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

An intra-abdominal cyst is a rare complication of ventriculoperitoneal (VP) shunt. A 19-year-old male was admitted complaining of abdominal pain and distension, dysuria, constipation, headache, and fever. He had undergone a VP shunt for obstructive hydrocephalus caused by a cerebellar astrocytoma 16 years earlier, and had received shunt revision twice, 5 years and 3 months earlier, respectively. Examination on admission revealed neck stiffness, early papilledema, a mass in the lower abdomen, and abdominal muscular guarding with rebound tenderness. Laboratory studies showed leukocytosis of the peripheral blood and pleocytosis of the cerebrospinal fluid (CSF). Abdominal ultrasonograms and computed tomographic scans demonstrated a cystic lesion. Under the diagnosis of meningitis and local peritonitis with an intra-abdominal cyst, we sistemically administered antibiotics and externalized the shunt. However, since the cyst fluid could not be aspirated through the abdominal catheter, it was exchanged with a flexible catheter under fluoroscopic control, according to Seldinger's method. A total of 400 ml of cyst fluid was drained. Staphylococcus epidermidis was detected in both the cyst fluid and the CSF. After meningitis subsided, repositioning of the abdominal catheter into the other side of the abdomen was performed but resulted in shunt malfunction and meningitis due to the same organisms. After meningitis again subsided, the VP shunt was converted to a ventriculoatrial shunt. The clinical course was uneventful thereafter.
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PMID:Intra-abdominal cyst following revision of ventriculoperitoneal shunt--case report. 170 49

The isolation and enlargement of the fourth ventricle after a ventriculoperitoneal (V-P) shunt was classified as "isolated fourth ventricle (IFV)". The term, "disproportionately large communicating fourth ventricle (DFV)" was first introduced by Scotti et al as being an enlarged fourth ventricle communicating with the third ventricle. The authors present a case of DFV after the resection of an astrocytoma. Upon recurrence of the tumor a second resection was carried out 5 years later. It was found that IFV had evolved because a cyst in the right temporal lobe was obstructing the aqueduct. After shunting of the tumor cyst, the aqueduct was again found to be patent and the fourth ventricle gradually decreased in size. A 34-year-old female presented headache, nausea, and a mild left hemiparesis. An initial CT scan demonstrated a fourth ventricle of approximately normal size and a right temporal mass. The first craniotomy revealed an astrocytoma. A CT scan after the surgical procedure showed enlargement of all ventricles, especially the fourth, resulting from the blockage of the foramina of Luschka and Magendie. The insertion of a V-P shunt was followed by a reduction in size of all ventricles. The diagnosis of DFV was thus confirmed because the fourth ventricle had a demonstrated communication with the third ventricle. After a second craniotomy for tumor recurrence five years later, a CT scan revealed the enlargement of the fourth ventricle and a cyst in the right temporal lobe. A metrizamide CT scan revealed that the cyst was isolated and an RI ventriculogram confirmed obstruction of the aqueduct.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of disproportionately large communicating fourth ventricle after resection of temporal astrocytoma that evolved an isolated fourth ventricle]. 176 41

We present 11 patients with intracranial gangliogliomas. The age ranged between 4 and 69 years with a mean of 32 years. The most frequent clinical manifestations were epilepsy in 7 cases and headache in 4 cases, and had begun from 15 days to 12 years before diagnosis. The gangliogliomas were located supratentorially predominantly in the temporal lobe (5 cases), except one, which was located within the cerebellum, which is extremely rare. EEG evidenced focality in 8 cases. The CT scan showed hypo or isodense images which were often associated with cysts, and that partially or totally enhanced with contrast administration in 7 cases (63.3%). Calcification was seen in only one case (9%). All our cases were treated surgically. Three patients were reoperated for recurrence. One case was reoperated twice and the histologic study showed astrocytoma grade II. Radiotherapy was given in two cases. In one case after subtotal surgery and in the other after the second operation for recurrence. Follow-up ranged between one and thirteen years, with a mean of 6.8 years. There was only one death. We used the CT scan for follow-up. However, nowadays MRI is more useful than the CT scan to distinguish recurrences.
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PMID:Gangliogliomas: clinical study and evolution. 181 44

