Gastrodin product of orchids gastrodia dry root extract of raw materials, Yunnan. gastrodin good sedative and hypnotic effect, neurasthenia, insomnia, headaches relief. Chinese medicine the gastrodia to treat pain, dizziness, numbness, shock pain convulsions. Clinical applications: the treatment of vertebral basilar artery insufficiency; treatment of vestibular neuronitis; the treatment of vertigo.
basic informationgastrodin Gastrodin
Molecular formula: C13H18O7
Molecular Weight: 286.28
chemical name: 4 - (hydroxymethyl) phenyl-beta-D-Glucopyranoside
4 - (hydroxymethyl) phenyl-β-D glucopyranoside.chemical properties:
Description: white needle crystal, melting point 154 ~ 155 ℃. soluble in water, methanol, ethanol, not soluble in chloroform and ether.
Description: White prismatic plexus crystal, double melting point of 96 to 98 °/145 ~~ 148 °, [α] 150/D-66.4 ° (C = 0.65, water). White needle crystal, melting point 154 ~~ 156 °, [α] 23/D-59 ° (C = 1.97, methanol). IR λKBrmax cm-1: 3700 ~ 3000 (s), 1615 (m), 1590 (m), 1510 (s); uv λMeOHmax nm (logε): 277.5 (2.96), 271 (3.04); nmr (D2O) δ : 3.36 ~ 4.12,7.19,7.42 (4H, A2B2 type, J = 9).
[function] gastrodin good sedative and hypnotic effect of neurasthenia, insomnia, headaches relief. Chinese medicine the gastrodia to treat pain, dizziness, numbness, shock pain convulsions.
[side effects] From: Tianma injection
acute toxicity experiments: mice orally or intravenously injected gastrodin dose used 5g/kg, observe the three days, no poisoning and death.
sub-acute toxicity test: 4 to 6 days in dogs and mice administered through blood tests, red blood cells, white blood cell and platelet counts had no effect. Determination of blood tests had no effect on alanine aminotransferase, protein and cholesterol. The animal's heart, lungs, spleen, liver, kidney, stomach and intestinal tissue section examination, no cell degeneration. These results suggest that gastrodin the hematopoietic system, liver, renal function and blood lipids had no effect.
【Function】 the ① Jiannao Bunao ney Bunao mention gas benefits of God; ② regulating the cardiovascular and cerebrovascular function, enhance the body immunity; ③ help yang, up five workers and injured seven, through blood, fails to grasp; ④ with three anti-, three towns: epilepsy, anticonvulsant, anti-rheumatic; sedative, antispasmodic, analgesic; ⑤ more research to show that the gastrodia Augmentation of students, the brain, maintain a good state of learning, mental remain sober-minded and full of energy, the elderly, aging, etc. have a good long-term use of gastrodia popular color outstanding.
(gastrodine) a grape glycosides (see glycosides), molecular formula C13H18O7. An active ingredient in traditional Chinese medicine Gastrodia. Melting point ~ ° C than the optical rotation α ° (water); soluble 96 98 - 66.4 D15 water, methanol, acetone and hot ethyl acetate, insoluble in ether. The gastrodin enzymatic hydrolysis of bitter almond (hydroxymethyl) phenyl alcohol aglycones. Good sedative and hypnotic effect gastrodin, toxicity, neurasthenia, insomnia, headache, have a certain effect. Chinese medicine Tianma is the main drug of tcm treatment of headache, dizziness, numbness, pain convulsions scared. vascular blood pressure, vascular endothelial cell secretion of the vasoconstrictor factor endothelin (ET), endothelium-derived vasodilatory factor and nitric oxide (NO ) were associated with hypertension. The constant release of ET to maintain the balance of vasoconstriction, blood pressure, vascular endothelial cell injury, regeneration, produce large amounts of ET corresponding clinical and pathological changes of hypertensive patients. Hypertensive vascular endothelial injury, circulatory, angiotensin Ⅱ to increase, resulting in superoxide dismutase inactivation of NO and the NO decreased, indirect vasoconstriction, vascular endothelial dysfunction, suggesting that ET and NO to participate in the incidence of hypertension and development , ET synthesis and release of further increase of NO decreased hypertension further aggravate the condition.
