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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Disruptive behavior disorders, including conduct disorder, oppositional defiant disorder, and disruptive behavior disorder not otherwise specified, are serious conditions in children and adolescents that include a behavior pattern of violating the basic rights of others and age-appropriate rules or standards and may include aggressive behavior. Although no pharmacotherapy is currently approved for use in this population, evidence suggests that atypical antipsychotic treatment may be useful in patients with these conditions who present with problematic aggression. Currently, research on risperidone shows it to be effective in treating aggressive behavior in this patient population. Limited research is also available on olanzapine, quetiapine, and aripiprazole, but more research is needed on these and other agents. As with any pharmacotherapy, adverse events (including weight gain, headache, and somnolence) should be carefully considered with these medications, especially in children and adolescents, and it is important to properly dose and monitor patients during medication therapy.
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PMID:Atypical antipsychotic treatment of disruptive behavior disorders in children and adolescents. 1853 63

We established a cohort of 60 subjects with chronic daily headache (CDH) out of 1533 community-based elderly in 1993 and finished two short-term follow-ups in 1995 and 1997. All of the 26 survivors without dementia (4 M/22 F, mean age 82.7 +/- 3.4 years) finished the follow-up in 2006. The mean headache frequency was 8.4 +/- 11.8 days per month in the past year, and seven (27%) had persistent CDH. Based on the International Classification of Headache Disorders, 2nd edn, the CDH subtypes diagnoses were chronic migraine in three subjects, chronic tension-type headache in three, and one with medication-overuse headache. All these seven subjects had CDH during the 1995 and 1997 follow-ups. The diagnosis of CDH with migrainous features increased from 25 to 71% in those with CDH from 1993 to 2006. Migraine was the most common headache type in those with CDH resolution. Aggressive treatment should be applied especially for those with persistent CDH at short-term follow-ups.
Cephalalgia 2008 Oct
PMID:A 13-year long-term outcome study of elderly with chronic daily headache. 1862 6

Low-grade fibromyxoid sarcoma was first described in 1987 as a rare soft tissue neoplasm characterized by a bland and deceptively benign histological appearance but with aggressive behavior. A 20-year-old male patient presented with a recent history of headache and seizure. A right frontal mass was detected on MRI and he was operated upon to remove the intracranial mass. Histological examination revealed mildly atypical fibroblastic cells embedded within a myxoid matrix. Nuclear atypia and pleomorphism were minimal, and necrosis was not present. The lesion was diagnosed as a low-grade fibromyxoid sarcoma. Although primary intracranial low-grade fibromyxoid sarcoma has characteristic histological features, clinical and radiological correlation is necessary to make the correct diagnosis.
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PMID:Primary intracranial low-grade fibromyxoid sarcoma (Evans tumor). 1877 26

A 51-year-old woman with left proptosis, diplopia, headache, and nausea was found to have bilateral intraorbital abscesses, left superior ophthalmic vein thrombosis, bilateral cavernous sinus thromboses, and a left temporal lobe intracerebral abscess. Because the paranasal sinuses were unaffected, a dental origin was suspected and confirmed. The causative organism was Streptococcus milleri. Aggressive surgical intervention included bilateral orbital abscess drainage and dental extraction, and medical therapy included intravenous metronidazole, ceftriaxone, heparin, and methylprednisolone. A left sixth cranial nerve paresis was the only long-term sequela.
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PMID:Bilateral intraorbital abscesses and cavernous sinus thromboses secondary to Streptococcus milleri with a favorable outcome. 1880 67

