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

The side-effects of two opioid agonist-antagonists, nalbuphine and pentazocine, were assessed when used for patient-controlled postoperative analgesia. Forty ASA I or II patients scheduled for upper abdominal surgery were randomly allocated to two equal groups. The anaesthetic technique was the same for all the patients: premedication with atropine and diazepam, induction with thiopentone and suxamethonium and maintenance with fentanyl, pancuronium, nitrous oxide and halothane. Patient-controlled computer assisted analgesia (On-Demand Analgesia Computer) was started in the recovery room at least 2 h after the last administration of fentanyl. The parameters used were: a routine hourly dose (the half of that received during the previous hour), with on demand delivery of nalbuphine (15 micrograms.kg-1) or pentazocine (45 micrograms.kg-1) aliquots respectively, with a refractory period between two demands of 4 min and a total hourly maximum dose of 16 mg and 48 mg respectively. The following parameters were measured before the start of self-administration, and every hour afterwards for 24 h: systolic (Pasys) and diastolic blood pressures, heart rate, pressure-rate product (PRP), respiratory rate, end-tidal CO2 and pain (by way of a three point scale). Analgesia was assessed on a four-point scale every 6 h. The total doses of nalbuphine and pentazocine administered were 94 +/- 43 mg and 251 +/- 150 mg respectively. The only parameters significantly different between the two groups were Pasys and PRP, being higher in the pentazocine group. There were no significant differences in the side-effects (drowsiness, nausea, vomiting, headache, amnesia, logorrhoea and urine retention). All patients in both groups were satisfied with this technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparison of nalbuphine and pentazocine in the treatment of postoperative pain by self-administration]. 266 Jun 40

Among the various reported neuropsychological effects of electroconvulsive therapy are amnesia, delirium, peripheral neuropathy, headaches, and seizures. A case history is presented that describes a previously unreported neurological sequela: the development of intractable yawning during a course of electroconvulsive therapy. Neuropathophysiological mechanisms possibly relating to this phenomenon are discussed.
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PMID:Yawning as a complication of electroconvulsive therapy and concurrent neuroleptic withdrawal. 289 29

There is some suggestion in the literature that patients with migraine may be at an increased risk for developing complications as a result of cerebral angiography. To assess this risk, we reviewed the charts of 142 patients with migraine. A total of 149 angiograms were performed for acute headache (55), new focal symptoms (40), exertional (including coital) headaches (nine), hemiplegic migraine (three), ophthalmoplegic migraine (five), vertebrobasilar migraine (six), migraine accompaniments (three), and other causes (14). Transient events were seen in six patients and these were transient amnesia (one), hemisensory changes (two), hemiparesis (one), global confusion (one), and angina (one). One patient with a history of severe ischemic heart disease developed a myocardial infarction two hours after angiography. Focal cerebral events occurred in 2.6% of cases. This compares with a rate of complications of 2.8% caused by angiography in a prospective study of 1002 patients from our center. According to our findings, it appears that a history of migraine does not increase the risk of complications caused by angiography. Angiography during episodes of acute headaches would also appear to be a safe procedure. Transient focal neurologic symptoms, however, are not infrequent, especially in cases of classic migraine.
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PMID:Migraine and the risks from angiography. 339 65

Two patients with postconcussional syndrome whose most severe symptoms were blackouts, headaches, and amnesia episodes appeared to respond to naltrexone. Because life-saving emergency trauma services are widely available, it is likely that the incidence of postconcussional syndrome will increase.
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PMID:Naltrexone treatment for postconcussional syndrome. 359 7

