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

Hypocalcemia, although a relatively uncommon sequela of operations for carcinoma of the larynx and pharynx, often presents as an acute medical emergency. In its chronic form, hypocalcemia may be a difficult disorder to control. Understanding the etiologic basis of hypocalcemia secondary to operations for carcinoma of the head and neck requires knowledge of the pathophysiology of the preoperative and postoperative factors affecting calcium homeostasis. These factors include thyroidectomy, hypoparathyroidism, hypomagnesemia, anticonvulsant therapy, estrogen replacement therapy, oral contraceptives, blood transfusions, hyperventilation alkalosis, hypoalbuminemia, corticosteroid therapy, depression, emotional stress and diet. Often the onset of symptoms and signs of hypocalcemia occurs within 24 to 48 hours after the operation. The symptoms may include mental depression, headache, tingling of the hands and perioral region and abdominal pain. Unrecognized chronic hypocalcemia may lead to the development of cataracts, convulsions and psychosis.
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PMID:Etiologic factors in hypocalcemia secondary to operations for carcinoma of the pharynx and larynx. 67 61

We presented a case of hemangioblastoma associated with spina bifida occulta, persistent metopic suture, thyroid adenocarcinoma, vertebro-occipital anastomosis and erythrocytosis. We have not found a hemangioblastoma with these associations, as far as we have seen in the literature. 36-year-old male was admitted with complaints of nausea, vomiting and ataxic gait in June, 1970. On admission, the examination revealed no evidence of increased intracranial pressure except for elevated CSF pressure by lumbar puncture and incoordination. The peripheral blood count disclosed slight erythrocythemia. Vertebral angiography revealed a vascular lesion of 2.0 cm in diameter situated almost in the midline of caudal cerebellum receiving its blood supply from the right posterior inferior cerebellar artery. In addition, a right vertebro-occipital anastomosis was visualized. Plain reoentgenograms showed persistent metopic suture and spina bifida occulta of C 5 - 6. After admission, installation of Ommaya reservoir and decompressive suboccipital craniectomy were performed, and a thyroid papillary adenocarcinoma was totally removed. After discharge, he had been well for two years until a month previously to the second admission, when he commenced to have again headache, nausea, and vomiting with ataxic gait. Vertebral angiography showed the tumor enlarged in size measuring 4.0 X 5.0 cm and the tumor stain was more irregular and less homogenous than 3 years before. Brain scan revealed an increased uptake in the midline of the posterior fossa. After readmission, in April, 1973, he gradually developed dysphagia, disturbance of articulation and inactivity of mentality and died from pneumonia in October, 1974. Autopsy revealed a vascular tumor originated from the medial portion of the right cerebellum and the tumor showed multiple cyst formation in the rostral part in contrast to the caudal solid mass. Histologically the tumor tissue was composed of capillaries supported by fine argyrophilic fibers, large clear interstitial cells containing lipid granules and hemosiderin pigment. Carcinoma of the right lobe of the thyroid was found with metastasis to the bone marrow, lungs and anterior cervical lymphnodes and lymphnodes at the left supraclavicular angle. Bone marrow showed marked erythropoiesis. The case reported here provides an evidence to suggest that there is more than a random relationship between hemangioblastoma, dysraphic state and thyroid carcinoma. The other association, the vertebrooccipital anastomosis may result from the enhanced demand of blood supply by hemangioblastoma but this speculation needs further examination.
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PMID:[A case of hemangioblastoma associated with spina bifida occulta, persistent metopic suture, thyroid adenocarcinoma, vertebro-occipital anastomosis and erythrocytosis (author's transl)]. 79 Feb 13

A woman, born in 1923, suffered since menarche of pain of the vertebra and has had a headache during menstrual periods. 1963 she developed a transverse lesion of the cord with an incomplete paraplegia because of an endometriosis externa of spinal canal. After a 12 years symptomless interval, she complained again of a transverse lesion. Histological examination disclosed an endometrioid carcinoma with infiltration of vertebral bodies. The rare occurrence of malignant transformation in endometriotic tissue is pointed out.
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PMID:[Endometrioid carcinoma of the spinal canal (author's transl)]. 91 20