1.2 anti-platelet effect with the turbidimetric method of platelet aggregation rate, the results showed that gastrodia extract on the rabbit in vitro, rat semi-in vitro and mice in vivo platelet aggregation test, can inhibition of adenosine diphosphate (ADP)-induced platelet aggregation; in vitro, Fraction G2 can inhibit platelet aggregation induced by platelet-activating factor (PAF).
1.3 the nerve cells in the role of Liu Zhonghua investigated gastrodin nerve cells induced by alzheimer's disease (AD). ginseng total saponin as a positive control, cell viability was detected by morphological observation and MTF methods. Results Compared with the control group, the Han 25-35 on cultured neurons obvious morphological changes in the MTF tests showed significantly decreased cell viability, increased lactate dehydrogenase (LDH) release, the difference was significant (P <0.05 ); when different concentrations of gastrodin and total ginsenoside in advance, Aft25-35 nerve cell damage significantly reduced cell viability was significantly increased, LDH release to reduce the results showed that different concentrations of gastrodin 5-35 induced nerve The injury is also a strong protective effect, can significantly reduce the mortality rate of nerve cells, the strongest protective effect the concentration gastrodin 0.05 mg/ml.
1.4 against free radicals and protect the cell membrane and reperfusion-induced oxygen free radical generated caused by lipid peroxidation leading to renal tissue injury is an important mechanism for the pathogenesis of ischemic renal failure. Period of ischemia and reduce the organization oxygen content, can cause the organization's own antioxidant reduced ability; reperfusion, oxygen-rich blood to re-perfusion in ischemic tissue, while also providing a large number of electron acceptor can lead to a large number of oxygen free radicals in the organization explosive increase in a short period of time and accumulation of highly reactive oxygen free radicals and contain rich in unsaturated fatty acids in the cell membrane system of lipid peroxidation, resulting in cell morphology and function of the damage. gastrodin can be reduced in vitro "ischemia reperfusion injury and LDH release in the nerve cells to maintain membrane fluidity; and can significantly reduce the formation of lpo in, showed that gastrodia known as the removal of excessive free radical, also showed that in vitro ischemia-reperfusion damage nerve cells in a wide range of protective effects.
1.5 on the immune function gastrodia injection can significantly enhance murine macrophage phagocytosis and lysozyme. hemolysis blank experiments, the the IRFC test and anti-SRBC test values were significantly higher than that showed that the gastrodia injection have enhanced the role of cellular immunity and humoral immunity in non-specific immunity in mice.
2 clinical applicationa substrate of 2.1 treatment of vertebral-basilar lack of vertebral artery insufficiency is a common disease of internal medicine paroxysmal vertigo symptoms, patients with serious impact on work and life. Zha Lai 38 cases the diagnosis of vertebral artery insufficiency were randomly divided into observation, effective in the treatment group the (gastrodin group) 12 cases, effective in 5 cases, 2 cases, the total efficiency of 89.47% The control group (SM group) was effective in 8 cases, 6 cases, 5 cases, the total efficiency of 73.68%, gastrodia injection is effective treatment of vertebral-basilar artery insufficiency. vertebral basilar ischemic syndrome of the vertebral basilar artery system for cervical degenerative disease directly or indirectly caused by the traditional method of treatment is the application of the blood circulation and vasodilator drugs.
2.2 the treatment of vestibular neuronitis
Dongyu Juan, such as H. 102 cases of patients with vestibular neuronitis were randomly divided into treatment group the (gastrodin group) 50 cases, 52 cases in the control group (dizziness stop group). After treatment, the symptoms improved time to treatment group (3.0 ± 1.5) days, the control group (6.0 ± 2.7) d, two sets of difference significant (t = 6.97,/9 <0.01); symptoms and signs disappeared, time to treatment group (6.0 ± 2.4) days in the control group (12.0 ± I.6) d significant difference between the two groups (t = 14.79/9 <0.01).
