Headache caused by pathologic conditions of the nose and its accessory sinuses / by Gerhard H. Cocks and John E. MacKenty.

  • Cocks, Gerhard Hutchison.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Headache caused by pathologic conditions of the nose and its accessory sinuses / by Gerhard H. Cocks and John E. MacKenty. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    might term a neuropathic temperament plus pressure within the nose. In these people the sensibility to pain is a heritage. Usually there is a family history of migraine, neurasthenia, epilepsy, alcoholism, rheumatism, or gout. These patients have a low reserve of nervous endurance and readily succumb to slight continuous peripheral irritation. 2. The inflammatory group may likewise be divided into two subdivisions: (a) including cases where there is pressure within the nose, plus chronic sinusitis; while (b) deals with acute sinusitis. i. (a). Pure Pressure Cases. Case i.—Almost constant left-sided supra-orbital headache since childhood. Marked deflection of nasal septum to left, pressing against middle turbinate. Sub- mucous resection. Complete cure of headache. Mrs. H., age 38, gives a history of an injury to the nose in childhood. She has had headache since childhood, growing worse in the last ten years, Pain is complained of almost constantly, and is felt above the left brow and in the left temple. The pain is dull with occasional severe exacerbations, when it becomes acute and is then accompanied by vomiting. Examination.—The nasal septum shows an acute angular deviation to the right, close to the floor of the nose. There is a corresponding sulcus on the left side with a slight devia- tion to the left, completely obliterating the view of the middle turbinate on that side. There is compensatory hypertrophy of the left inferior and of the right middle turbinate. Adrena- lin applied to the left side of the nose gives temporary relief. Operation.—A submucous resection was performed, remov- ing the deformed parts of the septum. Six months later the patient reports that she has been absolutely free from headache since operation. Case 2.—Unilateral headache of twenty years’ dura- tion ; deflection of septum to left with adhesion to middle turbinate. Submucous resection of septum and separa-