 months. ...
We hypothesize the reason the vessel distal to the stenosis appeared occluded on DSA images, when CTA clearly showed the vessel to be patent, is related to differences in image acquisition time for DSA and CTA modalities. Angiographic runs are obtained during the course of a single intracranial circulation cycle, typically 5-7 seconds on average, by using a 3-4 frame per second filming rate, whereas CTA studies are acquired over approximately 60 seconds by using a single detector and 30 seconds by using a four detector helical scanner, allowing the contrast material to circulate up to 4-12 times in the intracranial vessels before imaging, which permits flow of a larger volume of contrast material through a tight stenosis. This greater volume of contrast material distal to a tight stenosis coupled with the HU-based methods of transmission tomography, may help to make these vessel segments more conspicuous, thus rendering visibly stenotic, but patent, arterial segments on CTA images that appear ...
TY - JOUR. T1 - Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents: retrospective multicentric data analysis on 107 patients. AU - Mauri, G.. AU - Michelozzi, C.. AU - Melchiorre, Fabio. AU - Poretti, D.. AU - Pedicini, V.. AU - Salvetti, M.. AU - Criado, Enrique. AU - Falcò Fages, J.. AU - De Gregorio, M.à .. AU - Laborda, Alicia. AU - Sonfienza, L.M.. AU - Cornalba, Giampaolo. AU - Monfardini, L.. AU - Panek, Jiri. AU - Andrasina, T.. AU - Gimenez, Mariano. N1 - Cited By :2 Export Date: 8 March 2017. PY - 2016. Y1 - 2016. U2 - 10.1007/s00330-016-4278-6. DO - 10.1007/s00330-016-4278-6. M3 - Article. VL - 26. SP - 4057. EP - 4063. JO - European Radiology. JF - European Radiology. SN - 0938-7994. IS - 11. ER - ...
Evidence-based recommendations endovascular stent insertion for treating intracranial atherosclerotic disease (ICAD/intracranial stenosis)
Background The long-term patency of the portal vein (PV) in patients who survive after pancreaticoduodenectomy (PD) remains unclear. The aim of the present study was to investigate the clinical...
Results Thirty stents were deployed. Before stenting, the mean vessel diameter was 3.4±0.21 mm at point A, 3.06±0.18 mm at B, 3.16 ± 0.21 mm at C, 2.67 ± 0.27 mm at D, and 2.56 ± 0.23 mm at E. The deployment of two stents resulted in statistically significant increases in both the average vascular diameter and cross sectional area (CSA) at points C (3.51±0.22 mm and 9.76±1.17 mm2, P= 0.0006 for diameter and 0.001 for CSA, respectively) and E (2.88±0.32 mm and 7.28±1.46 mm2, P= 0.01 for diameter and 0.02 for CSA, respectively) compared with pre-stenting. At angiographic follow-ups compared with before stenting, significant increases were documented at point C (3.42±0.22 mm and 9.42±1.37 mm2, respectively) at first angiographic follow-up but at points A (3.62±0.45 mm and 10.51±2.37 mm2) and B (3.26±0.24 mm and 8.47±1.26 mm2) at second angiographic follow-up. No significant vascular stenosis was demonstrated at double stent segment compared with single stent or native artery segments. ...
Pulmonary fibrosis is a scarring of the lungs. We have few treatments and none to reverse it. Bronchiectasis is a chronic scarring infection of lung with grape-like collections of pus-filled cavities adjacent to airway passages in the lung. They cause a chronic cough and serve as reservoirs of chronic infections. Bronchiectasis is treated medically and surgically in select patients. COPD stands for Chronic Obstructive Lung Disease, and usually requires aggressive medical management (multiple inhaler and oral medications) to reduce recurrent infections, lung and heart failure, and hospitalization. It sounds like you need to optimize your existing lung function, and stop smoking now if you still smoke. If you have been a non-smoker, more investigation is usually needed ...
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I think the original scare with anti-TNF treatments and strictures was that the rapid healing of the mucosal/drapid decrease of inflammation in regards to strictures could cause scarring/fibrostenotic strictures. Ive read some studies that do not support this and many say it can be very helpful in decreasing the strictures.... unless of course the stricture is already a fibrostenotic/stricture cause from scar tissue ...