Neuropsychological impairment and pathologically delayed Acoustic Brain stem Responses (ABR) have been found in patients examined after minor head injury. The relation of these alterations with the emergence of post-concussional symptoms is unknown. In this study 27 patients were examined with ABR within 48 hours of a clearly defined head injury and with a complete neuropsychological test battery one month after the trauma. They were checked for postconcussional symptoms such as headache, depression or dizziness one year later. ABR recordings were pathological in four patients. Neuropsychological testing showed no difference between patients and age-matched controls. No correlation was found between postconcussional symptoms and ABR and neuropsychological examination results, posttraumatic amnesia, and neurotic symptoms present before the trauma. Subclinical brain stem involvement as shown by ABR does not seem to correlate with symptoms of the postconcussional syndrome. This greatly limits the use of ABR in forensic medicine.
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PMID:[Value of neuropsychologic tests and acoustic evoked brain stem potentials in the prognosis of subjective complaints in patients with brain concussion]. 361 86

In an unselected series of 488 patients with head injuries referred to a general surgical department, there were 126 children aged 0-19 years whose head injuries were a result of traffic accidents. In age group 0-4 years, only 23% of the head injuries were due to traffic accidents. In age groups 5-9, 10-14, and 15-19 years, however, traffic accidents were the main cause of the injuries, being responsible for 47%, 65% and 82% of the cases respectively. Both age groups 5-9 and 10-14 years had an unusually high proportion of bicycle injuries, while motorcycle and automobile accidents were the leading causes of injury in age group 15-19 years. Eight children (6%) died as a result of head trauma. Furthermore, among the survivors there were 8 children with severe head injuries (post-traumatic amnesia lasting 24 h), the rest being minor head injuries. All the survivors but one returned to school and achieved reasonable performances. Repeated follow-up studies at 3 months, 1 and 5 years, including interviews with the parents, disclosed that several of the children had headache, dizziness and other complaints. These subjective complaints subsided with time, but with different patterns, in the younger and older age groups. It is concluded that the "postconcussional syndrome" is not uncommon in children, but it may be better tolerated and resolves more completely with time than in adults. Eight children (7%) had one seizure or more during the 5-year follow-up period.
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PMID:Pediatric head injuries caused by traffic accidents. A prospective study with 5-year follow-up. 392 Dec 51

Head trauma is a significant health care problem. Treatment of the head trauma patient requires assistance from many different disciplines in order to maximize recovery of function. The fact that one fourth or more of head trauma patients are impaired in recovery because of psychological factors suggests that appropriate treatment programs are not being implemented in the United States. Organic factors can produce many of the symptoms reported by head trauma patients. However, these factors are more likely to contribute indirectly to such symptoms, and their influence declines as recovery progresses. Recovery from head trauma follows identifiable stages. During the period of coma, the extent of the organic disturbance is sufficient to impair brain-stem functions. Once consciousness is regained, there is a period of gross memory dysfunction. Coma and posttraumatic amnesia represent the acute phase of recovery, during which patients are often hospitalized and receive intense medical care. Once gross functions return, intense medical care is no longer needed. However, the head trauma victim has not returned to a premorbid status at this point. This phase, between recovery from posttraumatic amnesia and stabilization or recovery of premorbid level of functioning, can best be considered the chronic phase of recovery. The chronic phase of recovery is characterized by defects in cortical functions, including impaired intellectual functions, memory weakness, difficulty in processing complex stimuli, slowed reaction time, and other deficits. While these deficits may not be profound, they do correlate with the severity of injury and the degree of eventual recovery. This observation lends further credence to the presence of underlying disturbance of neurologic functioning. During this chronic phase of recovery, head trauma patients may have made good physical recovery and may feel well enough to return to work. However, they frequently process less information and may experience difficulty with tasks that require attention and effort. Such patients tire rapidly and experience stress symptoms, such as headaches and irritability. These symptoms correspond to environmental demands, but they also reflect underlying neurogenic weaknesses. Emotional sequelae that often emerge during the chronic phase of recovery may be related to the patient's reduced ability to cope with environmental stress. Therefore it is not surprising that emotional sequelae appear to correspond more to environmental demands than to severity of injury per se.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Psychological sequelae of head trauma. 640 May 99