We report the cases of 37 patients with carcinoma of the lung revealed by brain metastases. The most frequent clinical manifestation was focal neurological symptoms associated with headache and vomiting in 50% of the cases. X-ray films of the chest were abnormal in 34 patients. At the time of diagnosis 11 patients also presented with extra-cerebral metastases. The histological type of the primary lung tumor was obtained by examination of the thorax in 32 cases and in 5 cases from brain or lymph node metastases: 11 patients had small-cell lung carcinoma and 26 had non small-cell lung carcinoma. The overall actuarial median survival was 4.5 months, irrespective of the histological type. The group of 20 patients who underwent neurosurgery had a longer median survival (10 months versus 4.5, p < 0.05), and in the subgroup where brain and lung resections were combined the median survival was even longer (13 months). Cerebral relapses occurred in 12 patients: in 7 out of 15 patients with brain surgery but without adjuvant brain radiotherapy, and in 5 out of 16 patients with brain radiotherapy without neurosurgery. No cerebral relapse was observed in the group of 5 patients who had complete resection followed by radiotherapy of the brain. This demonstrated a clear benefit from postoperative radiotherapy. Conventional chemotherapy induced objective responses only in the small-cell carcinoma group and could be too toxic when combined with simultaneous radiotherapy, but it proved a useful adjuvant treatment in patients with radiotherapy of the brain.
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PMID:[Cerebral metastasis disclosing primary bronchogenic cancers]. 133 93

Solitary cerebellar metastatic tumors are rarely reported in the literature. We reviewed 240 posterior fossa tumors treated in the past eight years. There were 11 cases of solitary metastases in the cerebellum. The primary tumor was lung cancer in five cases and breast carcinoma in two cases; the remaining three cases had colon cancer, nasopharyngeal carcinoma (NPC) and Ewing's sarcoma, respectively. All patients underwent craniectomy and gross total excision of the tumor. Seven patients survived less than one year, two cases died in the second year, and one case of NPC survived for more than two years. The only survival is a case of Ewing's sarcoma who underwent surgery 14 months ago. The symptoms and signs of all patients improved satisfactorily after surgery. Four patients received postoperative irradiation to the posterior fossa and two cases of lung cancer had a thoracotomy for the primary lung lesion; however, the survival period was not prolonged. We suggest that a cancer patient or a patient in the fifth to seventh decades of life presenting headache, gait disturbance and vomiting should promptly undergo a computed tomography (CT) scan of the head. In selected cases, surgical intervention for solitary metastatic tumors in the tiny posterior fossa may be the best initial treatment. Adjuvant therapies should then be added according to the type of tumor.
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PMID:Solitary cerebellar metastases: analysis of 11 cases. 136 66

Interstitial laser phototherapy (ILP) guided by magnetic resonance imaging (MRI) may become an attractive adjunctive modality for the treatment of deep and surgically inaccessible tumors of the head and neck when accurate methods of laser dosimetry and "real-time" monitoring techniques with the MRI are introduced. We recently demonstrated in ex vivo and in vivo models, a linear relationship between levels of laser energies, thermal profiles, MR signal intensity changes, and histopathological tissue damage. Results of treatment in a patient with an unresectable large right jugulodigastric metastatic squamous carcinoma using new approach of MRI guided ILP are now reported. The patient complained of significant right-sided neck pain and headaches secondary to a rapidly growing metastatic lymphadenopathy which recurred after previous surgery, radiation, and chemotherapy. Two treatment sessions were used at an interval of 2 weeks. Each treatment was performed in the MRI suite under heavy sedation. Using a 600-microns bare fiber of the Nd:YAG laser implanted interstitially under MR guidance, the metastatic node was treated at three sites. T1- and T2-weighted images were performed prior to, immediately after, 24 and 48 hours, and 4, 5, 7, 9, 16, and 25 days post-treatment. Successful relief of pain and growth arrest of this node was observed after the second treatment and at the 3-month follow-up. These results demonstrate that this technique of ILP guided by MRI may be feasible in humans, and will become clinically practical when appropriate methods of dosimetry and instrumentation are developed.
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PMID:Metastatic head and neck malignancy treated using MRI guided interstitial laser phototherapy: an initial case report. 137 May 65

A total of 15 patients with measurable advanced colorectal adenocarcinoma were prospectively treated with fazarabine (Ara-AC), reconstituted in dimethyl sulfoxide, and administered at a starting dose of 48 mg/m2/day as a continuous intravenous infusion for three days. The dose was repeated every 21 days and dose escalations or reductions were made on the basis of toxicities encountered in the preceding course. No patient achieved either a complete or partial response. Major toxicities encountered were granulocytopenia, thrombocytopenia, nausea, vomiting, anemia, and headache. All toxicities were reversible upon discontinuation of the drug and no life-threatening toxicities occurred. These data indicate that further clinical trials in colorectal carcinoma with this agent and schedule of administration are not warranted.
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PMID:Phase II trial of fazarabine in advanced colorectal carcinoma. 137 22