A properly functioning hemodialysis arteriovenous (AV) access is essential for the hemodialysis patient. Unfortunately, venous stenosis and, to a lesser degree, arterial stenosis often develop, resulting in inadequate dialysis, extended treatment tim
Elasticity is known as the spatial rate of change of displacement as a result of the tensile stress created by a certain amount of pressure on live tissue. A displacement in tissues can be created by external compression or internal physiologic forces, such as vascular pulsation.2,3 On the external compression method, strain evaluation by elastography in sonographic devices equipped with software is performed by periodic and short-term up and down movements of the probe on the tissue. During downward compression, slight pressure is applied. The strain level of the tissues can be observed in real-time in different color codes. In the systems involving the combined autocorrelation method developed by Shiina et al,12 which we also used in our study, there is a pressure scale simultaneously displaying the appropriateness of the manipulation as upward and downward movements on the sonography screen. The application is correct when the values displayed on the scale are 3 and 4 (Figs 1⇑⇑⇑-5). ...
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In the literature, one finds few obvious associations with other hereditary or acquired diseases distribution of fats.. 1) The syndrome of DERCUM. Exceptionally, the pelvic lipoma could be integrated in a syndrome of DERCUM (4 cases). It is about an affection characterized by the presence of painful fat masses laid out on the trunk and the members, by obesity, sensitive and psychic disorders; the evolution is fatal and of unknown origin. Sometimes, hormonal disorders are discovered (thyroid and pituitary gland).. 2) Lubricating degeneration of lymphatic (hypoplastic pelvic lymphadenopathy). It is about a very rare affection (2 cases in 1975 less than 10 cases in 1983). The lymphatic ganglia are invaded gradually by mature fatty tissue, without any sign of malignity.. On the level of the small basin, the ganglia are bulky and at the origin of an extrinsic compression of the pelvic bodies. Some could think that it was about a lubricating metaplasy of the ganglia in response to chronic infections. ...
AccessGUDID - METACROSS RX (04540778153370)- METACROSS RX is a Percutaneous Transluminal Angioplasty (PTA) Balloon Dilatation Catheter for peripheral indications. METACROSS RX is a rapid exchange (RX) type and the maximum diameter of the compatible guidewire is 0.035 inches (0.89 mm).
Stryker ($SYK) is facing a sobering FDA report that points to the companys Wingspan stent as being more damaging than helpful in some cases and of neutral benefit in others, according to a Bloomberg story.
recurrent - MedHelps recurrent Center for Information, Symptoms, Resources, Treatments and Tools for recurrent. Find recurrent information, treatments for recurrent and recurrent symptoms.
Care guide for Colon Stricture. Includes: possible causes, signs and symptoms, standard treatment options and means of care and support.
A PubMed search was conducted with the question to evaluate the evidence on the optimal reference standard for radiological sequencing to investigate and confirm a clinical diagnosis of PAES. The search terms included were "popliteal artery entrapment syndrome" or "PAES" and "radiology" and "imaging". The included articles were published from 2014 onward full text availability was a requirement. The search criteria excluded review articles (n=2), articles pertaining to surgical treatment (n=1), articles pertaining to surgical procedural factors (n=1), prostatic artery embolisation (n=2) and chronic galactocele (n=1). Subsequently, four articles were included in this review. The criteria yielded two case studies, a peer-reviewed editorial and a retrospective case series.. Williams et al. presented that a combination of ultrasound (US) and magnetic resonance imaging (MRI) techniques coupled with dynamic ankle movements can effectively identify and specifically locate arterial compression in ...