In this report we present aspects of the epidemiology of headache (i.e., pain in the head, face, ear, or neck) among children with brain tumors. The data are derived from the 3,291 subjects in the Childhood Brain Tumor Consortium databank. Overall, 62% of the children with brain tumors experienced chronic or frequent headaches prior to their first hospitalization: 58% of children with supratentorial tumors and 70% of children with infratentorial tumors. The relative frequency of headache increased through age 7 and then leveled off regardless of tumor location. For children under age 5, headache rarely had a duration of more than 1 year prior to hospitalization. Among children over age 4, headache duration of at least one year was significantly greater for supratentorial than for infratentorial tumors. Children with a brain tumor and headache had a different distribution of symptoms and neurologic signs than those without headache. Tumor location and headache status were interactively associated with the presence of other symptoms and neurologic signs. Children with headache had a greater number of other symptoms and neurologic signs. Regardless of tumor location among children with headache, nausea or vomiting, papilledema, and hypoactive tendon reflexes were more frequent, while upper extremity weakness, optic atrophy, and irritability were less frequent. Diplopia, coma, stiff neck, anesthesia or hypesthesia, pupillary abnormalities, and abnormalities of personality, academic performance, or speech were associated with headache in children with supratentorial tumors. No specific symptoms or neurologic signs were associated with headache in children with infratentorial tumors. Supratentorial craniopharyngioma, ependymoma, and protoplasmic astrocytoma were associated with significantly high rates of headache as was infratentorial pilocytic astrocytoma.
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PMID:The epidemiology of headache among children with brain tumor. Headache in children with brain tumors. The Childhood Brain Tumor Consortium. 202 72

From may 1986 to July 1988 ten patients have been treated by interstitial implantation of radioactive isotopes using Yttrium 90 colloidal solution (9 cases) and Aurum 198 grains (1 case). There were 7 cystic out of 8 craniopharyngiomas, one malignant pituitary adenoma and one hemispheric Astrocytoma grade III-IV. In all but one patient the tumors were recurrent after one or more reductive or palliative operations. To external radiation undervent preoperatively two cases (one craniopharyngioma and one pituitary adenoma). Target volume was established by CT data and X-ray studies after stereotaxic injection of contrast medium (one case). Doses for intracystic irradiation were calculated using the Backlund's formula. The lowest activity was calculated to be 3.84 mCi, and the highest 12.9 mCi (m 6.8 mCi or 252 MBq). The delivered activity was 100-200 Gy of Y90 (m 140 Gy). The activity of Au198 was determined using the producers dosimetric tables. The radionuclide implantation was performed by stereotaxic techniques with Leksell's system in 5 patients. In 5 patients the surgical procedures were open: 3 osteoplastic supratentorial and 2 craniectomies for direct instillation of Y90 into the craniopharyngiomatous cavities spread to posterior fossa. Early short lasting side effects of endocavitary irradiation were observed in 5 patients (headache and somnolence; adynamy, pseudobulbar symptoms and rigor; insomnia and agressiveness; lack of orientation and increased mental irritability). The longest follow up was 26 months. The clinical response to intracystic instillation of Y90 was very favorable in 8 cases: 7 craniopharyngiomas and one pituitary adenoma. A satisfactory anatomical result with diminution or retraction of cystic cavities was evident in all cases. The more pronounced achievement of intracystic irradiation therapy in our series were the effects on stabilization or recuperation of vision and on improvement of visual field finding. The recovery of endocrine insufficiency was also noted. Two patients died: the 3-year old child, one year after implantation of Au198 grains in a huge calcified craniopharyngioma, and a woman, 67 old, twelve days after Y90 instillation to a hemispheric glioma grade III-IV.
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PMID:[Implantation of radioactive isotopes in intracranial tumors]. 248 66

Brain stem glioma is the third most common childhood brain tumor, comprising 10-15% of this group of neoplasms. Typical presenting symptoms include ataxia, diplopia and headache, while signs of increased intracranial pressure occur later in the clinical course. Although prolonged failure to thrive, characterized by cachexia and vomiting are rare manifestations of brain stem lesions, in this study we report a 9.5-year-old boy with failure to thrive since infancy which remitted after excision of a brain stem astrocytoma.
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PMID:Chronic dysphagia, vomiting and gastroesophageal reflux as manifestations of a brain stem glioma: a case report. 248 55