In a lot of 3 patients with olfactory meningioma, one patient drew particular attention by the particularities of its evolution, which was asymptomatic for a long time and atypical. The disease started at the age of 38 with asthenia, headaches, dizziness and X-ray images of left parasellar calcified brain tumour, without neurological signs of a focus at any of the repeated clinical or paraclinical examinations. After eight years focal signs appears: left pyramidal irritation, absences, left hyposmia, without altered visual acuity or conclusive scintigraphic and EEG alterations. Left carotid arteriography indicated a space-occupying process. The disease progressed slowly with left hemiparesis and corresponding effects. A diagnosis of "left olfactory meningioma" was established in the Neurosurgical Clinic, Bucharest. The situation deteriorated in 1977: total left anosmia, Jacksonian seizures, sometimes generalized, uncinate fits, paroxysmal headaches, amnesia disturbances and marked right hemiparesis. Recent scintigraphic and EEG alterations likewise lent support to a diagnosis of brain tumour. The existence of calcified, asymptomatic, trailing brain tumours, with an atypical and late evolution of unilateral olfactory meningioma, without Foster-Kennedy syndrome, demands from the beginning close surveillance and complex investigations, since a prolonged absence of anosmia and focal phenomena does not exclude the possibility of a meningioma of the olfactory groove, and may often lead to errors of diagnosis.
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PMID:[Data concerning a case of long-term, asymptomatic, calcified cerebral tumor with late evolution of olfactory meningioma]. 644 61

Three members of a university football team were evaluated because of migraine symptoms precipitated by head trauma. Analysis of the clinical data from these cases, as well as eight previously reported in athletes, reveals that the head trauma is usually minor and not associated with amnesia; and, after a symptom-free interval most often of several minutes, visual, motor, sensory, or brainstem signs and symptoms begin. These usually last for approximately 15 to 30 min and are followed by headache frequently accompanied by nausea and vomiting. In 9 of 11 cases, attacks have occurred with subsequent head trauma. Only 4 of the 11 athletes admitted to spontaneous episodes, however, the incidence may be higher since they have not been followed by a sufficient period of time. Prophylaxis with antimigrainous drugs does not appear to be indicated. The decision as to future participation in contact sports is based primarily on the results of a thorough neurologic evaluation. The possible long-term sequela of this apparent "benign" condition, particularly in those athletes with repeated episodes, is not known since the entity has only recently been recognized. A migraine attack occurring in the course of an athletic event, particularly contact sports, can simulate a serious neurologic emergency. Despite its frequency in the general population and a propensity for onset in the first three decades of life, migraine has not been appreciated in the past as a possible significant sports medicine problem.
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PMID:Migraine precipitated by head trauma in athletes. 737 55

We present a rare case of thalamic germinoma with crossed aphasia in a dextral. A patient, 17-year-old righat-handed male, was admitted to Nippon Medical School Hospital with chief complaints of headache, abnormality of visual field and speech disturbance. There were pigmentations on the back of hand, foot and the perineum. Neurological examination revealed left homonymous hemianopsia, right slight degree of ptosis, left facial palsy, a mild paresis of the left upper extremity and motor aphasia. Right carotid angiography showed marked unrolling and midline shift of right anterior cerebral artery. CT scan revealed ring-like high density area in the right thalamic region, which was enhanced after constant infusion. Brain scintigraphy also showed an abnormal accumulation at the same site. The hen-egg sized tumor of 40 g. weight was almost totally removed by the right fronto-parietal craniotomy. The tumor was characterized histologically by the so-called two cell pattern with teratomatous components. As postoperative treatment local injection of adriamycine, irradiation and immunotherapy with picibanil were performed, and then left hemiparesis was markedly improved without sign of recurrence. Language evaluation was performed after operation. There were dysarthria, remarkable word amnesia, paraphasia and perseveration. Repetition was also impaired. His speech function was concluded to be a mixed type aphasia mainly composed of Broca's aphasia. The speech function of thalamus and crossed aphasia with dextrales were discussed.
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PMID:[A case of thalamic germinoma with crossed aphasia in a dextral (author's transl)]. 743 99


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