Severe primary central nervous system (CNS) involvement such as vasculitis and pachymeningitis can rarely occur in rheumatoid arthritis (RA) even in the absence of systemic disease activation. The authors illustrate a female patient with well-controlled RA who presented with headaches, encephalopathy, seizures and relapsing focal neurological deficits. Primary rheumatoid cerebral vasculitis and pachymeningitis were diagnosed based on suggestive brain magnetic resonance (MR) imaging, MR angiography, cerebrospinal fluid analysis and cerebral angiography. MR showed abnormal leptomeningeal enhancement and hyperintense FLAIR signal in the cortical subarachnoid spaces consistent with pachymeningitis. Cerebral angiography findings were consistent with vasculitis. Aggressive treatment resulted in significant clinicoradiological resolution. Cerebral vasculitis is a rare but certain manifestation of RA. This complication can be diagnosed in the presence of suggestive angiographic and CSF findings. The condition may be steroid resistant, and needs to be treated more aggressively.
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PMID:An unusual central nervous system involvement in rheumatoid arthritis: combination of pachymeningitis and cerebral vasculitis. 1909 17

Many women experience emotional or physical side effects when taking oral contraceptives (OCs). Despite the potential impact on women's health and well-being, there are no valid methods to screen women for their risk of OC side effects. The present paper presents the results of two studies where anthropometric indicators of androgen exposure, 2D:4D and middle-phalangeal hair, were examined for their potential as predictors of OC side effects. In study 1, 2D:4D was associated with women's reports of a history of: (a) negative mood side effects; (b) discontinuation due to negative mood side effects; (c) specific mood side effects (i.e., crying, sadness, and altered trust in one's partners) and (d) specific physical side effects (i.e., headaches, fatigue, and decreased sex drive). In study 2, 2D:4D and/or middle-phalangeal hair was/were associated with a reported history of: (a) discontinuation due to negative mood side effects; (b) specific mood-related side effects (i.e., negative mood, disrupted sleep, increased aggression, and altered trust in one's partner) and (c) specific physical side effects (i.e., headaches, decreased menstrual cramps, and increased sex drive/arousal). The general pattern was that adverse OC side effects were experienced by women with lower 2D:4D and fewer middle-phalangeal hairs. Almost all relationships remained significant when response bias was controlled. These results suggest a possible role for prenatal testosterone exposure and both androgen action and sensitivity in women's experience of OC side effects. Furthermore, these two digit measures may be useful predictors of hormonal contraceptive side effects in women.
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PMID:Putting a finger on potential predictors of oral contraceptive side effects: 2D:4D and middle-phalangeal hair. 1913 Nov 72

Headaches are common during childhood and a common pediatric presentation to emergency departments (EDs). The most common diagnoses for acute headache in the pediatric ED are viral upper respiratory tract infection with fever, sinusitis, and migraine, accounting for 70% to 75% of presentations; serious neurologic diagnoses are rare. Most literature recommends against neuroimaging for uncomplicated headache given the absence of any other signs or symptoms associated with causes of intracranial pathology and the presence of a normal physical examination. Cerebral sinovenous thrombosis (CSVT) is a rare entity whose diagnosis relies heavily on neuroimaging and which carries high morbidity and mortality if untreated. Pediatric CSVT has yet to be presented in the emergency medicine literature. We report the case of a child who presented to the pediatric ED with headache, which was complicated by background difficulties with aggression and other behavioral issues. This case illustrates an extremely rare ED presentation of CSVT masquerading as migraine headache and discusses the diagnostic dilemma of neuroimaging.
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PMID:Cerebral sinovenous thrombosis masquerading as migraine: a case report. 1928 74

(Full text is available at http://www.manu.edu.mk/prilozi). The research concerned a group of 59 children, 22 girls and 37 boys, mean age 12.5 +/- 1.24 years, with tension type headaches. Their clinical results (neurological, neuropsychological, radiological and laboratory) were normal, suggesting psychosomatic etiology. The characteristics of the headache correspond to a nosologic entity known as tension-type headache. The aim of this study was to evaluate the psychological characteristics of these children and their families, especially the profile of the mothers. The psychological assessment, consecutively applied, comprised: Eysenck Personality Questionnaire (EPQ), Emotions Profile Index (EPI), General Anxiety State (GAS) and Human Values Rank (HVR). The mothers were examined by Family Inventory Life Events (FILE) and Minnesota Multiphasic Personality Inventory (MMPI) and also checked with the Child Behavior Check List (CBCL). The results obtained showed a non-negligible level of actual anxiety in all the children, who were mostly the first-born and lived in families with accentuated stress. The emotional profile of the children was characterized by impulsiveness, a feeling of fear, moderate aggression, but still with a great level of acceptability. The EPQ confirmed their extroversion, moderate neurotic manifestations and a need for social acceptance. These results suggest that in preadolescents emotional stress, combined with a "model" for somatization, could provoke specific involuntary contraction of the head and neck muscles causing local ischaemia, which may be the pathophysiologic cause of a tension-type headache. The therapy comprised EDR and EMG biofeedback, applied once per week, of 50-minute duration. The results obtained after 20 sessions are very satisfactory. In addition, some response-measures involving a change and adjustment of family relations and school environment are recommended. Key words: headache, children, biofeedback, psychophysiology.
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PMID:Psychological assessment and biofeedback mitigation of tension-type headaches in children. 1973 38