2.3 the treatment of vertigo
vertigo is dizziness a symptom of the patient conscious, the performance of the smooth body sensory disturbances, visual rotation, nystagmus, pale, nausea, vomiting, and other features. Zhengzhou Yan _1I_ will meet the diagnostic criteria, 77 cases were divided into treatment group 45 cases, 32 cases in the control group, treatment group I gastrodia injection control group qingkailing injection solution or Shengmai Injection. The treatment group were cured, 30 cases, 13 cases effective, ineffective in two cases, the total effective rate was 95.56%. The control group were 12 cases, 10 cases, 10 cases, total effective rate was 66.75%. Clinical observations suggest that gastrodia and gastrodia known as lower blood pressure and reduce peripheral resistance, the expansion of the arterioles and capillaries, and increased microcirculatory blood flow. gastrodin recoverable brain cortical excitability and inhibition of the imbalance between the process, with the central inhibition of sedation, sedative and analgesic. 2.4 this blessing analgesia observed 30 cases of migraine efficacy in patients with gastrodin treatment, headache disappeared 10 treatment group, significantly reduced the 16 cases, does not alleviate or mitigate the obvious four cases, the total efficiency of 86.7%; control group The headache disappeared in three cases, significantly reduce the seven cases, the pain does not alleviate or mitigate the obvious 16 cases, the total efficiency of 38.5%. The gastrodin can improve blood circulation to the brain, while adjusting the neurological dysfunction of the nervous system to control the vasoactive substances and caused pain to achieve analgesic effect.
injection can dilate brain blood vessels, improve brain cells against oxygen capacity, increasing cerebral blood flow, reducing cerebral blood
vascular resistance lead. Improvement of vertebral artery blood flow has a good effect, so that the vertebral artery insufficiency in patients with cerebral circulation has been markedly improved, in order to lift the insufficiency of balance disorders, vertigo, tinnitus, and nystagmus symptoms _l. The gastrodin can improve the anterior inferior cerebellar artery, posterior inferior cerebellar artery, labyrinthine artery and the inner ear blood supply is inadequate to protect nerve cells, promoting the function H of the myocardial energy metabolism. Widely used in clinical neurasthenia, neurasthenic syndrome and angioneurotic headache embolism (such as migraine, trigeminal neuralgia, occipital neuralgia, etc.), can also be used for traumatic brain injury syndrome, vertigo such as Meniere disease, herbal vertigo, traumatic vertigo, sudden deafness, vestibular neuronitis, and vertebral basilar artery insufficiency. With the continuous separation of gastrodia chemical composition of gastrodia pharmacological research and clinical applications will make more progress.
gastrodia elata the injection
Drug NameCommon name: Tianma injection
English name: gastrodin Injection
Pinyin: Tianmasu Zhusheye
The main ingredients gastrodin. Its chemical name: 4 - (hydroxymethyl) phenyl-beta-D-glucopyranoside hemihydrate.
Its structural formula is:
Formula: C13H18O7 · 1/2H2O
Molecular Weight: 295.38
traitsThe product is colorless transparent liquid.
Pharmacological experiments showed that the cerebral cortex of the gastrodin recoverable excitation and inhibition imbalance between the process to produce sedation, sleep, and analgesic central inhibition.
acute toxicity experiments: mice orally or intravenously injected gastrodin dose used 5g/kg, observe the three days, no poisoning and death.
sub-acute toxicity test: 4 to 6 days in dogs and mice administered through blood tests, red blood cells, white blood cell and platelet counts had no effect. Determination of blood tests had no effect on alanine aminotransferase, protein and cholesterol. The animal's heart, lungs, spleen, liver, kidney, stomach and intestinal tissue section examination, no cell degeneration. These results suggest that gastrodin the hematopoietic system, liver, renal function and blood lipids had no effect. concentration level of sedation consistent with an elimination half-life of 4.44 hours. in vivo distribution in kidney, followed by liver, lung, heart, spleen and brain. From the urine excreted from urine, feces and bile total of 76.8% of the administered dose, 97% from the urine, mainly the first two hours, very little bile and feces. the neurasthenia syndrome and angioneurotic headache embolism (such as migraine, trigeminal neuralgia, occipital neuralgia, etc.) can be used for traumatic brain injury syndrome, dizziness disorders such as Meniere's disease, herbal vertigo, traumatic vertigo, sudden deafness, vestibular neuronitis, vertebrobasilar insufficiency.
usage dosageintramuscular injection, a 0.2g (sticks), day 1 or 2 times. organic disease may be appropriate to increase the dose, or as directed.
intravenous infusion, each 0.6g (3 sticks), day 1, 5% glucose solution or 0.9% sodium chloride injection 250 ~ 500ml diluted. the
adverse reactiona small number of patients with dry mouth and nose, dizziness, stomach discomfort and other symptoms, but will not affect the patients receiving medication, and need special treatment.
taboothe product to any component allergy disabled.
