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

Pheochromocytoma is an infrequent cause of hypertension. In spite of its rarity, pheochromocytoma has assumed notorious importance because or a wide variety of clinical features associated with this syndrome. Hypertension remains the most important clinical lead. The presence of other features, such as severe headache, perspiration, palpitations or orthostatic hypotension, makes the diagnosis of pheochromocytoma likely. The diagnosis of this condition can be made with greater certainty than that of any other form of secondary hypertension. Pharmacologic tests are no longer used for evaluation purposes. Biochemical tests are the most important aids to diagnosis, provided highly specific methods are used to determine the levels of urinary catecholamines or their metabolites. Interference by various drugs should be avoided. Most of the pheochromocytomas are found in the abdomen, predominantly in the adrenals. Successful outcome of surgery depends critically on adequate preoperative preparation of the patient with adrenergic blocking drugs and proper intraoperative care. Surgery should only be performed in an institution with experience in treating these tumors. Invasive localizing procedures could be dangerous in patients with pheochromocytoma and are best avoided. Medical therapy proves to be quite successful for those patients who are unable or unwilling to undergo surgery and for those with demonstrated malignant tumor. The postoperative course in most instances is uneventful. The physician should be aware of familial forms of pheochromocytomas and screen all the hypertensive members of the patient's family for the presence of this condition. Pheochromocytoma, with its multiple facets, presents a challenge to the clinician; however, with prompt diagnosis and proper treatment, pheochromocytoma can often be cured. The improved management of patients with this potentially lethal condition is the result of better knowledge of biochemical pharmacology, improved preoperative, surgical and postoperative care.
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PMID:Pheochromocytoma--recognition and management. 4 12

Monoamines are involved in the central nervous assimilation and modulation of the pain flow. According to a personal hypothesis, a disorder of this biochemical control (in particular a precariousness of brain 5-hydroxytryptamine turnover), is the basic mechanism of some painful conditions, such as migraine and other essential headaches. Acute (infusion) and chronic (ingestion) administration of tryptophan to migraine-headache sufferers improved the clinical course significantly in respect to placebo. Few patients with untractable pain from disseminated cancer received daily infusion of tryptophan and ingested a few gr of this amnioacid: improvement of pain and reduction of morphine necessity was observed. Parachlorophenylalanine chronic administration in migraine-headache sufferers lowered the pain threshold so far as to provoke (in 20% of cases) spontaneous pains in the trunk, legs and arms. This systemic pain syndrome was promptly reversible by discontinuing the treatment. Spontaneous pain syndrome was not reported by others in the healthy subject; this suggests an apparent vulnerability of 5HT turnover in essential headaches.
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PMID:5-Hydroxytryptamine and pain modulation in man: a clinical pharmacological approach with tryptophan and parachlorophenylalanine. 14 17

Seven patients with cancer complicated by nonmetastatic sagittal sinus thrombosis were encountered in a 7-year period. Five had hematologic malignancies and two had solid tumors. There were two different presentations. In the first, neurologic signs and symptoms (e.g., headaches, seizures, hemiparesis, lethargy) occurred suddenly in five patients shortly after initiation of cancer therapy. Four of these five patients recovered with minimal residua; the fifth died as a direct result of the sinus thrombosis. The second presentation occurred in the two patients with terminal cancer who declined gradually without focal signs; both patients died. Only arteriography can reliably establish the diagnosis of sagittal sinus occlusion. In patients with cancer, sagittal sinus occlusion probably results from a "hypercoagulable state" associated with the systemic neoplasm.
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PMID:Nonmetastatic superior sagittal sinus thrombosis complicating systemic cancer. 28 38

A 24-month-old female developed a central nervous system relapse, while in bone marrow remission, eight months after the diagnosis of acute lymphocytic leukemia was made. Inadvertently, she received 14 times the standard dose of intrathecal methotrexate (170 mg/m2 vs. 12 mg/m2). Treatment with intravenous leucovorin and oral dexamethasone was given. Her only symptomatology was mild headaches. No neurological abnormalities developed. Her cerebrospinal fluid methotrexate levels (5.2 X 10(-6)M at 23 hours and 5.9 X 10(-7)M at 47 hours) and half-life (t 1/2 = 8 hours) were within the range previously reported in patients following standard doses of intrathecal methotrexate who did not develop neurotoxicity. The various manifestations of neurotoxicity associated with the use of intrathecal methotrexate as well as those factors considered to play a part in the development of neurotoxicity are reviewed.
Cancer 1978 Apr
PMID:Intrathecal methotrexate overdose without neurotoxicity: case report and literature review. 34 94

We examined three patients with a chiasmal syndrome due to metastasis and were able to find only two additional cases in the literature. The characteristic presentation consisted of progressive impairment of vision without headache or abnormal plain skull x-ray films in patients with weight loss or diabetes insipidus. In three of the five patients, the primary malignant neoplasm was occult when symptoms and signs of chiasmal dysfunction were seen. Four patients responded well to irradiation. The chiasm may be compromised by suprasellar extension of pituitary metastasis, by infiltration from an infundicular or hypothalamic metastasis, or by hematogenous spread of tumor.
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PMID:Chiasmal syndrome due to metastasis. 47 20

