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

The occurrence of a brain abscess as a complication of halo traction and immobilization in the management of scoliosis is reported. Previous reports suggest that this complication is rare. Unique in this case is the development of an intracerebral abscess without skull perforation by the halo device and without evidence of contiguous spread of infection. Attention of clinical signs (headache) and the use of computerized axial tomography may allow for early detection and appropriate care.
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PMID:Brain abscess as a complication of halo traction. 728 Aug 25

Based on the findings from angiograms done over a 4-year period in Zambia, the most common indications were cerebrovascular disorders, head injuries, infective lesions, epilepsy and intracranial tumours. A few patients were also investigated for headache and vomiting, visual symptoms and papilloedoma. The overall positive yield at 23% was high. 10% of the abnormalities were cerebrovascular lesions. (Occlusive disease and subdural haematoma were common; aneurysms, arteriosclerosis, epidural haematoma, arteriovenous malformations were rare.) Compared with western countries, tumours were not as common but brain abscess was encountered more frequently. Carotid angiography is a valuable tool in tropical neurological practice and the pattern of disease differs from the western countries.
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PMID:Cerebral angiography in Central Africa. 729 88

Two hundred and nineteen patients, with intracranial complications of sinusitis, are presented. Sinusitis is still a life-threatening condition and if neglected, or mismanaged, can lead to intracranial complications that result in a high mortality and morbidity. Twenty-two patients had meningitis, 127 subdural empyema, 38 brain abscess, 15 combined brain abscess and subdural empyema and 17 extradural empyema. The diagnosis of intracranial abscess and sinusitis was made with the aid of a CT scan, and that of meningitis on cerebrospinal fluid microscopy, chemistry and culture. The most frequent presenting signs were fever (68 per cent) and headache (54 per cent). The most common localizing neurological sign was hemiparesis (35.5 per cent). Orbital inflammation was present in 41.5 per cent of patients. Treatment entailed immediate, appropriate, intravenous antibiotic therapy and prompt surgery, performed within 12 hours of admission. In patients with meningitis, the surgery entailed surgery of the sinus disease only. In patients with subdural empyema, brain abscess and extradural empyema, evacuation of the primary source of infection by the radical frontoethmoidectomy approach, immediately after drainage of the intracranial collection of pus, was carried out. There were 35 deaths (16 per cent). The highest mortality rate was recorded in patients with meningitis (45 per cent) followed by brain abscess (19 per cent) and subdural empyema (11 per cent). Despite advances in medicine, i.e. antibiotics and CT scan for early and accurate diagnosis, the mortality from sinogenic intracranial complications has remained significant. This can only be eliminated through education.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sinogenic intracranial complications. 749 46

We report two patients with solitary thalamic abscesses, occurring among 91 consecutive patients (2.2%) with computed tomography (CT)-diagnosed and surgically-verified brain abscess experienced in our college during 1975 to 1991. A 9-year-old girl with congenital heart disease experienced frequent vomiting followed by left hemiparesis and deterioration of consciousness. CT demonstrated a right thalamic ring-enhanced lesion. Purulent material was aspirated via a burr hole. She died of heart failure on the 5th postoperative day. Autopsy disclosed diffuse brain swelling and an encapsulated abscess in the right thalamus, which had ruptured into the third ventricle. A 30-year-old female experienced headache, nausea, and vomiting, which progressed to somnolence and right hemiparesis. CT demonstrated a left thalamic ring-enhanced lesion. Purulent material was aspirated by stereotactic procedures. All symptoms had resolved by the end of the 2nd postoperative week.
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PMID:Solitary pyogenic thalamic abscess--two case reports. 750 3

A 53-year-old male with normal immunity presented with Aspergillus brain abscess manifesting as frontal headache. T2-weighted magnetic resonance imaging revealed a hypointense lesion in the left frontal lobe extending into the right frontal lobe. The hypointense appearance on T2-weighted images appears to be characteristic of aspergillosis. Bifrontal craniotomy exposed an elastic-hard mass in the base of the left frontal lobe extending into the right frontal lobe, and into the left ethmoid sinus. The mass contained a cavity with white fluid. The abscess was removed almost totally. The histological diagnosis was Aspergillus abscess. Antibiotic treatment with amphotericin B and fluconazole was given for 2 months postoperatively. No recurrence was identified during 15-month follow-up.
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PMID:Aspergillus brain abscess in a patient with normal immunity--case report. 752 May 48

The objective of this study was to define the severe neurological complications that occur in recipients of an orthotopic liver transplantation, receiving FK 506 as their primary immunosuppressive agent. To accomplish this, 100 consecutive orthotopic liver transplantation patients were followed prospectively from the time of their transplant until the date of their initial post-orthotopic liver transplantation discharge from hospital. All major neurological complications occurring during this period were recorded and assessed. The frequency of severe neurological complications occurring in these severely ill transplant recipients was 34%. Delirium was noted in 16, coma in 9, seizures in 4, and 5 developed focal motor deficits associated with the finding of a brain abscess, transient ischemic attack or central pontine myelinolysis. At the time at which a major neurologic complication was noted, the blood level of FK 506 was recorded. No direct relationship between FK 506 blood levels and the presence or absence of major neurologic complications of orthotopic liver transplantation could be demonstrated. Based upon this series, it can be concluded that although FK 506 may contribute to the pathogenesis of minor neurological complications seen after orthotopic liver transplantation such as tremors and headaches, the pathogenesis of most of the major neurologic complications occurring after orthotopic liver transplantation is multifactorial and cannot be ascribed solely to FK 506 toxicity.
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PMID:Severe neurological complications following orthotopic liver transplantation in patients receiving FK 506 and prednisone. 752 72