Noteuse of the product period, such as the emergence of any adverse events and/or adverse reactions, consult your doctor. The simultaneous use of other medicines Please inform your doctor.
prohibit the use of drugs traits change.
pregnant women and lactating women medicationis not clear. the
overdosestill a lack of reports goods overdose. Once overdose should be symptomatic and supportive treatment.
validity period24 months.
quality standards differencesgastrodia intravenous injection are corporate standards, there are some differences in methodology and indicators, Pharmaceutical group production in Yuekang Dantong song contact Tong gastrodia injection of endotoxin content per 1mg gastrodin content less than 0.15EU less than 0.20 ~ 0.25EU standards of other manufacturers, fewer infusion reactions.
preparation.the listed gastrodin injectable formulations include freeze-dried powder, more than 10, more than 30 of the injection, lyophilized powder can only be intramuscular injection, is strictly prohibited for intravenous. Only some manufacturers of injection can be used for the vein, before the need to carefully look at the manual.
Specificationsinclude the following
200mg: 2ml/support (Dantong Yuekang Pharmaceutical Group)
600mg: 5ml/support (Qu network Tong, Yue Kang Pharmaceutical Group)
the current water injection, injection, oral tablet dosage forms of the clinical applications
Source Information: the gastrodia
The product of orchids gastrodia dry root extract, raw materials for Yunnan.
[Tropism of taste] Gan, Ping, liver, spleen, kidney, gall bladder, heart, bladder through.
[active ingredient] tubers Han Xiang the vanilla alcohol (Vanillylalcohol), vanilla orchid aldehyde (Vanillin), vitamin a substances, the prime class of crystalline neutral material and trace alkaloids, phlegmatic; gastrodia phenolic glycosides, gastrodin (Gastrodin)
said, "Drugs of justice: Tianma, gas gentle," by saying, liver suffering acute willing to slow the Use this to slow the liver. liver is wood cover, a wind gall bladder, liver deficiency, induced hepatic acute Jian Jin, can not keep the gall bladder, gall bladder fu wind, such as the days wind of Gudang wind wood gas, twenty years before all the wind out dizzy, are the wood is fixed by the liver and gallbladder qi wind, the wind of the non-exogenous weather, is the liver disease is Jinji Gan gentle Jian Jin, this is Bugan raise the bile, the Fengshen drug. Stroke, wind epilepsy, convulsion, head wind, dizziness, both the liver and gallbladder wind syndrome, noted this rule. If the liver the Jinji very same Huanglian Qingjiang its gas. Whichever weight down and taste thin, Tom Lee, can benefit lassitude, as amended up blood, zhu wind thermal hysteresis in the joint by this sparse smooth. The god of medicine where the deficiency disease. In patients with mild or severe dizziness in the clinical application of the above, can achieve a more significant effect. In addition, patients should cultivate good habits, such as more than a walk after dinner, the usual movement, and so these have a very good help for the recovery of insomnia symptoms.
boil is caused by what the?
infection and skin dirty, scratches, high ambient temperature or lower the body resistance to infection-related. boils can occur in any follicles of the skin area, often to the head, face, neck, armpits and buttocks so often by the friction of the parts is more common.
boil the pathogenic bacteria staphylococcus aureus based, Streptococcus, staphylococcus epidermidis, are also caused by the disease. Local and systemic skin's resistance to infection is reduced mainly due to Benbingfasheng, so infants, malnutrition, diabetes is a good risk of this disease. Dirty skin, skin abrasions, high ambient temperatures often lead to local infection such as the direct cause.
(B) the pathogenesis
bacteria invade the hair follicle and their sebaceous glands and sweat glands, in hair follicles and surrounding tissue multiply rapidly, producing toxins, causing local tissue degeneration, necrosis, and the center of the formation of boils, the performance of local congestion, exudation, induration. Aggregation of neutrophils to the damaged body tissue cells and bacteria to be destroyed, and he gradually necrosis and dissolution, the formation of abscesses in the dermis. Due to staphylococcus aureus, coagulase contain toxins, so the formation of pus bolt, protruding outward. Swelling and induration clinically visible in the center of a yellow-white pus plug. This is staphylococcus aureus infected lesion characteristics. ulceration after discharge pus, abscess gradually by the new fibrous tissue repair and healing.[Sign]
boil the early symptoms?