Four cases of brain tumors associated with hemorrhage from tumors as their first manifestation were reported. These were malignant astrocytoma in two cases, brain metastasis of hepatocellular carcinoma in one case and skull metastasis of hepatocellular carcinoma in one case. Clinical symptoms and sings were generalized convulsion, sudden onset of headache, vomiting and hemiparesis. It was difficult to confirm the diagnosis of brain tumors in such cases. Therefore it is important to perform follow-up plain and enhanced CT repeatedly and it is also important to make adequate biopsy of hematoma wall and surrounding tissue during operation.
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PMID:[Brain tumors associated with hemorrhage from tumors as their first manifestation]. 255 50

A case of malignant astrocytoma following radiotherapy for pituitary adenoma is presented in detail with a review of the literature. A 38 year-old housewife had developed a growth-hormone secreting pituitary adenoma, and received a total of 50 Gy at the pituitary region. Four years and six months later, she began suffering headache and vomiting. Computed tomography showed an extensive low density with ring enhancement in the right temporal region, corresponding to the previously irradiated field. A right frontotemporoparietal craniotomy was carried out, and a soft and reddish tumor was partially removed. The histological diagnosis was that of malignant astrocytoma. The patient was submitted to postoperative radiochemotherapy, receiving a total of 60 Gy, nimustine hydrochloride (ACNU), and tegafur (FT). Subsequently, after three months of clinical relief, she developed tumor regrowth, and died four months later. The present case fulfills the criteria for radiation-induced tumor established by Cahan et al.: A tumor location within irradiated area, no evidence of tumor prior to radiotherapy, a long latency period between radiation and tumor occurrence, and histological verification of the tumor. Thirty-nine cases of radiation-induced gliomas including the present case have been reported in the literature. It is noteworthy that the majority occur in the younger age bracket. Male preponderance is noted as it is in primary cerebral gliomas. The primary lesions for radiation frequently include leukemia and lymphoma. Craniopharyngioma, pituitary adenoma, and medulloblastoma etc are also included.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Malignant astrocytoma following radiotherapy in pituitary adenoma: case report]. 268 39

Brainstem tumors arise in portions of the rhombencephalon and mesencephalon. Some authorities include diencephalic tumors in this group. We have reviewed our clinical experience of 69 children (less than 21 years of age) with brainstem tumors evaluated and treated at Duke University Medical Center (DUMC) from 1960 to 1986. There were 19 patients with group 1 tumors (thalamus, third ventricle region, or midbrain) and 50 with group II tumors (pons, medulla oblongata). The common presenting signs and symptoms were ataxia, headache, motor loss, and cranial nerve palsies. The most commonly employed diagnostic imaging studies were air examinations and CT. Preradiotherapy confirmation of malignancy was obtained in five group I patients (astrocytoma, 4; germinoma, 1) and 8 group II patients (astrocytoma, 3; anaplastic astrocytoma, 2; glioblastoma multiforme, 3). All patients received radiotherapy. The 5-year survival rate for the entire population was 40%. The survival rate for group I patients was significantly better than that observed for group II patients. In the 50 group II patients neither patient sex nor age nor presence of cranial nerve palsies nor pretreatment CT scan findings nor field size influenced survival. A long duration of symptoms positively influenced survival. The vast majority of tumor recurrences were within the radiation field. Half of the patients had either stable or improved Karnofsky status 6 months following completion of irradiation. The management strategy for childhood brainstem tumors is discussed.
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PMID:Selection of a management strategy for pediatric brainstem tumors. 270 33

Brain tumors remain the second most common neoplasm of childhood, however, there is no adequate study of this disease in Thai children. From the year 1971 to 1987, 468 children under 15 years of age were admitted to the Department of Pediatrics, Ramathibodi hospital with the diagnosis of brain tumor. Four hundred and forty-four patients had primary intracranial tumors, of these, 17 were excluded due to inadequate information and the remaining 427 patients were studied. Male to female ratio was 1.3:1, the age ranged from one day old to 14 years old. The duration of illness before admission ranged from a few days to 4 years, with over 70 per cent within 3 months. Headache, vomiting and papilledema were the three most common symptoms and signs. Supratentorial and infratentoral tumors were seen in 209 and 216 patients respectively, craniopharyngioma was the most common supratentorial tumor (51/209) and medulloblastoma was the most common infratentorial tumor (95/216), however, malignant astrocytoma is the overall most common tumor type. Early diagnosis and treatment were needed for good outcome.
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PMID:Brain tumors in children at Ramathibodi Hospital. 273 28


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