Three hundred seventy-nine new patients with nasopharyngeal carcinoma (NPC) were followed clinically and the physical examination, including that of the nasopharynx by indirect mirror for symptoms after treatment. At the time of analysis, with a median follow-up of 34.8 months, 47 patients had developed recurrent disease in the nasopharynx and in the immediately adjacent regions. In 31 patients the first clinical features to suggest local recurrence were progressive symptoms (group A). In another 13 patients recurrence of tumor in the nasopharynx was detected by indirect mirror examination (group B). In the remaining three patients, the diagnosis was made during investigation for neck node recurrence. The more common symptoms at diagnosis of local recurrence were headache; cranial nerve palsy involving the third, fourth, fifth, and sixth nerves; and ear and nasal symptoms. Group B patients tended to have less of these symptoms. The presence of tumor was confirmed by fiberscopic examination and biopsy in all group B patients and 14 of 31 group A patients, the tumor was submucosal in the remaining 17 group A patients. The recurrence in group B patients was diagnosed significantly earlier than the group A patients (p = 0.0294), and group A patients suffered from more invasive and extensive disease in comparison with group B patients (p = 0.0044). There were significantly less patients in group A who were amenable to curative brachytherapy (p = 0.0280). Clinical follow-up for local NPC recurrence was found to be useful. More frequent use of fiberscopic examination in the follow-up, especially for those not adequately examined by indirect mirror examination, will improve the detection rate. Cross-sectional imaging techniques and the monitoring of tumor markers may supplement clinical and fiberscopic examinations. An algorithm for diagnosing recurrent NPC and possible treatment are suggested.
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PMID:Value of clinical follow-up for local nasopharyngeal carcinoma relapse. 158 38

A phase I trial of 5-fluorouracil (FUra) and leucovorin (LV) given with and without dipyridamole (DP) by concurrent 120-h continuous infusion was performed in 27 patients with advanced solid malignancies, 8 of whom had previously received FUra. The LV and DP doses were fixed at 500 mg/m2 daily and 7.7 mg/kg daily, respectively, whereas the FUra dose was escalated. Level 3 (450 mg/m2 FUra daily) represented the maximum tolerated dose for both FUra/LV+DP and FUra/LV. Dose-limiting stomatitis (greater than or equal to grade 3 or grade 2 occurring during the infusion) was encountered in 75% of the first courses given at level 4 (600 mg/m2 daily). Stomatitis was observed in 44/78 (56%) courses. Diarrhea was infrequent and mild. DP infusions were complicated by mild to moderate headache, which was controlled with narcotic analgesics, and mild to moderate nausea/vomiting. FUra-related toxicity was not enhanced by DP administration. Limited pharmacokinetic sampling at levels 3 and 4 revealed mean steady-state FUra concentrations of around 1.0 microM with infusions of FUra/LV+DP. Among three paired courses given with and without DP, no statistically significant difference was found in the total body clearance of FUra (P = 0.44). One partial response was seen in a patient with metastatic gastric carcinoma. For phase II trials, we recommend that concurrent 120-h continuous infusions of FUra (450 mg/m2 daily) and LV (500 mg/m2 daily) be given with and without DP (7.7 mg/kg daily) every 21 days.
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PMID:A phase I trial of 5-fluorouracil, leucovorin, and dipyridamole given by concurrent 120-h continuous infusions. 164 98

Turcot's syndrome is a rare, genetically transmittable disease in which patients with colonic polyposis (possibly complicated by the progression to adenocarcinoma) have malignant central nervous system neoplasms. Dominant, recessive, and sporadic cases have been described. A 26-year-old man is reported with no relevant family history who had intermittent abdominal discomfort in 1986. Sigmoidoscopy revealed numerous polyps, several of which showed carcinomatous change. Dukes' Stage C colorectal carcinoma was diagnosed. Treatment consisted of total colectomy with construction of a Koch's pouch. He remained well for 3 years until onset of headache, nausea, and vomiting. Computed tomographic scan disclosed a large, circumscribed, enhancing, right frontoparietal mass. After craniotomy and partial resection, histologic review disclosed anaplastic astrocytoma. He received cranial radiation therapy, 6000 cGy, by parallel opposed ports to the tumor bed, and carmustine 200 mg/m2 intravenously every 8 weeks. Flow cytometric DNA analysis was done on the paraffin-embedded archival material from the patient's normal colon, colonic adenocarcinoma, and anaplastic astrocytoma. DNA histograms revealed diploid distributions in all three samples. The G2/M fraction of the astrocytoma was elevated at 16%, and the S-phase fraction of the colonic adenocarcinoma was 19.4%.
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PMID:Turcot's syndrome. Flow cytometric analysis. 165


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