1. redness, swelling, heat, pain summary, cylindrical cone.
2. inflammation to the development of nodules increases, the pain intensified.
3. A few days later nodules central necrosis, abscess formation, dissolution, soft induration, pain relief, the central pus head most of the self-rupture, discharge pus, inflammation subsided recovery.
4. furuncle usually no obvious symptoms, but if the blood flow occurred in the rich parts of the body resistance weakened, it can cause discomfort, chills, fever, headache and loss of appetite and other symptoms of toxemia.
boil because of location, severity of different clinical manifestations may vary.
local swelling and pain sclerosis: no systemic symptoms of early disease and more, only infection redness, swelling, pain, range of not more than 2cm in diameter, small nodules gradually enlarged, as papules bulge. A few days later lesions extended about 3 ~ 5cm, nodules gradually softened, the center was white, a slight touch of the fluctuations; then ulceration pus, and the emergence of yellow-white pus plug. pus bolt off, pus shed, the inflammation subsides and healing. There is no pus boil bolt (the so-called headless boil), since the collapse a bit late, need to find ways to promote its pus discharge (Figure 2 ).
nose, upper lip and around (called "dangerous triangle") of the surface boil, add or pushed in touch, the bacteria via the angular vein, ophthalmic vein into the brain, causing intracranial suppurative infection. At this point may have fever, headache, vomiting, consciousness disorders.
early follicular redness, swelling, heat, pain, induration. After the white purulent center, there is volatility. May be associated with systemic fever, elevated white blood cell count and differential count.[Aftertreat]
1. composed of: a single head of garlic, honey, 9 grams. Usage: pound evenly wrap the affected area.
2. consists of: single head of garlic amount. Usage: peel and slice into 2 to 3 mm, with the first affected area with warm salt water when dry wash, and then sticking garlic, and gently massage the 10 to 20 minutes, 2 or 3 times a day, 2 3 There is no more. Indications: Boil, folliculitis. Note: In severe cases, such as local irritation may reduce the massage time, a serious condition should be added to serve anti-inflammatory drugs.
4. composed of: fresh Malan first 100 grams, the amount of liquor. Usage: Add a little salt before blindly smashed wine Ban Cheng paste, coating the surface of the skin furuncle carbuncle. Indications: furuncle, carbuncle.
5. Composition: rosin 10 grams of white wine. Usage: rosin research to fine tune white wine into a paste, resisting heat, wrap the affected area after dissolution, for the degree of responsibility to cover all of the above and then covered with wax paper and tape securely, to enhance efficacy, can drop a few drops of wine, rosin to keep moist. Indications: furuncle, carbuncle, folliculitis.
13. mung bean sugar kelp: seaweed 60 grams, shredded, green beans, 150 grams, with the soup, add brown sugar to taste food. There Sedative, diuretic, soft-kin, Phlegm, scattered gall tumor effect. For hypertension, beriberi edema, neck lymphadenopathy, simple goiter, prickly heat boils hot summer day in children poison, phlegm cough embolism.
14. yi melon soup: melon (not peeled) 500-600 g, yi 50-100 grams of soup. Can be flavored with sugar or salt, on behalf of the tea used, heat, hot weather, diuretic, dehumidification effect. Drugs for rush boils, eczema athlete's foot, yellow urine deficient.
15. Daozhi raw turnip, vinegar and rub the affected area transfer, heat treatment boil.
17. failure to adopt the open rose 3 - 5 朵 wash, add water, two pregnant, suffering from a cup of low heat, ice sugar 30 grams, made of rose soup, until the temperature dose, to cure blood stasis amenorrhea, boils Chung pain, traumatic swelling and pain.
19. a white sweet potato, peeled and chopped, smashed, can also be added with the same amount of fresh houttuynia smashed, spreads in the affected area, apply to the local heating that line replace (about two three hours long), and even apply a few days more, boils cure mastitis.
