Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a survey of 46 patients with haemagioblastoma of the CNS (Neurology Dept. University Hamburg, 1950-1980) most (n = 40) were found to have angioblastomas of the cerebellum (Lindau tumors). Of these patients 21 were re-examined in 1983. Headache was the most frequent initial symptom (43%), and within this group one-third (10%-15%) had dizziness, sensorymotor deficits and cerebellar gait disturbances. Signs of elevated intracranial pressure much more often led to the correct diagnosis than dizziness or dystaxia. After the introduction of CCT to the diagnostic procedure the combined evaluation of angiography of the vertebral arteries and CCT always permitted the correct diagnosis. The low neurosurgical mortality rate (13.5%) has decreased to 0% within the last decade. No relapses were found in 21 re-examinations including CCT and EOG compared to a frequency of 9.7% in all 46 cases. Significantly less often than expected from other data we found: signs of possible hereditary influence (0%), multiple tumor localization combined with angiomatosis retinae (0%), polyglobulia (10.8%). Psychopathologically relevant signs (45.6%) were, in all cases, combined with signs of increased intracranial pressure. The results of our re-examination demonstrate that late postoperative deficits as well as possible relapses are earlier and more precisely evaluated by the combined use of clinical examination, CCT and EOG.
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PMID:[Hemangioblastomas of the central nervous system. A clinical study]. 654 79

The rare case of a status of complicated migraine with more than two weeks duration and severe neurological deficits is reported. The clinical symptoms were global aphasia, mild fluctuating hemiparesis on the right side and headache without localization on one side. The presence of a characteristic constellation of morphological and functional findings on investigation (EEG, SPECT, TCD) helped to clarify the diagnosis. In addition, the functional investigations proved remarkably valuable in following the course of the illness. The decrease of clinical symptoms was clearly correlated with SPECT and TCD findings, while CCT and MRT remained unspecific and EEG did not become normal.
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PMID:[Functional and structural follow-up findings in complicated migraine]. 768 Jul 73

The frequency of postspinal headaches after accidental puncture of the subarachnoid space with 16-18 G Tuohy needles is reported at 59-85%. A case of postspinal headache syndrome persisting over a period of 6 weeks following epidural anaesthesia during labour is described. The treatment is discussed. CASE REPORT. A 30-year-old woman had severe postspinal headache for 6 weeks after epidural anaesthesia during labour. Conservative therapy for 3 days and 4 days of bedrest followed by crystalloid infusions during a 3-week hospital stay and a subsequent 3-week period of bedrest at home did not lead to lasting pain relief. Intracranial haematoma and other abnormal processes were excluded by CCT. A pathologic EEG was not confirmed by cranial MRT. A lumbar epidural blood patch of 15 ml of autologous blood was performed at L3/4. The patient stayed in bed for 12 h. After 3 h free of pain the patient complained of recurring headache. After a further 48 h of bedrest she had recovered. Because of lumbar pain 4 days after the epidural blood patch a MRT was performed, which showed the blood at L4 to S3 in the epidural space. DISCUSSION. The diagnosis of a cerebrospinal fluid leakage was based on the history and the main symptom of postspinal headache: the pain onset in the supine position. Such possible treatments as diminishing subarachnoidal pressure by bedrest, increasing cerebrospinal fluid production by infusions, increasing epidural pressure by epidural infusions and closing the cerebrospinal fluid leakage by epidural blood patch are discussed. The average success rate with the epidural blood patch is 93%. Volumes ranging from 5 to 20 ml are discussed for the autologous blood. We chose 15 ml of blood, to take account of the possibility that blood might settle in the wide sacral space. We were able to document the position of the blood patch as L4 to S3 on MR tomography (the injection site was L3/4). Most patients are free of headache 1 h after epidural blood patch. Our patient had to be confined to bed for another 48 h because of recurring headache. The blood patch alone was not immediately sufficient to prevent all further cerebrospinal fluid leakage. Probably more than one subarachnoidal puncture had been made during the difficult epidural anaesthetic procedure. On the other hand, the leak was probably only diminished because of the blood patch descending down to the wide sacral space. The combination of the large-volume blood patch, which diminished the leakage, and conservative treatment, which narrowed the transdural pressure difference, was successful: the 6-week postspinal headache was cured. CONCLUSION. Prolonged postspinal headache should be treated by epidural blood patch. The use of over 10 ml cannot be generally recommended, although in this case most of the blood patch of 15 ml was localized caudally. Careful monitoring for side effects is necessary with blood volumes larger than 10 ml. If there is no immediate relief, conservative therapy with 24-48 h of bedrest is recommended. If the headache persists a second blood patch should be performed, with the volume and the probable caudal spreading of the first taken into account.
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PMID:[Epidural blood patch for the treatment of postspinal puncture headache. Successful therapy after 6 weeks following accidental dura perforation in obstetric PDA]. 804 69

A patient with obstructive sleep-apnea-syndrome and congenital temporal and cervical hemangiomas developed severe headache under nasal BiPAP ventilation. Internal hydrocephalus was diagnosed by CCT and MRI and rise of intracranial pressure (ICP) under artificial ventilation was supposed. Polysomnography, ICP-measurement with a ventricular catheter and resistance to outflow-measurement were used to clarify differential diagnosis. During periods of apnea ICP was raised severely with a maximum in REM-sleep. With nasal ventilation no apnea was observed and ICP was normalized. Resistance to outflow was normal. A disturbance of CSF-dynamics or CSF-absorption leading to the patient's headache could be excluded. Duplex-sonography and cerebral angiography did not provide further information. After exclusion of other causes artificial respiration dependent swelling of the subcutaneous temporal and cervical hemangiomas was the most likely cause triggering the headache. A sufficient therapy however was not yet available. Probably the patient suffers from an abortive form of a Sturge-Weber-Krabbe-Dimitri-Syndrome.
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PMID:[Intracranial pressure in sleep apnea, hydrocephalus and congenital hemangioma. A case report]. 805 80