Basaloid squamous cell carcinoma (BSCC) is a distinctive variant of squamous cell carcinoma (SCC) with more aggressive behavior. It occurs preferentially in the upper aerodigestive tract. Sinonasal tract BSCC is uncommon, and only limited studies have been reported in literature. In these studies, most BSCCs arose from the nasal mucosa with or without extension to the paranasal sinuses. Rare reported cases of BSCC involved only the paranasal sinus. In this report, we present a case of a female patient with a sphenoid sinus mass. Clinically, the patient had progressively decreasing vision and headache. Magnetic resonance imaging (MRI) and computerized tomographic (CT) scan showed an infiltrating tumor mass involving the sphenoid sinus and the sella with compression of the optic nerve. Pathologic examination revealed an invasive basaloid epithelial neoplasm that was arranged in lobules, nests and cords. The tumor also showed palisading of peripheral cells, focal abrupt squamous differentiation and in situ carcinoma in the surface mucosa. In the immunohistochemical studies, this tumor revealed a strongly positive nuclear staining for p63. The morphologic and ancillary studies indicated a BSCC. To the best of our knowledge, this is the first report of sinonasal tract BSCC that mainly involved the sphenoid bone and sella. In this region, BSCC should be distinguished from benign and malignant neoplasms that more often affect sella and base of skull, such as pituitary adenoma with extensive necrosis, small cell neuroendocrine carcinoma (SCNC), olfactory neuroblastoma, malignant germ cell tumor, paranasal adenoid cystic carcinoma (ACC), and a variety of metastatic malignancies.
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PMID:Sphenoid sinus basaloid squamous cell carcinoma presenting as a sellar mass: report a case with review of the literature. 2097 44

A 16-year-old female, with unremarkable medical and family history, presented with a huge dural-based mass in the right frontotemporal fossae, manifesting as headache. The patient underwent subtotal tumor resection. Intraoperative findings revealed focal erosion in the temporal fossa dura mater and skull adjacent to the lesion. Most of the tumor was located extraaxially, but a part of the tumor had invaded the temporal lobe, and had tightly adhered to the middle cerebral artery and its perforating vessels. Histological examination revealed cellular pleomorphism with mitotic activity, focal necrosis, but lacking endothelial proliferation, consistent with anaplastic pleomorphic xanthoastrocytoma (PXA) with component of anaplastic astrocytoma. Postoperatively, the patient underwent local irradiation and temozolomide administration, but the tumor relapsed 13 months later. Second tumor resection was performed followed by gamma knife radiosurgery, but the residual tumor progressively grew, extending into the contralateral hemisphere, and formed an enormous mass in the left frontal lobe at 17 months. Magnetic resonance imaging performed at 18 months revealed extracranial infiltration of the frontal tumor, through the cribriform plate, with enormous extension into the paranasal sinuses, nasal cavity, and orbit during the next month. The patient died at 20 months after the initial surgery. PXA with anaplastic appearance may have a component of anaplastic astrocytoma with more aggressive behavior.
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PMID:Anaplastic pleomorphic xanthoastrocytoma with a component of anaplastic astrocytoma presenting as skull base tumor followed by downward extracranial extension. Case report. 2120 89


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