23. fresh buckwheat leaves 60 grams, Shuijianbi day one; or fried yellow noodles with the vinegar into a paste, applied to the lesion, sooner or later be replaced. Governance sore, swollen boils, erysipelas, mastitis, and swelling of unknown drugs.
appropriate patients to eat what?
patients unfit to eat what?
data only refer to the specific, please ask a doctor.[Prevent]
how to prevent boils?
boil is born of acute suppurative superficial skin disorders, widely available health, children, young people more common. "Surgical management case" that: "boil persons, birth processes, floating red rootless feet, swollen found in the skin, only the width of an inch, there is less pain, a few days later Microsoft, thin peel, the beginning of the blue water, the latter from breaking the pus out of. "The disease occurs in the summer and autumn, protruding roots shallow, swelling potential limitations, lift the red pain, mostly in the range of about 3cm, easily swollen, easy to collapse, Yi Lian. Early can be divided into a head, without the first two kinds of general light and easy to cure the symptoms, so the saying goes, "no boil the size of a pus like." ;;; ;;;;; ;;;;; ;;;;; But also due to the formation of improper treatment or care "mole cricket boils," or repeated seizures, lack of disunion. Multiple furunculosis ", is difficult to cure.[Treat]
boil precautions before treatment?
attention to the skin clean, timely replacement of underwear and avoid skin injuries, especially in the summer, to bathe, wash your hair, hair, changing clothes, nails, children in particular should pay attention. With honeysuckle and wild chrysanthemum Jiantang tea. boil the surrounding skin should be kept clean and coated with 70% alcohol to prevent infection spread to nearby hair follicles.
boil Chinese medicine treatment methods
A Differential Treatment:
2. shushi heat Melancholia: seen in summer and autumn, the affected area, such as agglomeration cone, single or multiple, burning pain, chest tightness, anorexia, deficient urination, red tongue, greasy or yellowish, veins slippery. Qingshu dampness, detoxification swelling. Qingshu Decoction.
3. Is virtual evil love cards: distributed in the body, local color dark red, pus scarce, one after another, delayed healing, with fever, irritability, thirst, or fatigue, limb soft, red tongue thin yellow, rapid pulse. Righting detoxification. Liu wei di huang Decoction.
Second, external treatment and other treatment:
2. Pus, the clip bolt out the pus.
Western boil treatment
3. The formation of abscess, incision and drainage should be timely but should be avoided boil the face cut.
1. The principles of early treatment to promote inflammation subsided, after early drain purulent pus; timely elimination of systemic adverse reactions.
2. Local treatment
(1) Physical therapy: early, ultraviolet micro-irradiation, can promote local anti-inflammatory, to prevent proliferation. Swelling stage, the selection of FM, infrared and other heat, promote boil liquid. 2 to 3 times / d, 20 ~ 30min / times.
(5) to keep local clean and dry: adhere to local skin cleaning, daily showers are the best conditions. Young children with skin, topical lip after taking a bath in summer, to avoid the formation of multiple Boil.
3. Systemic treatment usually does not require systemic treatment of boils. But facial boils or accompanied by chills, fever, headache, general malaise, etc., should be given antibiotics. Clinical observations and experimental results show that the efficacy of penicillin, cephalothin, cefazolin and amikacin better effect.
(B) the prognosis
generally good prognosis after active treatment, without sequelae.[Examine]
boil should be how?
2. diabetes check
boil diseases easily confused?
1. Multiple sweat gland abscesses are summer disease, more common in infants and young children and frail mother's head, forehead, etc .. Lesions of multiple subcutaneous abscesses. Surface tenderness, inflammation lighter. No pus bolt, left scars. Usually accompanied by a lot of prickly heat. Generally known as prickly heat poison. It was also known as pseudo furunculosis (Pseudofurunculosis).
2. hidradenitis suppurativa common in young women, lesions of the skin induration. Subcutaneous abscess formation, followed by skin redness, swelling, heat, pain, ulceration scarring. Lesions occur in the armpits, groin, genital and perianal, umbilical, etc.
3. acne acne mild infection, red, swollen, painful, but the disease is small, the top a little bit like creamy.
more back symptoms
small blisters appear back back pain back spasms, back pain does not have subtle linen spine back pain sinus pain Road with sensory ataxia spinal nerve root damage spinal cord hemisection syndrome, spinal cord lesions of hemorrhagic infiltration of the spinal cord injury spinal cord infarction, cauda equina involvement across the spinal cord within the spinal cord gliosis in the spinal cord anterior horn of the spinal cord lesion cavity formed spinal thalamic tract compression
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