Laryngoscope Set

If You Hate Getting Headache Read This Now!

So You Have Been Given A Diagnosis – Has This Been Helpful To You?

I suspect not, for diagnosis is based on a set of signs and symptoms – a diagnosis does not give you any information as to what is causing your headache or migraine.

The diagnosis you have been given is based on the International Headache Society’s classification system. However, because consistent research is lacking and evidence for assumptions is inadequate, a large part of the diagnostic classification system is based on expert opinion and compromise; the system is subject to criticism and frequently challenged. The authors of the classification system have acknowledged this, indicating that the system is unwieldy, lengthy and very detailed and that it was essentially intended for research rather than as a clinical tool. This is not assisted by the fact that there are overlapping symptoms between cervicogenic (neck-related) headache, tension-type headache and migraine (making differential diagnosis unconvincing), and increasing evidence which suggests that the different headache types share a common mechanism – perhaps the different headache and migraine types are not separate entities, but simply different expressions of the same process.

It is interesting to note that the ‘triptans’ (medication designed specifically to abort the migraine process) are effective in managing migraine, tension-type headache, menstrual migraine, cluster headache, sinus headache, cervicogenic and post-traumatic (whiplash) headache – Why? Supposedly the ‘triptans’ stop the migraine by constricting or narrowing the blood vessels … but are menstrual migraine, tension headache and sinus headache, for example, caused by expanding blood vessels?

Other questions are intriguing also …

Why is it that whiplash-associated headaches exhibit similar features to migraine, tension-type and cervicogenic headache?

Why is it that accompanying neck pain and or stiffness, and headache or migraine triggered by neck position or movement, which are distinctive features of cervicogenic headache, and a history of migraine, tension headache, menstrual migraine, cluster headache start soon after neck trauma?

Why is it that many women not only endure menstrual migraine but also experience similar headaches at other times in their cycle, when oestrogen levels are not significantly lowered – for example mid cycle when oestrogen is at its highest? Menstrual migraine supposedly results from decreased eostrogen …

The answers can be drawn from the recent and significant research, which has demonstrated that the brainstem is sensitised or hyper-excitable in both migraine and tension-type headache sufferers and that the ‘triptans’ desensitise the brainstem (suggesting that sensitisation is evident in range of headache and migraine conditions – and the upper cervical spine (neck) is in a key position to sensitise the brainstem).

It is appropriate that the first step is for your headache or migraine to be assessed by your doctor who will then determine if a neurological opinion is required and whether a scan of your head is necessary. In the vast majority of cases a scan is negative, that is, no abnormality is present. Subsequently, what usually happens is that medication is suggested, and then starts a ‘merry-go-round’ of trying different medication regimes; you as headache or migraine sufferer are (perhaps unnecessarily) destined to a lifetime of medication.

At this point, what is missing is a thorough examination of the structures of the upper neck.

Why is it that the role of the cervicogenic (neck-related) factors in headache and migraine, is largely dismissed by the medical model of headache? Perhaps it is because consideration of the neck does not fit the medical model and anything that does not fit into the medical model is not given serious consideration. Furthermore, because examination of the neck does not fit into the medical model, there has been little interest in developing the role of treating the neck for the relief of headache or migraine. Given the significant number of people who suffer headache and migraine it is essential that all factors that could sensitise the brainstem be investigated equally (this is not the case with the cervicogenic aspect) to create a more comprehensive approach.

As a result of my unparalleled clinical experience I have developed an approach, which not only determines if disorders of your neck are likely to be the source of your headache symptoms (sensitisation), but can also identify the spinal segments at fault. This diagnostic accuracy increases the chances of a successful outcome.

I know that some of you may have had your necks examined and treated unsuccessfully but until your neck has been examined by a practitioner* experienced in this approach, your upper neck cannot be ruled out as the source of your headache or migraine – what is it to be – the possibility that your neck has been the unidentified source all along or a lifetime of ongoing medication?

Hint: If your headache or migraine is one sided and then on another occasion is on the other side, or if your headache can swap sides within the same episode the source of your headache is your neck and it is the C(cervical) 2-3 spinal segment!

Dean

Dean H Watson

Consultant Headache & Migraine Physiotherapist; International Teacher; Director, The Headache Clinic & Watson Headache Institute; PhD Candidate Murdoch University, Western Australia; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia; MAppSc(Res) GradDipAdvManipTher

Experienced health practitioners trained in the Watson Headache Approach perform the examination and treatment techniques developed by Dean Watson. These techniques are based on his extensive experience of 7000 headache patients (21,000 hours) over 21 years and are now taught internationally.

For your nearest practitioner who has completed training in the ‘Watson Headache Approach’ please refer to the ‘Practitioner Directory’.

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About the Author

Dean Watson of YourHeadache Solutions, Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School of Physiotherapy, University of South Australia; PhD Candidate, Murdoch University, Western Australia. On his site you can search all topics about headache migraine, headache treatment, migraine treatment, headache causes, migraine causes headache symptoms and more.

All about Angiography?!?

Hi dudes. I want to have some information about some of the peripherals used in Angiography.
I want to know about the use of the following items:
1. Angiography Sheets84” x 120” Cardinal Health
2. Radiology Angiography needleBD Luer-Lok/ Merit
3. Guidewire
4. Heparin (Injectable Anticoagulant)
5. Zilocaine
6. Sidex
7. Three-way
8. Angiocath
9. Knife for Angiography
10. Angiography Film
11. ER Box Set
12. Laryngoscope
13. Angioset
14. Catheter (tube)
15. Contrast Agent

What is the use of each?!

Regards,
Reza

In order to understand how these terms relate to angiography or how to perform angiographic procedures most radiologists have to do at least a one year fellowship in Vascular & Interventional Radiology.

I can't give you an all encompassing explanation of how to be an angiographer, but the long and short or it is that most procedures (whether arterial or venous) involve a puncturing a vessel (typically a small nick via a #10 blade) in the right inguinal (groin) region, so long as that approach is reasonable and is most preferred for right-handed angiographers. and then passing some type of guidewire, often hydrophilic in nature (Glidewire) via a sheath under fluoroscopic guidance in the direction you'd like to then advance some sort of catheter over the guidewire and eventually you select the proper type of guide wire and type of catheter in order to select the vessel that you're interested in. You can then do a lot of things including injecting radiocontrast into the vessel that you've selected to characterize it or even inject various types of chemoembolic agents, perhaps mixed with contrast into the vessel(s) of interest. It's essentially the same technique whether you're doing peripheral angio or cardiac angiography as well, you simply need to know the anatomy you're dealing with and the appropriate catheters to use in order to get to where you need to and obviously you will need to learn the appropriate infusion rates based on the catheter you're using and the vessel which you're interested in characterizing when you do a run (sequence of radiographs).

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