The number of brain abscesses has been reduced since the preantibiotic era. This was accomplished by judicious use of antibiotics, by the advent of computed tomography, and by improvements in patient care and surgical techniques. Analysis from 122 patients with brain abscess demonstrated this trend of progress. Our series had a 3.2-to-1 male predominance. The underlying conditions included otolaryngologic infections (26 cases), cyanotic heart diseases (27 cases), implantation abscess (25 cases), lung infections (5 cases), meningitis (4 cases), osteomyelitis (2 cases), decreased immunity from chronic systemic diseases (12 cases), and unknown causes (21 cases). Otolaryngologic subgroups can be detailed as chronic otitis media with cholesteatoma (15 cases), chronic otitis media with mastoiditis (4 cases), sinusitis (2 cases), esophageal stenosis (3 cases), cheek cellulitis (1 case), and nasopharyngeal carcinoma (1 case). The initial symptoms and signs were headache (46 cases), fever (36 cases), altered consciousness (30 cases), neurologic deficits (33 cases), vomiting (11 cases), and seizure (17 cases). Of the brain abscesses treated, multiple brain abscess represented 16.4% of all cases. The overall percentage of patients with full recovery was 52.5%, whereas 84.8% of otolaryngologic subgroup recovered fully. The overall mortality was 19.7%. The mortality rate of brain abscess from otolaryngologic sources was 3.8%, whereas that from nonotolaryngologic sources was 24%.
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PMID:Brain abscess: with special reference to otolaryngologic sources of infection. 760 12

Brain abscess following dental or periapical infection is rare in childhood. This report describes brain abscesses found in two children with dental caries. Case 1.--A 12 year-old boy was admitted because he had suffered from acute meningitis for 3 days. Clinical examination showed symptoms of meningitis plus palsy of the right third and fourth cranial nerves and of the left facial nerve, and a defect in the left temporal field. Funduscopic examination showed papilledema; CT scan and MRI showed a ring-shaped lesion in the right occipital area. The patient was given cefotaxime and thiamphenicol. The abscess was drained; bacteriological examination showed Actinomyces viscosus and Peptostreptococcus magnus. The neurological condition and the CT scan lesion improved, but intracranial pressure increased again on the 17th day after the onset, requiring replacement of the antibiotics by rifampicin and ampicillin plus clavulanic acid for 2 months. This brain abscess appeared to be metastatic, derived from the infection of a large dental cyst due to a dental infection that had been treated 6 months earlier. Case 2.--A 8 1/2 year-old girl was admitted because she was suffering from palsy of the left facial nerve and left arm. She had had headaches and fever for a few days. Clinical examination showed the palsies and drowsiness. CT scan showed two brain abscesses. The patient was given ceftriaxone, fosfocin and metronidazole. She had been treated for a gingival abscess 1 month earlier, and had two infected teeth extracted. Improvement of the intracranial pressure was transient and the antibiotics were changed on the 12th day of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Brain abscess complicating dental caries in children]. 798 45

A case of perforated mitral valve aneurysm following aortic valve replacement associated with infective endocarditis was reported. The patient was a 29-year-old man, who was suffering from high fever, Osler's nodules and headache. A brain abscess was recognized in a computed tomography and 3rd grade aortic regurgitation was recognized in echocardiogram and aortography. Hematological studies suggested the inflammation and gram-positive cocci was incubated from his arterial blood. Then infective endocarditis with aortic regurgitation was diagnosed. AVR was performed following 8 weeks treatment with antibiotics, when he had negative CRP and his blood culture. After the operation, he was received the intravenous antibiotic therapy for 6 weeks and oral antibiotic drugs was given following his hospital discharge. At 6 months after AVR, mitral valve aneurysm was recognized in his echocardiogram. At 30 months after AVR, the perforation of it was revealed and mitral valve replacement was performed with his negative blood culture. The patient was discharged 28th day after MVR. There has been no active inflammation from his first hospital discharge and following days, the mitral valve aneurysm and the perforation was caused by weakened tissue of the anterior mitral leaflet due to sibilant inflammatory change.
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PMID:[A case of perforated mitral valve aneurysm following aortic valve replacement associated with infective endocarditis]. 805 30

A case is reported of a brain abscess, which ruptured into the lateral ventricle and was treated using intraventricular irrigation with antibiotics. A 37-year-old man was suffering from a headache and high fever. Precontrast CT scan revealed a heterogeneous low density area in the left temporal lobe, and postcontrast CT scan showed a multilobular ring-like enhanced mass. Diagnosed as a brain abscess, intravenous administration of antibiotics was performed. On the sixth day the patient suddenly became drowsy. Postcontrast CT scan revealed an enhanced effect in the left lateral ventricular wall. Drowsiness was attributed to increased intracranial pressure and severe ventriculitis. Bilateral continuous ventricular drainage via the anterior horn of the lateral ventricle was performed. The drainage fluid from the left lateral ventricle was just like pus. Intraventricular irrigation with antibiotics between the bilateral anterior horns of the lateral ventricle, was performed in order to save the patient. The infusion fluid, Lactate Ringer's solution containing Cefazolin sodium, was infused into the right ventricle and CSF-like pus was drained from the left ventricle. The CSF reading gradually improved, and on the 14th day postoperatively irrigation was terminated. The postoperative course was uneventful. The diagnosis, treatment, and prognosis of patients with brain abscesses have improved dramatically as a result of more reliable methods of identifying infecting organisms, more effective antibiotic regimens, the development of microsurgical techniques and CT scan. However, despite these advances, the prognosis for brain abscess ruptured into the ventricle is usually very pessimistic.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Brain abscess ruptured into the lateral ventricle: the usefulness of treatment by intraventricular irrigation with antibiotics. A case report]. 807 4


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