The findings of our study strongly support the hypothesis that peripheral mechanisms, such as increased muscle tenderness, only play a minor role in the pathogenesis of tension-type headache.
A 85-year-old man presented to the emergency department with acute onset of right-sided chest pain after vigorous coughing. Physical examination revealed a progressive hematoma and a palpable bulge that enlarged with expiration. A CT-Scan confirmed a lateral lung herniation with a dissection of the intervertebral muscle. The Patient underwent a surgical reconstruction of the chest wall defect and an additional Mersilene Mesh repair of a consecutive diaphragmal rupture. The patient had an uneventful recovery and was discharged on postoperative day 11.
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