Nasopharyngeal involvement by Hodgkin's Disease is rare and may result in deafness, headaches, nasal obstructions and other symptoms. Compression of the pituitary gland with resultant panhypopituitarism has not been reported in nasopharyngeal Hodgkin's Disease. This paper documents a patient in whom Hodgkin's Disease of the nasopharynx eroded the bony sella turcica and compressed the pituitary gland causing anterior pituitary insufficiency. The patient presented with a skull x-ray and history compatible with a pituitary neoplasm. The diagnosis was established only by surgical exploration.
Cancer 1978 Mar
PMID:Panhypopituitarism resulting from Hodgkin's disease of the nasopharynx. 63 56

Thirty-three patients with metastatic brain neoplasms of various types received glycerol instead of corticosteroids during periods of brain irradiation. In the 25 symptomatic patients, responses from this treatment were seen in those patients whose primary symptom was vomiting (ten of 12 patients), headache (nine of ten), papilledema (five of nine), paralysis (six of eight), confusion (six of seven), and dysphasia (four of six). Glycerol was well tolerated; it did not induce immunosuppression when administered in combination with radiotherapy and chemoimmunotherapy. Further investigation is indicated to compare its efficacy with that of dexamethasone.
Cancer Treat Rep 1978 Jul
PMID:Glycerol: a successful alternative to dexamethasone for patients receiving brain irradiation for metastatic disease. 68 48

Twenty-two patients with cutaneous metastases of malignant melanoma were treated with intralesional injections of the methanol extraction residue of bacillus Calmette-Guerin (MER). The local reaction consisted of erythema and pustule formation followed by ulceration and tumor necrosis. Side effects included fever, chills, headache and malaise in the majority of patients; nausea, vomiting, cyanosis and hypotension occurred infrequently. Hypersensitivity reactions were not observed. Temporary abnormalities in liver function were seen in 11 of 19 patients tested. Reversible lymphopenia and thrombocytopenia developed in 7 of 17 and 7 of 18 patients, respectively. Immune function, as measured by skin tests for delayed hypersensitivity and the in vitro response of isolated lymphocytes to mitogens and microbial antigens, was not influenced by treatment with MER. Transient increases were observed in total hemolytic complement, complement components and the reduction of nitroblue-tetrazolium by neutrophils. Eight of eighteen evaluable patients showed a complete disappearance of all injected lesions. We conclude that intratumoral injection of MER is effective treatment for cutaneous metastases of malignant melanoma, with a complete response rate comparable to that observed after intralesional injection of BCG.
Cancer 1978 Dec
PMID:Intralesional injection of the methanol extraction residue of Bacillus Calmette-Guerin (MER) into cutaneous metastases of malignant melanoma. 72 66

Nineteen patients with various solid tumors were treated with Corynebacterium parvum for 10 consecutive days at doses ranging from 0.5 to 6 mg/m2. Major toxic effects included rigors and cyanosis, hypertension, headache, nausea, and vomiting. Toxicity was maximal during the first 3 days of treatment and decreased or even disappeared when, on subsequent days, increasing doses of the vaccine were given. Objective tumor regressions were observed in four patients.
Cancer Chemother Rep
PMID:Phase I study of corynebacterium parvum in patients with solid tumors. 76 53

A brief survey of the literature on the side effects of oral contraceptives is given. Of the many influences on laboratory results those related to (reversible) cholestasis or to a change in protein synthesis are the most important ones. A decrease of the tolerance for glucose is sometimes observed. Few of the clinical side effects attributed to oral contraceptives can be directly correlated with the pharmaceutical action of these drugs. Many so-called side effects of the pill are due to other factors such as altered psychosociological or sexual behavior, etc. However, among users of oral contraceptives there is a significant decrease in the number of benign tumors, particularly of the breast, the uterus and the ovaries. It is still an open question if this also signifies protection against cancer. Anemias due to iron deficiency are less frequent among users of the pill. According to recent studies arterial hypertension and cholecystopathies are probably directly related to oral contraceptives, but a causal relation has not been proven for migraine, headaches, depression etc. An elevated risk for vascular complications seems to be well established: there is a 4-6-fold increase of the estimated risk for venous thrombo-embolism and a 4-9-fold increase for cerebrovascular accidents among users of oral contraceptives when compared with nonpregnant women of the same age not using the pill. Oral contraceptives act as a supplementary factor of risk which may cumulate with other similar factors, such as arterial hypertension, hyperlipidemia, overweight, smoking etc. Mortality due to oral contraceptives is very much 10-50 x) inferior to the one caused by delivery and the post partum state. Since the number of failures in prevention of pregnancies is less for oral contraceptives than for any other method of contraception, the overall risk of death under oral contraceptives in this age group of women is least.
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PMID:[Real and seeming side-effects of oral contraceptives with an emphasis on medical and haematological problems. Review of literature (author's transl)]. 79 Mar 74


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