TY - JOUR. T1 - Endovascular management of iliac vein compression (May-Thurner) syndrome. AU - OSullivan, Gerard J.. AU - Semba, Charles P.. AU - Bittner, Craig A.. AU - Stephen, T. Kee. AU - Razavi, Mahmood K.. AU - Sze, Daniel Y.. AU - Dake, Michael D.. PY - 2000/1/1. Y1 - 2000/1/1. N2 - Purpose: To evaluate the feasibility of endovascular techniques in treating venous outflow obstruction resulting from compression of the iliac vein by the iliac artery of the left lower extremity (May-Thurner syndrome). Materials and methods: A retrospective analysis of 39 patients (29 women, 10 men; median age, 46 years) with iliac vein compression syndrome (IVCS) was performed. Nineteen patients presented with acute deep vein thrombosis (DVT) and 20 patients presented with chronic symptoms. All patients presented with leg edema or pain. In the acute group, patients were treated with catheter- directed thrombolysis (120,000-180,000 IU urokinase/h) and angioplasty followed by stent placement. In the chronic ...
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Ruchir Puri, MD, Steven P Bowers, MD. Mayo Clinic, Florida.. The video submission is a case presentation of a 66 Y male who underwent a TIF (transoral incisionless fundoplication) complicated by mediastinitis. He developed severe, refractory dysphagia. He was found to have extensive fibrosis and thickening of the esophageal wall with extrinsic compression of the esophageal mucosa. Because of the finding of normal esophageal mucosa, the authors felt esophageal preservation was reasonable. After failing over thirty endoscopic dilatations and requiring parenteral nutritional support he consented to the operation. The video demonstrates mediastinal dissection in the setting of severe periesophageal fibrosis, at times limited visibility due to steam production and subsequent myotomy of the thickened fibrotic anterior esophageal wall. An omental patch was used to buttress the myotomy and separate the fibrotic edges. Intraoperative endoscopy was performed to ensure an adequate myotomy and a ...
A term infant, born by caesarean section for fetal distress, developed grunting and cyanosis by 15 minutes of age. Ventilation at low pressures was achieved without difficulty but did not improve blood gas levels, and he died at 26 hours. Necropsy examination showed large heart and small lungs; histologically the lungs showed multiple obstructive lesions at medium size pulmonary artery level.. ...
In-stent stenosis after stent-assisted coil embolization is a rare but well-known complication. A 32-year-old woman with an unruptured wide-necked left internal carotid artery (ICA) terminus aneurysm and an ipsilateral very small anterior choroidal a
Technical success was 85% and 100% in balloon angioplasty and stent insertion, respectively. Clinical success was achieved in 78% of balloon angioplasties and in 100% of stent insertions. At 1, 5, and 10 years after balloon angioplasty, patency rates were 87%, 82%, and 68% respectively, and the rates of stent patency were all 100%. Portal vein size measured during the operation of patients with and without recurrence were 19±4.2 mm and 19±3.0 mm (P = 0.956), respectively. The balloon size of patients with and without recurrence were 11±1.95 mm and 14±1.66 mm, respectively (P = 0.013), when balloon angioplasty was performed after stenosis diagnosis ...
http://radiology.rsna.org/content/247/2 ... gures-only Here are some images from a study on MRVs of central venous stenosis. Starting in figure 2b you see a series of stenosed internal jugular veins. I would assume that these are acute occlusions, such as what ...
It is well recognised that vascular tissue and mechanisms of cervical arterial dysfunction (CAD) may give rise to pain in the cranio-cervical region (Taylor and Kerry 2005). It is perhaps less well known that vascular tissue can be the source of pain syndromes throughout the body, ranging from the obvious - abdominal aortic aneurysm (low back pain), through to the less obvious (or less well known) distal limb pain/numbness as a result of popliteal artery entrapment syndrome (PAES). PAIN may be local due to a nociceptor response in the tunica adventitia due to underlying pathology (arterial dissection, atherosclerosis, aneurysm) or distal due to ischaemia (which may be movement or exercise induced ...
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The Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study, is the first stroke prevention trial to compare intracranial stenting with medical therapy and incorporate intensive medical management to the study design. Patients in the study were ages 30 to 80 years old and had experienced a recent transient ischemic attack or another type of non-disabling stroke. All patients participated in a lifestyle modification program focused on quitting smoking, increasing exercise, and controlling diabetes and cholesterol ...
R MAGRILL, NO LAVET, RL TEPLITZ. Fatal congenital pulmonary artery stenosis with interatrial shunt; some considerations and report of a case. J Am Osteopath Assoc 1955;55(6):358-364. doi: .. Download citation file:. ...
