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1/2. Refractory headache in a patient with breast cancer and carcinomatous meningitis unresponsive to analgesics: case report. A 44-year old female presented with locally advanced breast cancer that had been treated with neoadjuvant chemotherapy followed by modified radical mastectomy and thereafter three cycles of paclitaxel. She presented with severe refractory headache that was unresponsive to oral analgesics including morphine. Both CT and MRI scans with contrast were normal, however her cerebrospinal fluid was positive for malignant cells. The patient's headache responded to whole brain radiotherapy. ( info)
2/2. Successful epidural blood patch treatment for spontaneous low cerebrospinal pressure headache with multiple leakages in lumbar spinal matter. The authors reported a 54 year-old Italian woman with headache attributed to spontaneous low cerebrospinal pressure and normal brain magnetic resonance imaging. Lumbar puncture was done and opening pressure was not measurable. 99mTc radionuclide cysternography was used in diagnosis and demonstrated 3 lumbar leakages and early appearance of bladder activity. Epidural blood patch was performed. This option was safe and successful to treat this kind of headache without relapse of symptoms after 3 years follow-up. ( info)
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