The left atrium and pulmonary veins initially develop separately in the 3- to 5-mm embryo (25 to 27 days gestation).1 The primordial pulmonary venous system is part of the splanchnic plexus, which initially connects to the cardinal and umbilicovitelline veins. At 27 to 29 days gestation, a small endothelial outgrowth from the posterior superior wall of the primordial left atrium develops just to the left of the developing septum primum. At 28 to 30 days gestation, this common pulmonary venous out-pouching engages the pulmonary venous portion of the splanchnic plexus and begins to drain blood from the pulmonary system. In normal development, the connections to the cardinal and umbilicovitelline systems atrophy, which results in complete separation between the pulmonary and systemic venous systems.. The sequence of connection of the out-pouching of the left atrium to the pulmonary venous plexus, followed by incorporation of the confluence of the common pulmonary venous system into the left atrium, ...
Details of the image Percutaneous transluminal angioplasty of an in-stent re-stenosis of the right subclavian vein in a dialysis patient Modality: DSA (angiography) (Venography)
Diagnosis of bronchial stenosis (costs for program #130101) ✔ Academic Hospital Eichsfeld ✔ Department of Pneumology ✔ BookingHealth.com
Our prospective study demonstrates that LE-PAD patients with a hypoechoic plaque in the femoral arteries are exposed to a significantly higher risk of developing myocardial infarction or stroke compared with those with a hyperechoic femoral plaque. Similar findings were obtained with both computer-assisted and visual analyses of plaque echogenicity. Notably, these results remained unaltered after accounting for factors known to have important impacts on LE-PAD patients outcome, including age, sex, previous cardiovascular events, and ABI.. Acute ischemic events are more closely related to the histopathological characteristics of atherosclerotic plaques than to the number of plaques or the degree of vascular stenosis (2,5-8,28,29). In this regard, the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) trial (8) has recently shown that lesions responsible for recurrent cardiac ischemic events are frequently angiographically mild, most are thin-cap ...
Preoperative evaluation. I. Circulatory status - evaluation of cardiac function. 1. Does the history of angina result in unusual risk to anesthesia and this surgery? Explain.. 2. Is additional workup needed?. 3. What tests do you want? Explain.. 4. How would you manage his preoperative cardiovascular drugs? Explain your rationale.. 5. How do nitrates cause antianginal effects?. Beneficial antianginal effects are a result of platelet effects, reducing myocardial demand, and increasing coronary perfusion. Nitric oxide inhibits platelet aggregation, venodilation decreases venous return and thus decreases left ventricular filling pressures, wall tension, and myocardial oxygen demand. Coronary spasm is relieved, and epicardial coronaries, collaterals, and stenotic segments dilate.. II. Assessment of cerebral blood flow. 1. What is the significance of transient ischemic attacks?. 2. Discuss cerebral vs cardiac etiologies.. 3. How will you assess this patient preoperatively?. 4. What significant ...
A 55 y/o woman was admitted to our hospital to be considered for the second renal transplant. She had agenesis of the left kidney and several stenotic segments in the right ureter which were associated with repeated pyenonephritides during her childhood. Ureteroplastic operation and partial resection of the right kidney were performed when she was 15 year old. Her renal function slowly deteriorated and at the age of 35 she started haemodialysis. A year later she received a cadaveric kidney and that graft functioned for 18 years. She underwent graftectomia and after one year on dialysis she received the second cadaveric kidney. The surgery was followed by delayed graft function, and a renal biopsy was performed on the day 6. C4d was negative and acute T-cell mediated rejection (ATCMR) grade IIA was diagnosed. She was treated with solumedrol. Her renal function slowly improved and the serum creatinine level (S-Cr) stabilized on 170μmol/l (1.9mg/dl). She felt well and came to the hospital 3 months ...
External compression headaches can occur when something worn on your head puts continuous pressure on your forehead or scalp. They often occur in people required to wear certain headwear, such as helmets or goggles, for their work or sports activities.. Sometimes an external compression headache is called "swim-goggle headache" or "football-helmet headache" or another name that refers to the equipment causing the headache. ...